“It Really Brought me in,Zoned me in,and Kept me There”: A Qualitative Study Exploring Carers’ and Volunteers’ Experiences of a Narrative Based,Dementia-Focused Virtual Reality Film

Abstract

Dementia is a growing global health challenge, with informal carers providing the majority of dementia-related care, and volunteers playing a crucial role in offering additional support. Both groups frequently report feeling underprepared to respond to the cognitive, emotional, and behavioural changes associated with dementia. Virtual reality (VR) offers potential as an immersive, experiential approach. This study explored carers’ and volunteers’ experiences of a co-created, narrative-based 360° VR film depicting the lived experiences of a woman living with dementia and her daughter. A qualitative exploratory design was employed. Twelve participants, comprising six informal carers and six volunteers with experience supporting people living with dementia, were recruited. Participants viewed the VR film using a head-mounted display and subsequently took part in semi-structured interviews. Data were analysed using Braun and Clarke’s reflexive thematic analysis. Three themes were identified. (1) “I was in their shoes”: Stepping into the world of dementia, captured how the immersive first-person perspective fostered emotional engagement, empathy, and focused attention. (2) “It made me stop and think before jumping in”: Reflection and change in caregiving approach, described how this perspective-taking prompted participants to reflect on their caregiving responses and place greater emphasis on patience, autonomy, and enabling support. (3)“It’s so powerful, but it needs to be part of something bigger”: Application, limitations, and future potential of VR, highlighted participants’ views that while the VR film was impactful and memorable, its value could be enhanced through facilitated discussion, additional scenarios, and signposting to further supports. VR may offer a valuable experiential tool within dementia education for carers and volunteers. Findings emphasise the importance of embedding VR within structured, facilitated training approaches rather than using it as a standalone intervention. Further research is needed to examine longer-term impacts, scalability, and application across wider educational and practice contexts.

Background

Dementia is one of the most significant healthcare challenges of the 21st century creating substantial demand for medical, social, and institutional support (World Health Organization, 2017). Dementia is a significant global health challenge, with its prevalence rising rapidly due to an ageing population (World Health Organization, 2025). Across the globe, family members acting as informal carers continue to serve as the primary providers of care for people living with dementia. International evidence consistently shows that most people living with dementia receive daily assistance or support from unpaid carers, with estimates indicating that informal care accounts for over half of all dementia-related care with informal caregiving, typically involving an average of 5 hrs of care per day (Alzheimer’s Disease International, 2022; World Health Organization, 2025).

Alongside informal carers, voluntary and community-based organisations play a critical role in sustaining dementia care systems worldwide. These organisations often provide emotional support, peer-led education, respite, and access to community resources, helping to reduce isolation and burden among unpaid carers (Malmedal et al., 2020). In many regions, particularly where formal care provision is limited, volunteer led services act as a vital bridge between informal care and healthcare systems, offering accessible, locally rooted support for both people living with dementia and those who care for them (McCall et al., 2020). This collaborative working reflects a broader recognition that dementia care is not solely a clinical challenge, but one that depends on integrated networks of unpaid carers, volunteers, and formal health care services.

Previous literature has described the complementary role of volunteers in supporting people living with dementia and their informal carers. Volunteers have been reported to work in partnership with informal carers through arrangements such as befriending schemes, dementia cafés, and carer support programmes, where volunteer input complements family care by enhancing social connection and emotional support (Malmedal et al., 2020; Smith et al., 2018; Tokovska et al., 2021). The literature emphasises the critical need for training for both informal carers and volunteers involved in dementia care (Huggins et al., 2023; Kim et al., 2025). Studies have found that informal carers frequently feel unprepared to manage the complex emotional, behavioural, and cognitive changes associated with dementia, contributing to increased psychological distress and reduced care quality (Lindt et al., 2020; Oliveira et al., 2024). Similarly, volunteers often report lacking confidence and knowledge in supporting people with dementia, yet with structured training, they can develop improved understanding, empathy, and preparedness, resulting in more sustained and meaningful engagement in their roles (Cheung et al., 2022; Pereira et al., 2022; Wilesmith & Major, 2020).

Virtual reality has been conceptualised as a real or simulated environment in which a perceiver experiences telepresence (Steuer, 1992). In the present study, an immersive 360-degree filmed experience was used. This approach enables visual immersion and a strong sense of presence through real-world footage viewed via a head-mounted display. Emerging research suggests that virtual reality (VR) has the potential to enhance dementia education and training among caregivers (Huang et al., 2024; Wang et al., 2023). VR-based simulation can empower informal caregivers by providing them with experiential insights into the cognitive and emotional experiences of individuals living with dementia (Gokani et al., 2025; Morganti et al., 2024). It is thought that heightened empathy may lead to more informed care decisions, improved interactions, ultimately enhancing the quality of life for both individuals with dementia and their caregivers (Huang et al., 2024). However, the application of VR in dementia education remains an evolving field, with scholars calling for more rigorous research to validate its effectiveness (Hirt & Beer, 2020). A recent review by Huang et al. (2025) focusing on dementia education and training for informal carers highlights the importance of developing digital resources that are culturally relevant, engaging, and tailored to carers’ specific needs in order to maximise educational impact.

Aim

To explore the impact of a person-centred, passive VR film on dementia awareness and empathy among formal and informal carers, as well as volunteers, by evaluating their experiences through qualitative interviews.

Objectives

To explore participants’ experiences, with particular attention to how the VR film shapes their perceptions of dementia, their reflections, and their perceived learning gained from the intervention.

To investigate how participants anticipate applying insights from the VR experience to their caregiving roles or personal contexts.

To identify perceived benefits, limitations, and suggested improvements to the use of VR in dementia training.

Design

This study adopted a qualitative, exploratory design using semi-structured interviews to explore participants’ experiences of the VR film. Ethical approval was obtained from Ulster University Nursing and Health Research Ethics Committee (Reference: FCNUR-25-035). The COREQ checklist informed the design, reporting, and transparency of the study (Tong et al., 2007).

Intervention

A film was created in 2020 by a theatre company Commedia of Errors (Commedia of Errors Theatre Company) in collaboration with DEEDS (Dementia engaged and empowered in Derry & Strabane) Project, a community-based group for people living with dementia, their carers and families. People living with dementia and their family members were invited to take part in the co-creation of a short film, which was later titled Bernie.

Participants (people living with dementia, family members and support staff) engaged in a nostalgia-based drama workshop designed to relax, enjoy themselves, and encourage them to share their stories about various aspects of their lives. Four of the participants were then selected for interview. Interviews focused on the life experiences of the participants, covering their early years, careers, current home lives, and experiences of living with dementia, from the initial symptoms to diagnosis and beyond. The lived experiences of family members were also captured. From these stories, one interviewee and her granddaughters’ experiences were selected for dramatization and to create the screenplay for Bernie. The script was filmed and edited with a production company using professional actors in November 2022. The person living with dementia and their family were invited to contribute to the prototyping, testing, and refinement phases of the intervention; however, they declined due to the nature of the intervention. However, other participants from the original workshops were involved in the initial stages of testing and refinement. The narrative follows the journey of Bernie, a woman living with dementia, and her daughter Rachel, who navigates both the rewards and challenges of caregiving. The film deliberately shifts perspectives, at times placing the viewer in the position of an observer, and at other points allowing them to experience events through the eyes of Bernie or Rachel providing insight into both the lived experience of dementia and the relational dynamics of care. The film was then developed into a VR resource, a live action 360 film.

Sample and Recruitment

We aimed to recruit a sample of 12 participants who had experience with dementia either as informal carers or in a voluntary capacity. Sample size was guided by the concept of information power, whereby fewer participants are required when the study aim is focused, the sample is specific, and interviews generate rich data for in-depth analysis. Given the shared experience of the VR film, the use of semi-structured interviews, and a reflexive analytic approach, the sample was considered sufficient to address the study aims (Braun & Clarke, 2021). The sampling approach was purposeful to recruit individuals with relevant lived experience to provide rich, meaningful data. Eligible participants included informal carers of individuals with dementia and volunteers who supported people living with dementia. Inclusion criteria required participants to be aged 18 years or older and able to provide informed consent. Individuals were excluded if they had a history of severe motion sickness or vertigo, or if they were unable to give informed consent. Participants were recruited through signposting from community networks. All who expressed interest took part, with no dropouts. All participants received a gift voucher for taking part.

Data Collection

Participants received a brief information session prior to the VR experience. This session, lasting approximately 10 min, provided an overview of the programme, explained the user experience, and included safety checks and personalised headset setup. The 360 VR film “Bernie” was then delivered via a VR headset. Immediately following the viewing, a debriefing session of approximately 10 min was conducted to offer emotional support and address any questions or concerns raised by participants.

Data were collected immediately following the VR intervention. Participants were first asked to complete a brief demographic questionnaire. Each participant then took part in a face-to-face semi-structured interview lasting approximately 20 to 30 min. Informed consent was confirmed prior to each interview. An interview guide was developed to align with the study’s aims and objectives, allowing for consistency while enabling flexibility to explore individual perspectives in depth. The interview guide was pilot tested prior to the study. All interviews were conducted in familiar settings, such as the usual meeting venues for carers’ and volunteers’ groups, to promote participant comfort by experienced researchers (A* & D*). With participants’ consent, interviews were audio recorded to ensure accurate capture of responses. Recordings were transcribed by an experienced transcriptionist, and transcripts were subsequently reviewed and checked for accuracy.

Data Analysis

Data analysis followed Braun and Clarke’s (2021) reflexive and inductive approach to thematic analysis. After transcription and accuracy checks, the research team (A* & D*) engaged in familiarisation by reviewing transcripts multiple times and documenting initial impressions. Data was coded independently by each researchers and then they came together to meet a consensus. Relevant data were then systematically coded. Codes were reviewed and grouped into broader themes through an iterative process, with themes, derived from the data, refined and reorganised as analysis progressed.

Findings

A total of 12 participants took part in the study, comprising six volunteers and six informal carers. The sample included one male participant. Ages ranged from 25 to over 65. Half of the participants (n = 6) reported daily interaction with individuals living with dementia, and the other half (n = 6) reported weekly interaction. All participants (n = 12) had engaged in prior dementia-related education or training. Seven participants had used virtual reality (VR) before, and five had not. With regards to technological confidence, five participants described themselves as very comfortable, three as somewhat comfortable, three as neutral, and one as somewhat uncomfortable using technology.

Three overarching themes were identified. The first, “I was in their shoes”: Stepping into the world of dementia, captures how the immersive VR experience enabled participants to inhabit the perspective of a person living with dementia, fostering emotional engagement, empathy, and reflective understanding. The second theme, “It made me stop and think before jumping in”: Reflection and change in caregiving approach, describes how this perspective-taking prompted participants to reconsider their responses to dementia-related behaviours, leading to greater patience, sensitivity, and support for independence. The third theme, “It’s so powerful, but it needs to be part of something bigger”: Application, limitations, and future potential of VR, explores participants’ views on the strengths and boundaries of the VR film, including its perceived value as an educational tool, the importance of integrating it with other forms of learning, and its potential application across wider contexts.

Theme 1: “I was in Their Shoes”: Stepping into the World of Dementia

Participants described the VR experience as emotionally powerful and thought-provoking experience that enabled them to momentarily inhabit the subjective world of a person living with dementia. The first-person perspective enabled them to feel as though they were experiencing dementia themselves, creating an empathetic connection that was often stronger than traditional learning methods.

“It’s just kind of putting you in that person’s world, which I think is excellent… to be completely consumed in their world.” (Volunteer, P4)

“It struck a chord with me more than it did in you giving me a book or reading that off today.” (Family carer, P2)

“That was me 100% in that story, like I was Bernie. It was good.” (Family carer, P7)

The immersive format was also valued for enhancing focus and minimising distraction. Participants emphasised how the headset created a contained sensory environment that demanded attention. This enforced attentional engagement appeared to deepen both emotional and cognitive involvement with the narrative.

“There’s no distractions. It consumes your every sense, whereas when you’re in a room and you’re listening to training you could be looking out the window, or you could probably get distracted, or you could be watching something on that wall, whereas the VR experience consumes you, so you have to feel part of it.” (Volunteer, P11)

“I thought it brought you into their world. It’s so easy to get distracted from a TV, or looking out a window, or hearing a noise. When you have that on, you’re solely focused on your visual, and I did, I was holding onto the chair even, and even when I was looking down the stairs, like it brought you into that space and time” (Family carer, P6)

The practical features of the VR equipment shaped engagement. Comfort, usability, and the absence of physical discomfort were described as enabling sustained immersion, suggesting that technical design supported rather than disrupted the learning experience.

“The quality, and definitely it was not as heavy on my head. It was light, which was good, and it didn’t feel like it was tight on my hair, and I didn’t have sore eyes or anything at the end or feel nauseous or anything” (Volunteer, P8)

Importantly, immersion was not attributed solely to the technology itself. Participants repeatedly highlighted the perceived authenticity of the film, including the realism of the acting, the use of local accents and language, and the cultural familiarity of the setting. These elements appeared to enhance credibility and emotional investment, allowing participants to recognise the story as plausible and reflective of their own contexts.

“I was more invested probably because of their accents, and I was like, right okay, well, they’re locals, like I was more invested in the story, whereas maybe if they had a different accent I probably wouldn’t have been as bothered about the story, and they used our lingo, and it was more targeted towards us.” (Volunteer, P11)

“I don’t know whether they were acting, or whether she actually had dementia, to me she came across as if she had dementia, and the girl came across very well too” (Family carer, P7)

For many participants, the film resonated strongly with their own caregiving histories. Familiar environments and interactions prompted recognition and emotional recall, reinforcing the sense that the experience mirrored real life rather than presenting an abstract or exaggerated portrayal of dementia.

“it just hits home. It could have been our house we were sitting in” (Family carer, P7)

“It rings true from my personal experience, and it certainly rings true in relation to the service users and clients that I would meet weekly” (Volunteer, P5)

By resonating with their personal caregiving experiences, the experience evoked emotions that facilitated reflective learning. These affective responses prompted participants to re-examine familiar situations through a new lens, reinforcing empathy and enhancing their understanding of dementia care.

“Its hard to put into words on one hand its very upsetting, kind of, but also good to see the dementia point of view, just very much like that anyway. Upsetting, and glad, it helps me think.” (Family carer, P1)

“When I look back I understand it now. I understand why mammy was like that. I just wish I understood at the time” (Family caregiver, P6)

These accounts suggest that the mechanism underpinning immersion involved the interaction of technological design, narrative authenticity, and personal relevance, rather than the headset alone.

Despite the emotional intensity of the experience, participants did not find the content overwhelming or distressing. Several described initial apprehension about becoming upset, yet reported that the film struck an appropriate balance between realism and emotional containment. This suggests the experience was perceived as emotionally challenging while remaining psychologically safe.

“I thought it was going to be more emotional. I was kind of going, I’m going to end up crying in this… but I didn’t. I was glad because I do cry easily. I thought it was going to trigger me more. But no.” (Family carer, P1)

“I was scared that would have made me cry knowing what they’d be experiencing” (Volunteer, P5)

Theme 2: “It made me Stop and Think before Jumping in”: Reflection and Change in Care Giving Approach

Participants described how the VR experience prompted a shift in how they interpreted behaviours associated with dementia. Rather than viewing agitation, frustration, or resistance as problematic behaviours to be managed, participants increasingly framed these responses as meaningful expressions of unmet needs, fear, or cognitive overload. This reframing marked a move away from reactive caregiving towards more reflective understanding.

“There’s a reason why they’re being agitated other than just for the sake of it.” (Family carer, P6)

“They’re not annoyed at you. They’re annoyed because they can’t do them things anymore.” (Volunteer, P11)

“We need to understand the reason behind the frustration as opposed to just seeing the frustration as it is” (Volunteer, P12)

The experience helped them reframe agitation and confusion as responses to environmental and cognitive stressors:

“They are scared, and confused, but they still want to be normal, they want to have a normal life, and there’s always that fear they’re going to forget. They’re scared.” (Family carer, P1)

“It helped me such a small task, that they probably do every single day, how difficult the smallest thing becomes.” (Volunteer, P8)

This deeper understanding was closely tied to emotional engagement. Participants described how the immersive perspective intensified empathy, allowing them to feel emotionally drawn into the experience rather than remaining detached observers.

“I suppose it did create more empathy. It did create more empathy because it made me realise how somebody is feeling, (Volunteer, P8)

“You can get yourself dragged in. I could feel myself getting dragged in and going, I’m Bernie here, I feel really annoyed that you’ve bought a stair gate, or I’m really scared that I’m at the top of these stairs. So, I could feel my emotions getting dragged into it for definite.” (Family carer, P1)

Importantly, this emotional engagement translated into reported changes in caregiving intentions. Participants described becoming more conscious of their tendency to intervene quickly and expressed a desire to slow down, observe more carefully, and respond to the expressed needs of the person living with dementia.

“It can be understandable that people just want to protect your loved one, and you want to just do everything to keep them safe. But you don’t have to be jumping in and doing all this, getting this, and buying that and, you know, just kind of play it by ear and see how it goes, respond to their actual needs. Not what you assume thier needs might be. ” (Volunteer, P11)

“Now, after today, maybe tonight, tomorrow.. I’ll have that wee bit in my head about taking a wee step back...without over-caring, for want of a better word..” (Family carer, P7)

The VR scenario prompted reflection on how to support people with dementia in maintaining independence. Participants discussed using more enabling and empowering language and actions and described reconsidering restrictive or overprotective practices.

“He probably should have that bit more less restriction around him. Like I would drive him to the shop, and I’ll be, I’ll go in for you, sure, it’s that fear of him doing something I think when he’s out” (Family carer, P10)

“I will change, you can show them that they can do it, you know, get them involved at letting them know they can still do things, that they’re not just left sitting in a corner, or challenge the mindset ‘You have dementia, you can’t do that.’” (Volunteer, P9)

“My daddy wouldn’t be great in the kitchen, and then there was a time when he says to me, “it’s like you’re watching me all the time” as if I’m waiting for him to make a mistake. So, I see that from the film as well, because it’s just like I’m still the same person, and maybe I am going a wee bit slower, but I can still do things until I’m not able to do them” (Family carer, P3)

Participants reflected on how “small actions” (Family carer, P3), such as reassurance or respectful communication can make a meaningful difference in the wellbeing of someone living with dementia. This emphasised relational care and emotional attunement rather than task completion.

“It made me think about how important the family is and trying to make the person feel comfortable and safe.” (Volunteer, P12)

“It has opened me to just think when daddy does say something, ask him why, or give him the time to actually vocalise what it is he’s trying to say.” (Family carer, P2)

“Just reassuring people… letting them know they can still do things.” (Volunteer, P5)

For some participants, the learning was not entirely new; however, the VR scenario served as a useful reminder or affirmation of existing knowledge. This validation was perceived as beneficial, reinforcing existing person-centred values and practices, while renewing participants’ commitment to them.

“It just reinforced what I know. It’s probably just hit home again that you just shouldn’t assume.” (Family carer, P2)

“It does no harm to remind yourself every now and again, especially when you have a personal experience, because sometimes it can be frustrating, and you have to kind of put yourself in that person’s shoes and realise the way they’re feeling, or why they’re lashing out... It just hits home then and makes you realise again.” (Family carer, P10)

“Well, you just confirmed what I’d been doing day to day, that you have to have patience with them, and be eye to eye with them, because they’re normal people. They have to be dealt with as a normal person.” (Volunteer, P12)

Theme 3. “It’s so Powerful, but It Needs to Be Part of Something Bigger”: Application, Limitations, and Future Potential of VR

Participants valued the VR format for its immediacy and memorability. Compared to more traditional learning methods, they felt VR promoted greater emotional and experiential understanding.

“I wouldn’t learn through a book. That VR definitely was fantastic… I would learn more in that seven minutes than I would have learned in probably seventy minutes in a book.” (Volunteer, P4)

“I like watching things. I am a visual learner, and I think a lot of people are like that.. because watching something, and this is only seven minutes, your attention is on it, whereas sitting in maybe like a group, like learning about it, you don’t really, your attention could go. So, it was good in that way.” (Family carer, P7)

The short length of the film was not seen as a limitation. Participants appreciated the conciseness and commented that it was sufficient to deliver a powerful message.

“The seven minutes of that there was fantastic.” (Family carer, P6)

“It’s more alive… any amount of reading and talking about it is great, but that wee 10 min to yourself, watching something like that, you’ve been through it, you have felt it and you carry that with you.” (Volunteer, P8)

Participants also explained they would welcome longer scenarios and suggested that the At the same time, participants expressed interest in extending the format. Suggestions included longer or multiple scenarios depicting a broader range of dementia experiences, highlighting the perceived value of VR as an expandable educational tool rather than a standalone intervention.

“I suppose it would be useful to maybe bring that into it as well about the different ways dementia can affect people. So, there could be a wee bit more or maybe different scenarios... You could have a couple of different scenarios..just to show people that there’s maybe a range of things that could affect their lives” (Volunteer, P9)

“It probably could have went on a bit longer. As I say, if there was a wee bit more elaboration in different things, or maybe a couple of different scenarios” (Family carer, P3)

Participants recognised the potential of the VR experience to provide practical insights for caregiving, raise awareness of dementia, highlight the diversity of dementia types, and act as a tool to signpost users to further sources of support and information. These reflections positioned VR not only as an experiential tool, but as a possible gateway to broader learning and service engagement.

“a wee clip of somebody approaching somebody with dementia in the wrong way, so the way that somebody engages, or how they approach, those sorts of wee things I think could be useful to add to it. There’s always more that you can add which would also help somebody to understand how all the senses might be affected.” (Volunteer, P4)

“Maybe a wee bit of an explanation into different types of dementia, because I know even from us having carers coming into mum at home, they weren’t fully aware of her condition, and how it might affect her, because they care for a lot of different people with different conditions.” (Family carer, P1)

“I think it might have been useful to have had something said in the film about maybe what the carer or family member had got that got them to that point ‘I was able to go and get some support through….. I was able to do this education programme, or I’ve been able to talk to a dementia navigator.” (Family carer, P3)

Participants’ accounts positioned VR as a catalyst for learning rather than a complete educational solution, with participants emphasising the importance of using it alongside other approaches, such as group discussion or written materials, to reinforce learning and accommodate different needs.

“I mean, there’s so many different ways to approach. learning about dementia, and I think using them, they could all be used together, because it’s kind of what I was saying earlier, you’re getting a different perspective each time, and that only helps you reinforce information, empathy, and experiences as well. “(Volunteer, P11)

“I think things like the VR experience, they do so much more than you trying to stand in front of somebody and tell somebody this is how dementia might affect somebody. I’m not taking it down because that has its place as well because it’s important from an information perspective that you have the theory, and the understanding, but to have something visually that you can experience, and feel, and see for yourself, is very powerful.” (Volunteer, P9)

Participants felt the use of VR film could be valuable both with and beyond the current setting. Suggestions included its use with healthcare staff, students, young people, and other family members. These suggestions reflected a broader perception of unmet dementia education needs across sectors.

“I think the more resources that there is for carers, for volunteers, for care providers, I think then that’s brilliant. So, developing things like this, especially in today’s technical world, I mean, even for younger people, that kind of method of delivery would be more impactful than them maybe going to a lecture, with greatest respect” (Family carer, P6)

“I think it should definitely be shown probably in schools, secondary schools, and health and social care settings. Why not use technology now to let people experience what a person with dementia may feel or experience, and I think it’s a really good way. Use it with the younger people as well, because it makes it a bit more interesting, and it lets them experience it in their own way rather than telling them they’ve to watch a textbook, or a presentation.” (Volunteer, P8)

Reflections on participants’ own encounters with healthcare and community services further reinforced this view. Perceived gaps in dementia knowledge strengthened their belief that immersive tools such as VR could play a valuable role in improving understanding across the general population.

“I know recently, I was in the hospital with my daddy, and it was clear to me that they didn’t know anything about dementia, in A&E. I just was like, do youse know what youse are dealing with here. So, I think it would be good for just the general population to see that kind of video, because then they might have an understanding a wee bit about what it’s like.” (Family carer, P6)

“I would even like to see that. I’m a social worker, but there’s probably social work teams that probably would benefit from that, because that is something that I found, because my daddy is only 63. People assume he doesn’t have it” (Family carer, P6)

Finally, participants acknowledged potential limitations. While most viewed the experience positively, some cautioned that the emotional intensity might be overwhelming for certain individuals. These accounts highlighted the importance of careful facilitation, preparation, and sensitivity when implementing VR, particularly with vulnerable groups.

“The only people I probably wouldn’t recommend it to is anybody that’s going through early stages of dementia just because, well, it would scare you.” (Family carer, P3)

“I think for most people it will be okay, but for some people that might be a wee bit disorientating for them. I think you have to have whoever’s administering it being very mindful of who they’re administering it to, and if it’s starting to feel uneasy for people” (Volunteer, P9)

Discussion

While virtual reality has gained traction in healthcare education, its use with informal carers and volunteers remains underexplored. Informal carers and volunteers provide substantial support to people living with dementia but often lack access to experiential training opportunities (Wang et al., 2023). This study addresses this gap by investigating the experiences of carers and volunteers engaging with a dementia-focused VR film, with findings suggesting how this immersive format can foster empathy, reflection, and behaviour change.

Findings suggest that narrative-driven 360° VR can evoke embodied perspective-taking, a transferable principle for VR training in healthcare and beyond. A recent review by Wang et al. (2023) highlighted limitations in existing VR dementia interventions that largely rely on sensory simulations using visual distortion goggles, headphones, or gloves to mimic perceptual and cognitive changes. While these tools aim to promote perspective-taking, the review concluded that they often achieve only limited immersion, offering users a sense of presence without facilitating full embodied experience. In contrast, the current study used a 360° first-person narrative film to situate viewers within the lived reality of dementia. In keeping with other studies, the first this design offered participants a coherent and emotionally engaging scenario, enhancing both cognitive and affective immersion (Cannavò et al., 2024). The emotional connection reported by participants was consistently attributed to the realistic and relatable nature of the VR film. Participants highlighted how the scenario mirrored their own caregiving experiences, with the authentic acting, high production quality, and regionally familiar elements (such as accents and language) enhancing immersion. These features contributed to a sense of believability and embodiment, which in turn strengthened emotional engagement and reflective learning. This also reflects the importance of co-design in the development of VR experiences, particularly in dementia education. Engaging people living with dementia as experts in their own experiences is critical to ensuring that simulation content is authentic, respectful, and meaningful (Moyle et al., 2025). Developing scenarios that accurately reflect dementia, and that can be adapted in depth (as identified in theme 3) will enhance the effectiveness and applicability of VR-based training (Hung et al., 2025). To ensure realism and relevance, it is essential that people living with dementia and caregivers are actively involved in shaping the content through co-design processes. Despite the recognised value of this approach, co-design is often overlooked in the creation of digital technologies (Conway et al., 2023). In this study, early engagement through storytelling workshops, interviews, and participant feedback contributed directly to the narrative and emotional tone of the film, grounding it in authentic lived experiences. This is a strength of the study (Simonsen & Robertson, 2013), as it enhances the authenticity, emotional resonance, and contextual relevance of the VR film, making it more likely to engage users meaningfully and foster empathetic understanding.

Participants frequently described a strong sense of being “in their shoes,” reflecting embodied perspective-taking rather than passive observation. The results of this study align with Wang et al.’s (2023) meta-analysis, which found that while virtual reality interventions overall did not significantly impact caregiver empathy, the Into D’mentia programme, also incorporating a narrative simulation film (Wijma et al., 2017), was the only VR-based intervention associated with a statistically significant improvement in caregiver empathy (Wang et al., 2023). Emotionally charged learning experiences are considered especially effective when they prompt personal reflection and re-evaluation of assumptions (Plass & Kaplan, 2016). As Makransky and Lilleholt (2018) argue, emotional and motivational engagement are critical mediators that can influence whether learning leads to behavioural change. In this study, participants described shifts in their caregiving approach, such as reframing dementia-related behaviours, slowing down, and offering greater autonomy, which illustrate how emotionally resonant experiences can translate into meaningful practice changes. However, concerns were raised within this study about the emotional intensity of the experience, suggesting the need to consider appropriate user preparation and support to ensure psychological safety, and perhaps guidelines to support this.

Implications for Practice, Education and Research

Recommendations for future education include integrating immersive VR film within dementia education programmes to support experiential learning, perspective-taking, and empathy, particularly where understanding lived experience is central. VR should be used as a facilitated learning tool rather than a standalone resource, embedded within sessions that incorporate guided reflection, discussion, or debriefing to support critical engagement and emotional processing. Educational use of VR would also benefit from adaptation to different learner groups, including students, healthcare professionals, volunteers, family carers, and younger audiences, with content and facilitation tailored to learners’ prior experience and emotional readiness.

Recommendations for future practice include the use of immersive VR experiences to support reflective caregiving approaches, encouraging carers and volunteers to pause, reconsider automatic responses to dementia-related behaviours, and adopt more enabling and person-centred practices. VR should be embedded within broader support and education pathways, alongside peer discussion, written resources, and signposting to services, rather than implemented in isolation. When used in practice settings, careful attention should be given to ethical and emotional considerations, including preparation, sensitive facilitation, and follow-up support, particularly for individuals who may find the content emotionally challenging.

Further research is needed to confirm these outcomes across diverse populations and settings. Larger-scale and comparative studies are required to explore the longer-term effects of VR training on caregiving attitudes, behaviours, and wellbeing, and to examine how such interventions might be embedded within existing educational frameworks. It is also important to investigate how different forms of VR, such as narrative-driven experiences versus task-based or sensory simulations, differ in their ability to elicit emotional engagement, support knowledge retention, and prompt meaningful behavioural change within dementia training. Future research should explore the use of dementia focused narrative VR beyond the context of informal carers and volunteers, as participants in this study highlighted its potential value for a wider audience, including health and social care professionals, students, and the general public. Given participant reflections that VR was most impactful when combined with other formats, such as discussion or written materials, future studies should evaluate multi-modal approaches that cater to diverse learning preferences (Conway et al., 2024). Participants further expressed interest in expanding the VR content to include a wider range of dementia symptoms and caregiving situations, indicating a need for more diverse and representative scenarios. These insights support the development of narrative VR as part of a broader dementia education strategy and point to the importance of evaluating its long-term impact, scalability, and integration into existing training frameworks.

Strengths and Limitations

There are several strengths to this study, including its focus on informal carers and volunteers, groups that are often under-researched in dementia education. The qualitative methods enabled an in-depth exploration of personal experiences, producing nuanced insights. The study provides clear recommendations for future research, offering a pathway for further exploration of narrative-driven VR in dementia education. However, the study is not without limitations. The sample size was small, with only 12 participants recruited from a single region, which limits the transferability of findings to broader populations. In addition, all participants were already engaged in dementia-related roles and training, which may have increased their openness to and positive engagement with the VR intervention. This study did not collect detailed information on the nature of participants’ prior experiences with virtual reality; therefore, it was not possible to explore how different forms of prior exposure to immersive technologies may have influenced participants’ engagement with or perceptions of the VR film. Finally, data were collected immediately following the VR experience, capturing only short-term reactions and not longer-term impacts on caregiving behaviours or attitudes.

Conclusion

This study demonstrates that a co-created, narrative-based 360° VR film can meaningfully support empathy, reflection, and understanding among informal carers and volunteers. Participants described how the immersive and emotionally resonant nature of the film prompted reflection on caregiving responses, autonomy, and communication in ways that differed from more traditional educational approaches. The findings suggest that the value of VR lies not only in immersion, but in its integration within facilitated and multimodal training. When combined with discussion and reflection, narrative VR shows promise as a complementary tool within dementia education for informal carers and volunteers. Further research is needed to examine its longer-term impact, scalability, and application across wider settings and learner groups.