University of Southern California: USC researcher envisions Siri-like assistants and VR travel for older people and their caregivers

USC Research Professor Skip Rizzo thought his mother might like a trip to Rome.

She put on a virtual reality headset, and soon her face was aglow: “Oh! Carl and I used to love this little bar that was right over here.” The visuals brought back memories from 35 years ago when she visited Italy with her husband; this time, Rizzo was right there with her, in a postage stamp-sized video off to one side.

It’s an elegantly simple thing — a VR headset preloaded with spherical video of the world’s great cities. The killer feature is the ability to email a Zoom-like link from the headset itself — and voilà, the VR user has a companion for her travels, and the companion can share the view on their own device.

“When I did it the first time, I felt like I was having a conversation with someone in that location, walking around and doing stuff,” said Rizzo, director for medical virtual reality at the USC Institute for Creative Technologies. He consulted with the medical device company Penumbra on the project. “Now, imagine someone in a care facility across the country. Instead of a phone call where you’re trying to figure out what to say when somebody isn’t engaging, it’s ‘Do you want to go to Rome?’ ‘Do you want to go to London today?’”


Skip Rizzo’s mother takes a virtual tour of Rome. (Video/Skip Rizzo)
There are few Americans who do not have an aging family member, friend, neighbor or colleague living with health and mobility challenges that come with advancing years. Millions of those individuals are facing another blow: Alzheimer’s disease or another form of dementia. It’s unclear when disease-altering treatments will arrive, so researchers are starting to look at ways that technology can enhance life and relieve some of the difficulties of caregiving.

Rizzo is best-known for his research using virtual reality to treat PTSD in veterans. He’s also developed “virtual humans” to interact, via computer, with service members who may need mental health services but don’t want to talk to anyone about it. Now, with his 89-year-old mother living with him, he’s returning to an earlier interest in gerontology.

Years ago, Rizzo visited nursing homes where he would find residents gathered at a table, sitting in silence. He had a stack of large cards featuring images of old household appliances or a silent movie marquee. When he pulled out a picture of a wringer washer, the room lit up. “Oh, I had one of those!” “I remember those!”

Facebook Live: ‘Rethinking Alzheimer’s Care’
WHAT
Live online discussion of “Rethinking Alzheimer’s care: Experts talk about challenges and new paths forward for caregivers”

WHO
Laura Mosqueda of the Keck School of Medicine of USC, Julie Zissimopoulos of the USC Schaeffer Center for Health Policy & Economics, Susan Howland of the Alzheimer’s Association California Southland Chapter and Michelle Levander of USC Annenberg’s Center for Health Journalism

In research-speak, he was “providing relevant stimuli for stimulating remote memory, aka Reminiscence Therapy.” Even if they couldn’t remember what they had for breakfast, Rizzo said, they could access well burnt-in memories from earlier in their lives, which activated them in a positive way.

Possibilities of VR and aging populations
If low-tech flash cards can bring joy and encourage engagement with the world, imagine the possibilities with virtual reality and Siri-like assistants. Rizzo said some companies are producing content that is relevant for older populations, and early research is showing that users are calmer, happier and looking forward to their daily experiences.

Such moments of pleasure are a needed boost in quality of life for both caregiver and care recipient. Research shows that most family caregivers of people with dementia report a high or very high level of emotional stress; finding ways to reduce that stress is increasingly important to comprehensive dementia care.

That’s why Rizzo and his colleague Elizabeth Zelinski, a professor of gerontology and psychology at the USC Leonard Davis School of Gerontology, are exploring ways to create a personalized “virtual caregiver support agent.”

The idea is to have a virtual helper responsive to the spoken word — like iPhone’s Siri, but embodied as a character that pops up on a phone or smart TV. The primary caregiver inputs biographical details about the care recipient so that the virtual helper can engage with the user.

VR and aging populations: From reminders to walks down memory lane
The No. 1 function would be programming in reminders for medication or doctor appointments, Rizzo said. The No. 2 function would be to fill in for memory lapses. For example, the user could say, “I can’t remember my niece’s name but I don’t want to bug my husband.” If that information isn’t in the system, a pop-up reminder prompts the caregiver to fill it in later.

The result is a support agent or companion that’s not only a stimulus for the user, but also a source of respite for the caregiver. The knowledge base is enriched over time, incorporating old or personal photos to prompt memories. The virtual agent can offer simple games like checkers.

Which is much like the way Rizzo spends time with his mother: “We always walk down memory lane and play games and stuff. So I would like to build out a virtual version of me.”

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