There is a number in almost every presentation about ageing in Portugal: life expectancy has risen. That is true, and it is good news. There is a second number that shows up far less often, and it changes the whole conversation.
In Portugal, someone who reaches 65 has on average around twenty years of life ahead — and around eight of them in good health. 2023 data points to close to 8.4 healthy years after 65, with women living more years overall and fewer of them in good health than men. Portugal is below the European average on this indicator, unlike its position on total life expectancy.
The gap between the two numbers runs to about twelve years. That is not a statistical abstraction. It is twelve years per person, multiplied by more than two and a half million people aged 65 or over — close to a quarter of the resident population.
Twelve years is where the sector lives
It is worth being clear about which years we mean, because the answer defines who works inside them:
- care homes and residential structures, where the person now lives;
- continuing care, the RNCCI, where function is recovered or stabilised;
- home support, while the house still works;
- palliative care, when the goal stops being to prolong and becomes to comfort.
None of these responses exists to add healthy years. They all exist to make the years that are not healthy liveable. That is a different mission, and it is frequently judged with the wrong indicators.
What technology usually promises, and what it should
Almost all technology sold to the ageing sector is sold on the prevention side: prevent falls, prevent decline, delay dependency. It is a legitimate market and, when it works, it is the best investment there is.
But prevention talk has a side effect: it leaves the people working in the twelve years without language. A care home manager is not preventing much — they are caring for people who have already crossed that point. And when every piece of promotional material talks about preventing, what is left is the sense that caring well is a consolation prize.
It is not. Improving a bad day is an outcome, not a rhetorical fallback.
Where virtual reality fits — and where it does not
Let us be direct, because that is the only way this is useful.
What RVer does not do:
- it does not add healthy life years. Nothing in the literature supports that, and we do not claim it;
- it does not prevent dependency, frailty or falls;
- it does not replace exercise, physiotherapy, nutrition or company — which are the interventions with the strongest evidence on the prevention side;
- it is not a public health intervention. It is a system used in a session, with one person, supervised by whoever is caring for them.
What it does, and it is what we have: immersive environments used inside those twelve years, as a non-pharmacological complement, decided by the clinical team — moments of calm, of reminiscence, of distraction during an uncomfortable procedure, of family presence from a distance. Every session is logged, which gives the team something it rarely has: a record of what was done and when.
The published research in this area is mostly about wellbeing, anxiety, pain and quality of life, not longevity. We have gathered it, with the themes and counts on show, in the study library. And where the evidence is weak, we say so there.
The indicator institutions are missing
If the mission is the quality of the years and not their quantity, indicators should follow. In practice, almost no institution measures what it does on that axis — it measures occupancy, incidents and care hours, which are operational indicators.
We do not have a finished answer to this, and be wary of anyone who does. We have one observation: when a team starts logging sessions of any non-pharmacological activity, it gains for the first time a time series to argue about. That does not prove effect. It allows a conversation with data instead of impressions, and that is already more than existed.
In short
- Around twenty years after 65, around eight in good health. Portugal is below the EU average on this indicator.
- The gap is the working ground of care homes, continuing care, home support and palliative care.
- Virtual reality does not shorten that gap. It works inside it.
- Anyone promising you healthy years with a headset is extrapolating.