The first session: the first five minutes

For whoever runs it, a resident's first session is often the twentieth of the week. For the resident, it is the first time someone has put something on their head and told them they are about to see a beach. The gap between those two perspectives explains most first sessions that go badly.

This guide is for the professionals who run sessions with RVer — from activities, occupational therapy, nursing, psychology or other fields. Who can run them, and with what training, is covered in who can run a session.

First of all: the moment and the person

The first session is not booked for “whenever there's time”. It is chosen.

• The resident. To start, someone who is stable that day, with whom the team has a relationship of trust, and who has shown some curiosity. This is not the moment to begin with the most agitated person in the house.
• The moment. A time when the person is usually at their best — often in the morning or early afternoon — away from meals, from medication that causes drowsiness and from the busiest hour.
• The setting. A quiet corner, with no television on and no people walking through. A stable chair with arms, where the person feels secure.
• The place to show. Somewhere the person knows or likes: the beach where they spent their holidays, the church in their village, a garden. The free “Life story” tool at /ferramentas/ helps gather this beforehand.
• The equipment ready. Headset charged and clean, content chosen, Companion app connected to the same Wi-Fi network — so that none of this happens while the person waits.

Explain in plain words and show the headset

The explanation should fit in two sentences. For example: “This is like a television you put in front of your eyes. You'll see a beach as if you were there. If you don't like it, we take it off straight away.”

A few rules that help:

• Speak face to face, at eye level, before the headset is on. Afterwards, the person can no longer see your face.
• Avoid technical words. “Virtual reality”, “360° video” and “immersive” help nobody decide.
• Always say they can stop. It is the most important sentence: it gives the person control and reduces anxiety.
• Agree on a signal for “enough” — raising a hand, for example — for those who speak little or hear poorly.
• Ask whether they want to try. And accept the answer. What to do when the answer is “no” is in when a resident refuses.

Many people feel calmer when they can hold the headset before it is on their head.

• Let the person touch it, feel the weight, see where you look through.
• Show where it rests — on the forehead and face, with the strap behind the head.
• Check whether they wear glasses or a hearing aid, and adjust carefully.
• Put it on slowly, from the front, saying what you are doing. Never from behind, by surprise.
• Adjust until it is comfortable, without over-tightening. An uncomfortable headset spoils any scene.

Inside: start seated, in a familiar place

The first minutes inside the headset are the ones that count.

• Always seated. The first session is done seated, or lying down with the dedicated mode, never standing.
• Start with a calm, familiar scene, with no fast camera movement. The person needs time to work out where they are.
• Stay alongside, with your hand close. The person cannot see you, but should know you are there. A light touch on the arm, agreed beforehand, can help.
• Ask what they see. “What can you see?”, “Have you been here before?”, “What does it remind you of?”. Open questions orient the person and turn the session into a conversation.
• Follow on the Companion app what the person is seeing, so you can comment and respond.
• Keep it short. The first time, a few minutes is enough. The length of later sessions is discussed in session length and frequency.

Take it off at the first sign

The rule is simple: at the first sign of discomfort, it comes off. Nobody insists on “just a little longer”.

Signs to watch for:

• dizziness, nausea, pallor or sweating — possible signs of cybersickness, described in comfort and motion sickness;
• hands reaching for the headset, trying to remove it, head pulling away;
• faster breathing, restlessness, crying or sudden silence;
• the person saying, in any way, that they don't want to continue.

Take the headset off slowly, tell the person where they are (“You're here in the lounge, with me”), give them time. An interrupted first session is not a failure; a session in which the person felt they could not stop is.

Not everyone enjoys it, and there is no way of knowing before trying. Some people prefer never to repeat it, and that is a valid answer.

Afterwards: record how it went

Two minutes of notes are worth more than a good memory. It is worth writing down:

• what was shown and how long it lasted;
• how the person reacted — what they said, what they recognised, whether they smiled, whether they became restless;
• whether there was any discomfort and what was done;
• what to change next time — another scene, another time of day, less time, another way of explaining.

This record is what allows the next session, perhaps run by someone else, to start where the first one ended. What the clinical team can see is covered in the session record.

Where RVer can fit in, and where it can't

RVer is a complementary activity, run by a professional, and a well-run first session is above all a calm moment and a starting point for conversation. It is not a clinical assessment, does not diagnose anything and does not replace any care. Nor is it for every resident or every day: there are people for whom the clinical team considers it unsuitable, and people who simply do not want it. Running a first session well also means accepting that.

In summary

• Choose the resident, the moment and the setting: someone stable, at a good time, in a quiet corner.
• Explain in two sentences, without technical words, and always say they can stop.
• Let the person see and touch the headset before putting it on; put it on slowly, from the front.
• Start seated, in a familiar place, with the professional alongside asking what the person sees.
• Take it off at the first sign of discomfort, without insisting.
• Record how it went, so the next session starts where this one ended.

This article is for information only and does not replace the institution's training or protocols. The decision to offer a session to each resident belongs to the team caring for them; if discomfort does not pass after the headset is removed, follow the institution's clinical procedures.

RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration.