There is a number nobody publishes: the proportion of times a session is offered and the person says no. In the practice of the teams we work with, it is not rare. And what happens next matters more than the refusal itself.
The most common reflex is to treat it as an obstacle — insist, persuade, "just try it for a moment". It is the worst route available, for a practical reason before an ethical one: someone talked into a session they did not want refuses every future one, and takes the rest of the ward with them.
Seven reasons, and what changes in each
Worth separating, because only three resolve by changing something.
1. They did not understand what it is. The most frequent, and the easiest. "Virtual reality goggles" means nothing to someone who has never seen a pair. Show the equipment, let them touch it, explain it comes off at any moment. Often the no becomes a yes here, and not through insistence — through information.
2. They fear being left in the dark or trapped. Legitimate and common, especially among older people. Answer with facts: they stay where they are, someone stays beside them, it comes off with one hand.
3. It is not a good moment. Pain, nausea, a visitor waiting, having just been repositioned. This is not a refusal of the technology — it is a refusal of now, and offering at another moment is the right response.
4. They do not like what was offered. A beach scene for someone with bad memories of the sea. Here you change the scenario, not the conversation.
5. They do not like the thing. Some people simply do not want a device on their face, and that needs no justification. It is a preference, to be respected like any other.
6. They are exercising control. In a life where almost everything is decided by others, saying no to something optional may be the only choice available that day. Insisting removes exactly what was being exercised.
7. There is a clinical reason. It should have been picked up earlier, and there are situations where it is not the right offer.
The three that resolve
Only reasons 1, 2 and 4 resolve by changing something — information, safety, content. The other four resolve by accepting. Knowing which one you are in is the competence that matters here, and no trick replaces it.
When the session starts and goes badly
Different from refusal, and more delicate. The person agreed, put it on, and halfway through there is discomfort, confusion or agitation.
The sequence is always the same, and is worth writing down before it is needed:
- Stop. Do not ask whether they want to stop — stop. Ask afterwards.
- Remove the headset and give orientation back: say where they are, who is there, what time it is.
- Stay. The minutes afterwards matter more than the session.
- Log what happened, including at what point. That is what stops the next person repeating the same offer blindly.
- Do not offer again the same day.
Worth distinguishing motion sickness from emotional discomfort: the first has physical signs and resolves by sitting and waiting; the second asks for presence and conversation, and sometimes asks that it not be repeated.
What this requires of whoever offers
One thing, and it is not technical: whoever offers has to be genuinely willing to hear no. If the session is being offered because there is purchased equipment that has to show usage, the person in front of you notices. They always notice.
It is also why consent here is not a form: it is the real possibility of saying no without it costing the person anything.
Where we do not help
We have nothing that increases acceptance, and be wary of anyone claiming they do. No feature persuades anybody. What exists on our side is modest and concrete: the session stops instantly and remotely from the Companion, without whoever is running it having to reach the headset; and refusals and interruptions are logged like anything else, which surfaces patterns a shift's memory loses.
A system that logged only the sessions that went well would be prettier and less useful.
In short
- Refusal is information. Seven reasons, and only three resolve by changing something.
- Persuading someone once costs you every future time.
- If it goes badly: stop first, ask afterwards, and stay.
- Log refusals and interruptions, not just what went well.
- Whoever offers must be able to hear no — otherwise this becomes about the equipment and not about the person.