In this sector's marketing material, "dementia" almost always appears in the singular. Anyone working in an activity room knows it is not like that: what works with one person may be irrelevant to another and uncomfortable for a third, and the diagnosis explains part of that.
None of this is ours to decide — the decision always belongs to the clinical team, who know the person. What follows is what tends to change in practice, so that the conversation with whoever is offering technology can be better informed.
Alzheimer's disease
The most common, and the one with the most literature on non-pharmacological activity. Memory for recent events deteriorates before older memory, which makes reminiscence the most natural territory: childhood places, the home town, the familiar sea.
In practice: old and familiar content before new content. A generically beautiful landscape usually yields less than a place with personal history, and biography is worth more than any catalogue. We have written in detail about Alzheimer's.
Vascular dementia
Two features change the planning. Progression is often stepwise rather than a steady decline — stable periods and abrupt drops. And variability within a single day can be large.
In practice: what went well last week may not this week, and that is nobody's failure. Worth logging the session rather than trusting the shift's memory, so the team sees the pattern instead of guessing it. Motor impairment is frequently associated, which makes position — stable seated, or lying-down mode — more important than in other cases.
Frontotemporal dementia
The one that least matches the stereotype. It often starts earlier, sometimes before 65, and what changes first is behaviour, language or social judgement — not necessarily memory.
In practice: the person may understand perfectly and still refuse abruptly, or lose interest halfway through without warning. That is not negotiated. It is also the population where it is easiest to misread signals: a flat reaction does not mean nothing is happening, and an intense one does not mean discomfort. And since many of these people are younger, reminiscence content "for older people" is inappropriate — the biography belongs to another generation.
Lewy body dementia — and here caution is greater
This deserves its own section, because it has features that interact directly with what an immersive experience does.
Visual hallucinations are frequent and part of the picture, often from early on. There are also disturbances of visual perception and visuospatial processing, marked fluctuations in alertness through the day, and frequently parkinsonian motor signs.
Placing an immersive display in front of someone whose visual perception is altered is not a neutral decision. We have no evidence of harm, and equally no evidence of safety in this population — what exists is reason for added caution and for the decision to be made by whoever knows the case, with close observation and short sessions, if at all. The neuroleptic sensitivity that characterises this dementia is unrelated to this, but it is a reminder that this is a picture where reactions depart from the expected.
If there is one sentence to take from this article: a supplier presenting virtual reality as good for "dementia" without distinguishing Lewy body has not studied the subject.
What is common to all
- The person, not the diagnosis, decides the content. Diagnosis helps anticipate; biography chooses.
- Short sessions, shorter than in other contexts.
- Someone familiar alongside, talking. The voice is part of the session.
- Stop at the first sign, and refusal is not negotiated.
- Log what was observed in the words of what was seen, not in conclusions.
What RVer does not do
Worth being explicit: it does not assess, classify or diagnose. It does not distinguish types of dementia, does not suggest content based on diagnosis, and does not measure response. The AI-assisted feature helps find a scenario from the kind of moment the team describes, and the choice always belongs to the team.
And the literature, which we gathered in the library, is mostly about wellbeing and reminiscence in mild to moderate dementia. For advanced stages, and for Lewy body in particular, it is thin.
In short
- "Dementia" in the singular is a commercial simplification.
- Alzheimer's: reminiscence, old and familiar content.
- Vascular: stepwise variability; log rather than trust memory.
- Frontotemporal: younger, abrupt refusal, a different generation's biography.
- Lewy body: hallucinations and altered visual perception — greater caution, and no evidence of safety in this population.