A simulated aged-care hallway. A man in his mid-eighties stands holding the rail as a carer wearing the headset approaches.

Dementia and changed behaviours training for care workers

When a resident living with dementia says no, the next sentence decides the morning.

The moment

Seven in the morning, and the answer is no

A woman living with dementia is woken for her shower by a worker she does not recognise. “We need to get you washed before breakfast” is true, and to her it can sound like a threat. Her voice rises, and so does the worker’s.

A VR aged care and disability services training scenario in which a care worker walks beside an older man holding a handrail in a corridor. — The corridor, first thing in the morning.

An older woman sits in her armchair beside her walker in a simulated front room, a prompt panel floating across the room. — Her armchair, and the words to choose.

A younger man stands near an older woman. A first person VR training scenario for aged care and disability services, seen through the headset. — Standing over her, or sitting beside her.

The rules

Dementia is named in the training rules

Australia and the United States both name dementia in the training they expect of care staff.

A VR aged care and disability services training scenario in which a young support worker stands alone in a staff alcove. — A new worker, before the morning round.

Australia: the strengthened Quality Standards

Australia’s strengthened Aged Care Quality Standards reach this moment twice. Under Outcome 5.6, people “who experience cognitive impairment (whether acute, chronic or transitory) receive comprehensive clinical care services”.

Action 2.9.6 asks that all aged care workers “regularly receive competency-based training in relation to core matters, at a minimum”, including “caring for individuals living with dementia”. Competence shows up in a bathroom, when a resident says no.

A support worker wearing a headset sits beside an older woman in a sunroom with plants at the window. — Eye level, unhurried, in a sunroom.

United States: nurse aide training

Federal nursing home rules at 42 CFR 483.95 set nurse aide in-service training of “no less than 12 hours per year”, which must “include dementia management training and resident abuse prevention training”.

The National Institute on Aging explains why: “People with Alzheimer’s disease may become agitated or aggressive as the disease gets worse.”

Where practice fits

Understand the cause, then say the second sentence

Dementia Training Australia describes changed behaviour, sometimes called BPSD, as something staff can learn to understand the causes of, and find ways to avoid or reduce.

An older woman sits near a younger man on a garden bench, seen through the headset. — Asking about the garden before anything else.

The worker who had practised

A second worker, on another morning, says her own name first, sits at eye level and asks about the garden. Nothing about the shower has been decided yet. Both workers completed the same module, and one of them had said that sentence before.

Practice gives every worker that sentence, in a VR de-escalation scenario where a wrong turn hurts no one.

How it runs

Short scenarios, between tasks

Care workers rehearse in a VR headset or with an AI roleplay partner in a browser. Each attempt leaves a record: who practised, which situations, how many attempts.

A care worker practises speaking from an armchair in the lounge. — Practising the words in a headset.

A man stands in an aged-care lounge among empty armchairs, a stack of glowing message panels beside him. — Message practice in an aged care lounge.

A participant discusses an XR rehearsal with a facilitator. — Talking it through after an attempt.

The evidence

What the research reports

A systematic review of VR simulation for family carers of people with dementia reports mixed results on empathy.

A woman in her seventies faces her own reflection beside a floral armchair in a sunlit lounge room. — An older woman meets her own reflection.

Empathy, and practice

Huang and colleagues report that “Inconsistent quantitative results were reported on the effects of VR-based simulation on empathy enhancement.”

Practice for care staff aims at something narrower and easier to check: the worker rehearses the exchange, gets it wrong without anyone being hurt, and tries again. Does VR training work? sets out effect sizes where studies report them.

Where PTR began

Aged care is where People Tech Revolution started

Two public strands of that start: university trials in aged care, and The Ageing Revolution.

Leonie Sanderson interviewed live on ABC News from Brisbane, captioned as Director of The Ageing Revolution. — PTR’s co-founder, interviewed on ABC News.

QUT’s aged care VR trials

QUT Design Lab ran Transforming Aged Care with Virtual Reality in 2021 and 2022 with Griffith, Melbourne, La Trobe and Monash, across six aged care facilities in Queensland and Victoria. ABC News named Leonie Sanderson, our co-founder, as the project coordinator.

A woman in her eighties wearing the headset lifts both hands in front of her, mouth open, during her first VR training experience. — An older woman’s first moments in VR.

The Ageing Revolution

The Ageing Revolution began in 2015 as a force to address ageism, and it calls People Tech Revolution its tech arm. The wider work is on the aged care training page, and the delivered programs are in the aged care and disability case studies.

Questions

What providers ask first

Short answers for educators, care managers and quality leads.

An elder sits in the good chair with her daughter beside her in a simulated regional aged-care room; a care coordinator in the headset listens rather than leads. — An elder, her daughter, and a listener.

How is this different from dementia awareness training?

Awareness training teaches what dementia is. This is practice for what to say when a person living with dementia is distressed, and it builds on those basics.