Aged care and disability, seen from the inside
Practice shaped with residents, families and care teams, so a worker finds the words for the family at the door before the visit.
The moment
A daughter arrives on a Sunday with a bag over her arm
A daughter arrives on a Sunday afternoon with a bag over her arm and a question the shift has been dreading. Whoever meets her at the door sets the tone of the visit in one sentence. A resident who refuses care, a complaint that has to be acknowledged before it can be investigated, a handover where the thing that mattered was never written down: staff ask to practise these.
Co-design in practice
Central Coast Council: disability awareness
Central Coast Council needed its community to understand daily life with disability. Its Access and Inclusion Reference Group co-designed a VR experience for local business, sport and recreation: a beach and a shopping centre, seen from inside the disability. Central Coast Council’s experience has run across the community more than 200 times, and teacher training, council staff training and CSIRO-facilitated sessions have incorporated it.
Working in aged care or disability?
The evidence
What the research says, and what it does not say yet
Written descriptions of lived experience fall short of the recognition a simulation from the resident’s own eyes can prompt. The Disability Royal Commission found community attitudes, not physical access alone, a fundamental driver of poor outcomes for people with disability. A 2024 systematic review of VR simulation for informal dementia caregivers reported inconsistent quantitative results on empathy and found no controlled trials with group comparisons, so every PTR pilot ends with an evaluation of its own.
The standard
Practice that can leave a record an auditor reads
Providers are now assessed outcome by outcome against the strengthened Aged Care Quality Standards, which sit under the Aged Care Act 2024, and each outcome carries a rating of its own. An assessor asks how staff learned to handle a resident who refuses care; a sign-in sheet from a lecture answers half of that question. A scenario the same staff repeat, with who ran it and when, gives an assessor something to read, where you set it up that way.
Where the founders learned aged care
Six facilities, two states, and a toolkit
Shut in her room by the lockdowns, a resident at Arcare Pimpama pulled on a headset and walked back into the London of her youth, and ABC News filmed her doing it. QUT Design Lab ran those trials in 2021 and 2022 with Griffith, Melbourne, La Trobe and Monash, across six aged care facilities in Queensland and Victoria. Leonie Sanderson managed the VR work through The Ageing Revolution, under a philanthropic research grant from Facebook; what the team learned became a free toolkit on cost, safety, apps and space.
"It just gave people - who'd pretty much been in lockdown or isolated from family and friends that sense of still being able to enjoy the world, and maybe at the age of 94 to do something they had never done before."
Leonie Sanderson
Co-founder, People Tech Revolution, on the aged-care VR trials she managed for QUT. ABC News, June 2022
Your questions
Questions providers ask before they start
The questions that come up early, answered in the words they get asked in.
Do our care staff need a headset each?
Not one each. The same conversation can be written where the shift allows, or spoken at the pace a resident sets, on a screen the home already has. The headset is the deepest version of it, not the entry fee.
When would anyone find the time?
Between rounds. A pause at the door is long enough for one exchange, and so is a quiet stretch in the chair beside the bed. Nothing has to come off the roster.
What does an assessor see?
Where you set it up that way, practice leaves a record an auditor can read: which conversation a carer rehearsed and how often they came back to it, rather than an attendance sheet saying somebody sat through a module.
Our compliance training already covers this, doesn’t it?
It covers what staff should know. It leaves out the handover that happens at the door, and the daughter who arrives on a Sunday with a bag over her arm. Those are the conversations this is for.
Have you done this in aged care before?
Leonie Sanderson ran the Transforming Aged Care with Virtual Reality trials across residential aged-care facilities in Queensland and Victoria, through The Ageing Revolution and with university research partners. The implementation toolkit that came out of it is free. That is where the founders learned this sector.
The doorway
The doorway, and the chair beside it
Aged care and disability work happens in the rooms people live in, and practice happens there too. A written rehearsal lets a worker review how they will open a conversation with a family member, using the care team’s approved guidance. Sitting down and saying it aloud is closer to the real thing: tone carries more than wording here, and a spoken run lets someone leave a silence and find out what it does.
The library
What practice looks like in aged care and disability services
The kitchen table, the garden, the planning meeting, the ramp: each scenario in the library is an ordinary moment, rehearsed until it is ordinary. The people who live those moments helped decide which ones were built.
Through the headset
A reception desk, a garden bed, a courtyard barbecue
Inside the headset the resident or the visitor is in front of you, waiting for a reply. The older man approaching the reception desk, the woman in the garden, the three people at the courtyard table: each answers what your staff say, not what they meant to say.
Co-designed
Scenarios shaped with the people who will run them
A resident practises a conversation from his wheelchair. A care worker practises speaking from an armchair. A support worker rehearses a coaching conversation. Each scenario was co-designed with the people who run it, in the room they run it in.
On ageing, long before the headset
A card game, a photo gallery and a company built to argue with ageism
Long before anyone here picked up a headset, Simon and Leonie were arguing with the way Australia talks about growing old. They started The Ageing Revolution for it in 2015, and it is still a company in its own right. Out of it came Carked It!, the card game about dying that won an Australian Good Design Award, and the Pikme gallery publishers license when they want ageing shown as it is. The longer version is on Our story.
Working in aged care or disability?
Related PTR work
An aged-care build draws on PTR’s facilitated VR, including the Everyday Inclusion and Mind Shift modules in the VR Library; the government and public-sector page covers PTR’s work with the same council.
Sources and further reading
The research, the toolkit and the standard the copy above draws on.
Virtual reality-based simulation intervention for enhancing the empathy of informal caregivers of people with dementia
The 2024 systematic review: inconsistent results on empathy, and no controlled trials with group comparisons.
National Dementia Education and Training Standards Framework
The sector’s formal priority of structured, competency-based training, responding to the Royal Commission into Aged Care.
Final Report, Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability
Community attitudes, not physical access alone, as a fundamental driver of poor outcomes.
Transforming Aged Care with Virtual Reality: the Transformational Toolkit
The free toolkit on cost, safety, apps and space that came out of the six-facility trials.
Virtual reality is helping residents with COVID isolation in aged care centres across Queensland
The resident at Arcare Pimpama who walked back into the London of her youth.
Strengthened Aged Care Quality Standards
The outcomes a provider is now rated on, one by one.
The rules behind this work
The duty in aged care, and what the same duty looks like abroad
Aged care and disability providers carry a training obligation under their own standards, and a similar one wherever else they operate.
Psychosocial hazards
The duty under another name, and where practice belongs inside it.
The Joint Commission
At hire, annually, and whenever the program changes, with the content named and documentation required.
What the record has to show
The five fields a training record must carry, and who can ask to see it.
Does VR training work
What the controlled studies measured, and what they found.
