March 4, 2014

Simulation Increases Empathy for People Living with Dementia

By Unreal Engine

The effects and possibilities of video games are not limited to the world of entertainment. From architectural visualization to medical training, Unreal Engine technology has been a valued tool in a wide variety of fields, but few projects have attempted to expand the human capacity for compassion and understanding as the Virtual Dementia Experience (VDE) from Opaque Multimedia.

Currently installed at Alzheimer's Australia Vic's Perc Walkley Dementia Leaning Centre, the Virtual Dementia Experience is a unique simulation designed to help elder care employees, facility designers, and even family members to better empathize with the difficulties faced by dementia sufferers.

The Virtual Dementia Experience uses a 10x2.5 meter projection and motion-tracking to immerse players in the simulation. They partake in everyday activities, such as showering and moving about the house. Meanwhile, the operator - a second person manipulating the game – can modify visual filters, move objects, and change the rules of an environment to simulate the effects of dementia.

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The simulation takes players through a typical morning routine, though locating the bathroom is a challenge when the operator can manipulate the destinations of doorways. Once found, even the simple act of locating the sink is made difficult by removing contrast and glare so that it blends into surrounding objects. Participants struggle to operate shower handles, to separate reality from hallucinations, and, perhaps most frightening, to distinguish a shaving razor from a toothbrush.

"Using serious games in delivering aged care education is a game changer. Our intention is that when people experience what it is like to have dementia it will change their attitude towards people living with dementia, then their behaviour and ultimately the way that they deliver care," says Maree McCabe, CEO of Alzheimer's Australia Vic.

"Our partnership with Opaque Multimedia has allowed for the fulfilment of this project. The work they have put in and the commitment they have demonstrated in researching the experience of dementia is extraordinary."

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As learned by Norman Wang and his Opaque Multimedia colleagues, Liam McGuire and James Bonner, comprehending and translating the perceptions of dementia for other people was not an easy task, and subverted many traditional theories of game design.

Wang explains, "Usually when designing a game, your design goal is to capture and engage the player, designing the environment to be easy to navigate, and making important items easy to see. In order to simulate what living with dementia might be like, we had to deliberately make our environment frustrating and hard to use. Consequently, we came to the realization that a lot of the principles behind a well-designed video game space also apply to designing spaces accessible to children and the elderly in real life."

Faced with the prospect of simultaneously immersing and disorienting players in a hallucinatory reality, Opaque Multimedia needed a toolset that was extremely flexible, but also well-supported and accessible to keep development moving quickly as they ventured into unknown territory. The team had excellent experiences using Unreal Engine technology for prior projects, so the Unreal Development Kit (UDK) was an easy choice.

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Elaborating upon the team's reasons, Wang recalls, "We knew we could develop the simulation faster and with a higher degree of verisimilitude using UDK than with any other product available to us. The WYSIWYG nature of the entire toolset allows for immense speed and flexibility in manipulating assets and level properties, and seeing exactly how they'll look in-game."

"Unreal Kismet provides a much needed bridge between level designers and coders, giving the level designer direct control over how gameplay logic works, which eliminates a lot of time consuming back-and-forth. The extensibility of Kismet with custom-written nodes means its power and scope is virtually unlimited."

Opaque Multimedia relied heavily on UDK's integrated third-party tools and features, including SpeedTree, Simplygon and APEX Physics, as well as the ability to import Autodesk FBX natively. Wang and his team overcame challenges with the help of the Unreal Developer Network (UDN) and UDK community.

Ultimately, the team's perseverance paid off in more ways than they had hoped.

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"For some participants, we've given them a small window into what their relatives might be experiencing. Even trained caretakers in dedicated facilities can still underestimate the impact aspects of the environment have on people with dementia and aging-related medical conditions, so this simulation is useful for professionals, including caretakers and facility architects, as well as the general public."

When asked what he hopes the project accomplished, Wang says, "The primary thing we want people to take away from the Virtual Dementia Experience is an understanding of what people living with dementia are going through; to put people in the shoes of people living with dementia and foster understanding and empathy"

For more information on the Virtual Dementia Experience and the work of Opaque Multimedia, visit and check out