Professor Hannah Keage | CAIN Lab

Using Virtual Reality to Enhance Wellbeing in Older Adults

Fri, 20 Jun 2025 00:00:00 +0000

Virtual reality offers unique opportunities to address key challenges facing older adults in residential care and community settings. Our research explores how immersive VR experiences can combat apathy through personalised reminiscence therapy, reduce loneliness via social VR connections, and improve quality of life for those in palliative care. By creating meaningful virtual experiences tailored to individual needs and backgrounds, we aim to enhance psychological wellbeing, foster social connections, and provide comfort during vulnerable life stages.

Delirium VULnerability in GEriatrics (DIVULGE) 2 Study

Wed, 01 Jan 2025 00:00:00 +0000

Post-operative delirium is a common, distressing, and debilitating condition associated with significant long-term decline in older adults. The impact of delirium is enormous: it affects 25-40% of older-surgical patients and costs over $8.8 billion annually in Australia. We do not have good ways to stratify delirium risk pre-operatively, which would enable prevention efforts to be incorporated in perioperative care as well as shared decision making for older patients prior to surgery. This knowledge is especially important in the context of delirium subtypes (hypoactive, hyperactive and mixed), which demand different care and have different prognoses.

The underlying functional brain mechanisms of delirium vulnerability (risk for incident delirium) are yet to be determined. We have demonstrated that those at high risk for delirium subtypes show a specific pattern of neuropsychological performance and clinical characteristics. We also know that delirium is associated with a slowing of brain activity and reduced functional connectivity across a network of brain areas. Therefore, it is likely that patterns of brain activity will differ in those predisposed to developing delirium after a surgery, and that patterns are dependent on the subtype of delirium; our pilot data supports this proposition (Boord et al., 2014, Brain Communications).

Funded by a NHMRC Ideas grant, we will address this major gap by collecting brain activity data (electroencephalogram/EEG) from older adults before they undergo elective surgery (CALHN, NALHN and SAHLN). We will then measure delirium in hospital after surgery. By linking EEG data to delirium outcomes and using computational neuroscientific approaches which have never been used in the delirium field, we will determine brain activity patterns that discriminate between those who do and do not develop delirium after surgery, and further, how these patterns vary relative to subtype. With findings, we will co-design translational outcomes with patients and clinicians.

Key CAIN Lab members involved: Aaron Clark, Dr Daniel Feuerriegel (alumni) and Prof Hannah Keage

Help After Leaving hospiTal (HALT)

Mon, 01 Jan 2024 00:00:00 +0000

The Help After Leaving HospiTal (HALT) delirium rehabilitation program is a multidisciplinary, scalable, and tailored rehabilitation intervention designed for older adults who have experienced delirium during hospitalisation and do not have dementia. The program aims to reduce cognitive decline and frailty and to support health and wellbeing following delirium. HALT was developed through a multistage co-production process involving people with lived experience of delirium and their support persons, healthcare professionals, and discipline experts. Development included initial stakeholder consultations (2020–2021), focus groups and interviews (2024–2025), and workshops (2025). Evaluation of the program’s feasibility and acceptability is currently underway (2026–2028). The development process was guided by the British Design Council’s Double Diamond Framework and informed by the Medical Research Council (MRC) Framework for developing and evaluating complex interventions.

The program

HALT is delivered remotely, facilitated by a health professional through phone calls or virtual sessions, enabling scalability and accessibility. The program comprises three essential modules (delirium education, vision and hearing, and medications) and five optional modules (cognitive engagement, physical functioning, wellbeing, sleep, and nutrition and hydration).

The three essential modules: delirium education, vision and hearing, and medications.

The five optional modules: cognitive engagement, physical functioning, wellbeing, sleep, and nutrition and hydration.

The family, friends and other support people booklet

The program comprises educational and activity-based content, alongside a family, friends and other support people booklet. The programme is designed to support healthy behaviour change and provide delirium education, drawing on two complementary frameworks: the COM-B model and motivational interviewing. Modules comprise two to eight sessions and are delivered sequentially. The intervention commences when delirium resolves and the program user is ready, and involves support persons where available.

The HALT team

To get in touch, please contact courtney.davis@adelaide.edu.au

Our funders and partners

We thank our funders The Hospital Research Foundation (2024–6) and The Northern Community Health Research Foundation (2026–8).

Psychological Health in Cardiac Patients

Sun, 01 Jan 2017 00:00:00 +0000

Beyond the physical burdens, cardiac patients experience high rates of anxiety, depression and cognitive decline. Despite the substantial negative impacts of these psychological symptoms on quality of life and clinical outcomes, there is relatively little research in this area, including in the development of psychological interventions. Over the last decade we have run multiple studies – assessing psychological outcomes of cardiac patients and testing psychological interventions – in transcatheter aortic valve implantation, coronary artery bypass grafting and implantable cardioverter defibrillator groups. We are also working on including psychological outcomes in cardiac clinical guidelines.

Key CAIN Lab members involved: Erica Ghezzi and Prof Hannah Keage