Virtual Reality in Non-Cancer Palliative Care: A Review of Current Applications and Future Directions

Abstract

Palliative care has traditionally focused on cancer patients, yet non-cancer serious illnesses such as heart failure, chronic obstructive pulmonary disease (COPD), and dementia account for a substantial proportion of end-of-life care needs. Virtual reality (VR) technology is emerging as a promising non-pharmacological intervention that may address the complex physical, psychological, and spiritual dimensions of suffering in this population. This review synthesizes current evidence on VR applications in non-cancer palliative care. Key findings indicate that VR can effectively reduce pain, alleviate anxiety and depression, and improve quality of life across multiple non-cancer conditions. Specific applications include nature-based immersive experiences for symptom management in COPD, personalized VR distraction for pain relief in advanced heart failure, and synchronized dyadic interventions that simultaneously support both patients and caregivers. Meta-analytic evidence shows moderate-to-large effect sizes for pain reduction, though the evidence base remains limited by small sample sizes, heterogeneous protocols, and a lack of randomized controlled trials specifically targeting non-cancer populations. Distraction is frequently cited as the primary mechanism, but emerging evidence suggests that VR may facilitate deeper processes including restoration of autonomy, symbolic connection, and spiritual meaning-making. Safety and tolerability are generally favorable. Future research priorities include adequately powered randomized controlled trials targeting specific non-cancer conditions, elucidation of therapeutic mechanisms, and development of standardized implementation protocols.