Designing Accessible VR Therapy for Aging Patients

Designed for standing users, used by people in bed

The original LUVRE app required complex multi-finger hand gestures and featured a deeply nested menu structure that created significant cognitive load for patients aged 60 and above. Designed for standing users with full mobility, it completely ignored the physical context of post-surgery use—patients lying in hospital beds with limited arm movement, often restricted to one hand due to IV lines or surgical incisions. This mismatch between design and reality led to a frustrating experience that prevented independent use and limited the app's therapeutic potential.

• Excessive cognitive load: multiple complex gestures, deeply nested menus; steep learning curve.
• Physical constraints ignored: designed for standing; real use from hospital beds; thoracic surgery patients often must use one hand.
• Dependency on caregivers: patients could not use the app alone; required constant assistance.

The original app was too complex. Patients in their 60s and 70s struggled with the gestures. They couldn't use it alone, especially after surgery when they're already in pain and limited in movement. Most needed help just to start a session.

— Stakeholder, LUMC

What the wards revealed

I conducted contextual research in real clinical settings, observing how the app was used by patients in hospital beds. I interviewed key stakeholders including surgeons, clinical technologists, and nursing staff to understand patient needs, pain points, and digital literacy levels. These conversations revealed that most patients had never used VR before and struggled with the complex gesture system, especially in their post-surgery state.

I then evaluated the existing product through task analysis and interface audit, identifying friction points in navigation and task flow. The analysis revealed that accessing core features required multiple steps through nested menus, and the gesture system was incompatible with one-hand operation. These findings, combined with stakeholder insights, directly informed the redesign priorities: simplify navigation, enable one-hand use, and reduce cognitive load.

• Navigation complexity: need for simpler, faster, more intuitive navigation.
• Zero VR experience: interface must feel self-explanatory and familiar.
• Unclear system feedback: complex menus and unclear feedback.
• Clarity and calm: patients valued clarity, speed, and minimal distraction.

Three constraints that changed everything

I redesigned the entire interaction model from first principles, reducing navigation complexity and replacing complex multi-finger gestures with simple point-and-select patterns familiar from smartphones. The new interface uses large touch targets, a flattened menu structure limited to two levels, and a 60% black overlay for UI legibility over 360° video. Every interaction was validated for one-hand use from a supine position, enabling patients to navigate independently from their hospital beds.

The redesign was built on three core constraints: one-hand operation (validated in hospital bed context), zero learning curve (familiar interaction patterns), and minimal cognitive load (maximum 2 navigation levels). These constraints forced simplicity and led to measurable improvements in usability and patient autonomy.

Calm over spectacle

The redesigned interface prioritizes simplicity, accessibility, and therapeutic calm. Every visual element, interaction pattern, and feedback mechanism was designed to work seamlessly from a hospital bed context while maintaining the immersive benefits of VR therapy.

Constraints as catalysts

One-hand navigation as a constraint

Rather than treating one-hand navigation as a limitation, I used it as a design constraint that forced simplicity. This constraint led to a cleaner interface, larger touch targets, and more intentional interaction design. Every element had to justify its presence and complexity, resulting in a more focused and effective user experience. The constraint became a catalyst for innovation, pushing us to find elegant solutions that worked within physical limitations.

Familiar over novel

I prioritized familiar interaction patterns over novel VR-specific gestures. Patients could point, select, and navigate using patterns they already understood from smartphones and tablets. This reduced the learning curve to near zero and made the app intuitive from the first use, critical for patients who had never used VR before. Familiarity reduced anxiety and increased confidence in independent use.

Calming over exciting

The visual design prioritized calm and tranquility over excitement or engagement. Soft colors, gentle transitions, and minimal visual noise created an environment that supported relaxation and pain management. This was particularly important for patients in post-surgery recovery, where overstimulation could be counterproductive. The calming aesthetic aligned with the therapeutic goals of the VR experience.

Autonomy through simplicity

By making the interface simple enough for independent use, I gave patients control over their recovery journey. They could use the app when they needed it, without waiting for caregiver assistance. This autonomy was empowering and supported better adherence to therapy, as patients could integrate it into their daily routine at home. The simplicity enabled independence, which in turn supported better recovery outcomes.

Independence as a design outcome

The redesign transformed an inaccessible VR experience into a tool that enabled independent use for older patients. By addressing cognitive load, one-hand physical constraints, and digital literacy barriers together, the app moved patients from dependency to autonomy. Patients could access therapy on demand, without waiting for caregiver assistance, which improved confidence and made non-pharmacological recovery support realistically usable.

Technology as support, not replacement

While VR expands what's possible in care, it should never replace the human connection between patient and caregiver. The job is simple: support recovery and autonomy without adding friction. Technology should reduce anxiety, not become another thing patients have to fight.

• More extensive user testing with actual post-surgery patients.
• Longitudinal outcome measurement (pain management, medication use, satisfaction).
• Progressive disclosure of features as patients become more comfortable.