3.1 - Eskoo, Seinäjoki

The Wellbeing Services County of South Ostrobothnia, Support and Competence centre Eskoo

The Seinäjoki unit within Eskoo Joint Municipal Authority is a national pioneer in nature-based methods. The pilot is developing a virtual model for clients with reduced mobility and extensive care needs, providing psychosocial support, recovery, positive experiences, and inclusion.

Aim

The pilot aims to support clients’ recovery, provide positive experiences, and promote inclusion through environments and natural elements that are relevant to each client’s well-being. It also focuses on providing high levels of psychosocial support, as well as support for challenging behaviour and communication. Through this approach, the project explores how nature-based interventions can be combined with digital solutions to create meaningful, personalised experiences for people with extensive care needs.

 
Participants, units, and interventions with follow-up

Eskoo Care Unit

24/7 care unit for adults with profound intellectual and multiple disabilities in demanding care for 14 clients.

• Equipment used in interventions: dome with visual and auditive sensations without headsets
• Multisensory interventions: olfactory and tactile sensations are possible
• Methods used in assessing the effects: Photovoice, observations, HRV-measurements (Firstbeat)

Eskoo Support Unit

Adults with needs of high psychosocial support and support in everyday life for 19 clients (incl. intellectual disabilities, neuropsychiatric disorder, autism spectrum disorder, and behavioural challenges)

• Equipment used in interventions: dome and VR glasses with headsets
• Multisensory interventions: olfactory and tactile sensations are possible
• Methods used in assessing the effects: Photovoice, observations, HRV-measurements (Firstbeat).
  IRL interventions included if possible

Eskoo´s employees

Nurses and social counsellors work in three shifts at Eskoo. Other staff can also participate in the research.

• Equipment used in interventions: dome and VR-glasses with headsets
• Multisensory interventions: olfactory and tactile sensations are possible
• Methods used in assessing the effects: HRV measurements (Firstbeat and Oura), questionnaires and interviews.
  IRL-interventions included if possible.

Results

A Photovoice study indicated that virtual nature can broaden the otherwise often limited lives of adults with profound intellectual and multiple disabilities. The Dome enabled residents to experience distant environments within their immediate surroundings.

At Eskoo, clear differences were observed between clients. Those in need of relaxation benefited more from calm and low-stimulus environments, while clients in need of activation preferred more lively environments—especially those including animals or movement in the environment, such as rowing a boat along a river.

For clients with severe developmental disabilities at Eskoo, the virtual nature experiences in the Dome have worked well due to its accessibility and ease of use. The Dome studio was located close to the residential units, and clients could easily enter the room together with a care professional, who participated in and facilitated the experience according to the clients’ needs and preferences.

Over time, the virtual nature experiences in the Dome have become a natural part of daily life at Eskoo and are highly appreciated by both clients and staff members. The Dome has enriched the everyday lives of the clients in a positive way and has become a place for both relaxation and social interaction.

For this client group, it has been important to offer a wide variation of environments and activity levels, corresponding to diverse individual needs—from stimulation to opportunities for calm and relaxation. For some clients, the Dome with virtual natural environments has been the only place where they can fully relax during the day.

Virtual nature interventions can also support care personnel’s well-being, recovery, and stress management—both after work shifts and during work shifts when participating in the experiences together with clients.

HRV- Results

Our sub-study focused on residents of the Eskoo care facility in Finland and examined physiological responses to dome-based virtual nature sessions among adults with intellectual and/or physical disabilities. Across multiple sessions, heart rate (HR) and heart rate variability (HRV) were measured to explore how participants physiologically responded to the immersive nature experiences.

The results showed measurable physiological changes during dome sessions, although responses were not uniform across participants. Two main response patterns emerged: residents who were typically calm and bedbound showed signs of increased cognitive engagement, while more restless participants displayed physiological patterns consistent with calming and regulation.

These findings suggest that dome-based virtual nature experiences may support well-being through different regulatory pathways depending on participants’ baseline arousal and behavioral profiles.

Published articles

Peltomäki, S., Gummerus, J., & Kontu, E. (2026). Positive moments in residential settings for adults with profound intellectual and multiple disabilities. Disability & Society, 1–25. https://doi.org/10.1080/09687599.2026.2667532

Manuscript

Niemi, M., Pálsdóttir, A. M., Bohlin, E., Dolling, A. & Slunga Järvholm, L.The effects of virtual nature interventions for clients and care providers in disability services and psychiatric care. Manuscript in preparation for scientific publication 2026.

Gorr, N, Ochi, A., Niemi, M.,  Huotilainen, M. An Accessible Path to Nature: Piloting Virtual Nature Interventions Among Adults with Disabilities by Examining Heart Rate Variability. Manuscript prepared for submission 2026.

Summary presentations (from Vaasa conference, dec. 2025)

Virtual nature interventions for clients with disabilities in Eskoo’s Support and Care units in Seinäjoki, Wellbeing Services County of South Ostrobothnia, Finland.
- Minna Huotilainen, Johanna Mäki-Rautila et.al 

Effects of Virtual Nature Interventions on Heart Rate Variability – A Case of Eskoo Clients 
- Minna Huotilaninen et.al