Virtual Reality Cognitive Intervention for Critically Ill Delirium Survivors (VR-Cog)

Inclusion Criteria:

* Adults aged 50 years or older
* English speaking
* Admitted to the intensive care unit (ICU) with acute respiratory failure/invasive mechanical ventilation
* Screening positive for delirium (using Richmond Agitation Sedation Scale and Confusion Assessment Method for the ICU)

Exclusion Criteria:

* Acute neurologic injury such as stroke, traumatic brain injury, brain mass, intracranial hemorrhage, seizures, or central nervous system infection
* Chronic cognitive or physical function deficit preventing participation in study interventions or assessments (determined by chart diagnoses and direct participant interview)
* Chronic cognitive impairment (including mild cognitive impairment or dementia) identified by chart diagnosis, prescription of anti-dementia medications, or Informant Questionnaire on Cognitive Decline in the Elderly Score (IQCODE) \>3.3 obtained from family caregiver
* Severe, uncorrected vision or hearing impairment preventing participation in intervention or outcomes assessments
* Admitted with acute alcohol or drug intoxication or withdrawal
* Severe, uncontrolled psychiatric disorder (bipolar disorder or schizophrenia)
* History of severe vertigo, motion-induced sickness, headaches, light sensitivity, seizures, or prior intolerance of virtual reality (VR)
* Receiving comfort care measures or not expected to survive the hospitalization
* Prisoners or patients unable to provide consent
* Not expected to be discharged home from the hospital, or living more than 50 miles from the nearest recruitment site, or homeless