The promise and pitfalls of using robots to care for the elderly

In the living room of her home, an elderly woman named Claudine is slow-dancing with a robot. The humanoid robot’s name is B.E.N., an acronym derived from Bionically Engineered Nursing. Like an embodied version of Siri or Google Assistant, B.E.N. is designed to offer 24/7 help to Claudine whenever she needs it. B.E.N. can bring Claudine her meds. It can wake her up in the morning. And, if she’s sad, it can comfort her — by offering solutions like watching TV or, in this case, dancing.

Depending on your perspective, this scenario could be a positive game-changer for caregiving or, perhaps more likely, a disturbing techno-dystopian nightmare straight out of Black Mirror. Fortunately for those in the second group, it’s not real. Well, not exactly. The scenario is the provocative opening scene of an ad for France’s Society of St. Vincent de Paul charity, intended to highlight the plight of old age loneliness. It also pushes the idea that, in some domains, no technology can substitute for real human contact.

But while the ad may present a science fiction take on caregiving robots, a growing number of real-world researchers and companies are developing tools designed for exactly this task. And, despite what you might initially fear, the results are really promising.

The rise of social robots

Why caregiving robots would be considered desirable is no mystery. As robots have become more capable of interacting both verbally and physically with humans, a wealth of possible new applications have opened up. Caring for the elderly, as well as those with neurological diseases such as dementia, is one obvious use case. This is especially true of societies in which birth rates are slowing, while people are simultaneously living longer. It’s no accident that much of the innovation has taken place in Japan: a country which has led the way in robotics research and acceptance, but does not have enough young people to adequately care for its elderly population.

The results of these initiatives are “affective” robots such as Wandakun the robot koala and Paro the robot seal. Such robots cannot carry out physical tasks like preparing meals or fetching items on command. Instead, they are designed to provide emotional support. Paro is able to make eye contact by sensing where a human voice is coming from. It is also able to sense touch and, based on how it is stroked, change how it responds. The idea, supported by the U.S. Food and Drug Administration (FDA), is that as users comfort Paro by giving it the comfort it “needs,” they also comfort themselves.

Paro was among the first of these kinds of robots, but it is not the last. With a price tag in the region of $6,400, it is too expensive for many to own — but other cheaper products, such as the Tombot, created with support from the legendary Hollywood animatronics company Jim Henson’s Creature Shop, are now appearing on the market.

On the surface, robots like Paro and Tombot aren’t all that different from the B.E.N. robot which danced with Claudine. But there is reason to believe that it can be. Research has suggested that, rather than replacing human interaction, the presence of a Paro robot can actually increase socializing between residents in locations such as care homes. It can, for instance, help improve the mood of being feeling depressed or withdrawn — and make them more likely to interact as a result.

It may also help individuals with dementia to calm down and feel more comfortable. One study related the story of a female resident in a care home, suffering from mid-stage dementia. After not speaking for more than one year, she joined a table of other residents stroking a Paro seal. She then started to talk about growing up on a farm and caring for the animals there.

Caring for the caregivers

Robot could also support caregivers, in addition to the people being cared for. This could mean helping out with physical tasks, thereby freeing up more of their time and energy to spend interacting with the people they are looking after. It could also mean supporting the mental health needs of caregivers who may be struggling to cope with family members or other loved ones with dementia.

“Caregivers themselves have a high rate of physical, cognitive, and mental health issues at rates much higher than their age-matched cohorts,” Laurel Riek, an Associate Professor of Computer Science and Engineering at the University of California San Diego, told Digital Trends. “Caregivers often undervalue their own care in relation to their caregivee. Exploring the use of technology to help provide caregivers support has the potential to be beneficial to many people.”

Recently Riek and a team of scientists spent six months working with family members, social workers, and other caregivers to help ascertain their needs in terms as caregivers when designing robots for people with dementia. As part of the work, the UC San Diego researchers co-designed robots with the caregivers. The project helped highlight specific use cases for such robots — such as being able to interject and help redirect conversations when the person being cared for was asking challengingly difficult repetitive questions.

“It was interesting that caregivers envisioned robots for supporting joyful moments between their caregivees and themselves,” Riek continued. “It also was interesting how caregivers decided to design their robots in terms of appearance and behavior. For people with early stage dementia, caregivers wanted robots that were in the background, and were helping mediate interaction between caregiver and caregivee. In later stages of dementia, caregivers preferred robots to be more in the foreground to help interact with their caregivee and provider caregivers with respite.”

Project like this provide a far more nuanced insight into the role that robots can play in these scenarios than simply ruling it dismissing it altogether. “We are now building high-tech prototypes based on the robot designs caregivers created,” Riek said. “We look forward to running pilots with them in homes this Fall.”

Promoting independence

There’s another twist to the story, too. More dystopian takes on robot caregivers imagine a kind of sterilized institutionalism. We picture old folks in sheltered accomodation, receiving no human contact for days; stuck in a chair stroking a robot pet, with meals delivered by delivery bots. But cutting edge technology could also promote new levels of independence that allow people to live for longer in their family homes.

Tools like robotic exoskeletons can help people with limited mobility to more easily maneuver about. Smart homes can also be designed to help facilitate independent living. This could be something as simple as voice recognition technology to operate lights, televisions and more. It could be more complex, too — with the house playing a key part in observing behavior to look for signs that a person is not coping.

One company playing an active role in this area is IBM. Nicola Palmarini is an IBM research scientist whose A.I. lab in Cambridge, Massachusetts has explored this application of artificial intelligence for around a decade. “Our purpose is to focus on how much we can support people living independently in their own homes,” Palmarini said. “We want people to be able to remain healthy in their own ecosystem and environment.”

This month, IBM Research U.K. announced a new partnership with the British startup Cera Care to carry out a six-month pilot study to see whether Lidar technology, the bounced laser tech which helps autonomous cars to “see,” can be used as a privacy-conscious way to monitor behavior. As part of the study, they will install these sensors in up to 15 houses in the U.K. to see whether this tech, combined with machine learning tools, could be useful in keeping tabs on resident’s health. These Lidar sensors will be positioned as unobtrusively as possible while maintaining their functionality. Once set up, they do not need any regular servicing.

Without resorting to filming people with a camera, IBM U.K. and Cera Care hope that this technology could help spot changes in the way a person walks or identify emergency situations. It could then alert caregivers if necessary. Such machine learning tools could even prove better at spotting changes than humans due to their ability to analyze alterations in behavior over long periods of time.

“We believe that sensors and A.I. is the future of at-home care and the only way to keep up with ever-growing demand for these type of services,” said Dr. Ansgar Lange, Chief Product Officer at Cera Care. “Additionally, technology can help to overcome the ever growing finance gap and support a sustainable care and healthcare system. While this kind of approach is only starting to get traction today, when today’s tech savvy demographic starts caring for relatives in the future, this kind of digital solution will seem second nature and we anticipate will be widely embraced by the care industry.”

Dull, dirty, dangerous, and… caring?

There are all sorts of reasons we may worry about handing a role as human over to a machine. Robots and A.I., we are frequently told, promise to carry out the three d’s of work: the dangerous jobs, the dull jobs, and the dirty jobs. None of these hopefully apply to looking after our elderly relatives. But, while few people would wish to hand over 100% of caregiving to robots — any more than we would not visit a parent on their birthday because we know that Facebook will send them an automated message — it’s also important to realize that there are uses for technology in this domain.

A growing amount of research suggests that the best partnerships are those which involve humans working alongside robots and A.I. Denying that there is a place for technology in caring occupations is shortsighted, and risks losing out on some really valuable possibilities. Deciding we don’t want robots involved in caregiving altogether is like deciding that, because you wouldn’t want a robot doctor to tell you that you’re dying, there’s no space for A.I. in hospitals.

Plenty more work needs to be done in this space going forward. It’s also crucial that these tools are viewed as augmenting human carers, rather than replacing them. But the good news is this: The people making these robots share exactly the same concerns that you do. And they’re in no rush to build a B.E.N.-like mistake.