Could robots help in meeting
increasing care needs?
Even though the research on care robots has not led to their wider industrialisation, the market of service robots is increasing steadily and the growth is expected to be significant in the coming years
The Finnish Basic income experiment that started in 2017 is coming to its end. What next?
Ageing of population is a reality in all the European countries. At the same time, there is less informal care provided by the family as women also participate in the labor market, family members often live far away from each other and families are smaller. There is a need to find new ways to support older people who are able and willing to live at home as long as possible as well as to support their families, and informal care givers in organizing care. New robotic technology is expected to help meeting this need in the near future. Care robots are foreseen to increase older people’s autonomy and assist caregivers. Robots are expected to enable renewed ways of providing care, as well as significant reforms of service provision.
By definition, a care robot is a machine which is able to either autonomously or semi-autonomously conduct tasks that are related to physical or emotional care. Care robots have been designed to provide assistance with daily living, cognitive support and training, assistance and support for caregivers, collaboration within a smart-home environment, social interaction and remote medical triage.
A major concern regarding the introduction of care technology is whether it affects the lives of the care recipients in a positive or negative manner, with consideration also given to their family and close ones. The new technologies should always be based on the needs, wants and wishes of the users, and be shaped around the users’ conditions taking into account also the social context in which the technology is to be used.
Robots for care?
Care robots may be categorized in three groups: monitoring, assisting, and social robots. A monitoring robot can help observing behavior and health. It may follow and register factors related to a person’s state of health and safety related issues and, for example, call for help when necessary. These robots can remind the elderly about eating, taking medication etc. and facilitate, for example, interaction with health care personnel. They are also developed to check for signs of stroke or fall.
Assistive care robots support people in everyday needs as butlers or assistants offering help with eating, dressing, toileting or moving from bed to bathroom. Social robots provide companionship and can be used as therapeutic tools, for physical or social activity and entertainment. For instance, a social robot could remind his elderly client of physical or cognitive exercises and instruct him or her accordingly.
A lot of expectations are attached to care robots and other care technologies for helping to solve the questions of increasing care needs and decreasing amount of working age people paying for and providing care. However, until now, such expectations have not materialised and the current household robots are rather low-tech artefacts.
At the moment research, debate and discussions about care robots are vivid in Western societies. The technologies are developing rapidly and future robot-assisted care scenarios are largely presented in the media. Nevertheless, we do not yet have very sophisticated care robots on the market. Even though the research on care robots has not led to their wider industrialisation, the market of service robots is increasing steadily and the growth is expected to be significant in the coming years. Yet, care robots form only a minor share of the market at the moment. Currently a robotic vacuum cleaner is perhaps the most common assistive robot for households. In Finland, a Nordic country with a rather high level of technology use, about 3 per cent of care workers in elder care have encountered care robots in their work.
In sum, the expectations towards care robots have not yet materialized. Rather, technology developers and engineers are urgently searching for the most beneficial directions for their work. Therefore, now it is the time to take part in the discussions and bring in essential questions related to the design and conditions for the possible use of care robots.
Assistive robots to do the job
Some robots are designed to automate human activities to be conducted with little or no human direction. From this point of view care is seen as a series of activities out of which some can be replaced by a technological device to cut costs, to be more effective and to save time and human labor. The feeding robot Obi for home care or autonomous mobile delivery robots Tug and Awabot that are designed for hospital logistics are examples of assistive robots.
A feeding robot assists in eating very practically: brings the food from the plate to the mouth. The idea is that a frail or disabled person does not need a human assistant when s/he can eat with the help of the robot. The American made robot Obi can be rented with a monthly payment of 300 dollars.
Figure 1. The Feeding robot Obi
(Picture from www.meetobi.com)
The logistic robots are developed for delivery and transportation tasks that have formerly been done by human workers in hospitals or other institutions. The logistic robots may transport laundry, medical equipment or mail, for example. The idea is that these kinds of robots effectively take over practical tasks that are essential for care work but are not directly related to care giving. These kinds of tasks do not require, for instance, multi-tasking which combines social and practical skills that only humans have.
Robots for meeting social needs
Social robots are interactive robots capable of affectional bonding. They are designed to meet the intrinsic human needs of emotional bonding. Examples of social robots that are meant for care of older people are the pet-like robot Paro and a small humanoid Zora.
The interactive seal Paro has sensors to recognize light and dark, to recognize being stroken or beaten or being held. It is programmed to learn on a basic level its users behavior. Paro responds to people as if it was a live animal pet and recognizes some words. The producer describes it as an “interactive therapeutic robot designed to stimulate patients with Dementia, Alzheimer's, and other cognition disorders”.
The humanoid Zora is an interactive robot about 60 cm tall whose communication skills consist of being capable of repeating the pre-programmed sentences and tasks. It is capable of directing simple physical exercises or playing games. The robot is designed to be used both with children and older people.
Figure 2. Zora robot (on the left) can dance, Paro robot is an interactive pet
Social robots are designed for affectual bonding, physical or cognitive activities, entertainment and socializing. They do not conduct physical and concrete care tasks but they may be used as interactive tools or instead of pets, for instance. Many social robots including Zora are partially or fully remote controlled to simulate advanced capabilities.
Care robots raise questions and doubts
Care robots as assistive devices may enhance autonomy for those care receivers who want it. Yet, care is different from other services or commodities. Physical, social and emotional encounters are an integral part of care. For example, eating may be an important social event. Also, a person taking care of the logistics and walking on the corridors of a hospital to bring sheets or clean instruments may have a larger social role in the care setting than solely doing the assistive tasks. The fear is that if hospitals or homes are furnished with monitoring and assistive technology, human contacts are minimal and the social and emotional needs for care are forgotten.
Seen purely from the point of view of care ethics, the idea of robots as caregivers is not appropriate since the most essential aspects of care – attentiveness, empathy, encountering a person and responding to changing needs according to situational considerations – call for human presence. Yet, more sophisticated and capable assistive devices than what we have now would be welcome in many situations. People who need care and assistance should have control of their own lives as far as possible. The robotic technologies may bring interesting and important possibilities of increased autonomy for those care receivers who want it.
According to existing theories on care ethics and good quality of care the most essential aspects of care are related to human characteristics and emotional capabilities. From this point of view a robot giving care seems inhuman, deceptive and wrong. However, seen from the perspective of a person who needs assistance but is fully capable of both control and choice, a robot might be a warmly welcomed means for maintaining autonomy. Sometimes people in need for care may not at all want to be dependent on other people but may prefer assistive devices instead.
This research is part of the multi-disciplinary project Robotics and the Future of Welfare Services (ROSE) 2015-2020 funded by the Academy of Finland.
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