Would you trust a robot to look after the people who brought you into this world?

While most of us would want our parents and grandparents to have the attention of a kindly human when they need assistance, we may have to make do with technology.

The reason is: there are just not enough flesh-and-blood carers around. We have more seniors entering aged care than ever before, living longer and with complex needs, and we cannot adequately staff our aged care facilities.

The percentage of the Australian population aged over 85 is expected to double by 2066 and the aged care workforce would need to increase between two and three times before 2050 to provide care.


The looming dilemma

With aged care workers among the worst-paid in our society, there is no hope of filling that kind of demand. The Royal Commission into aged care quality and safety is now underway and we are facing a year of revelations about the impacts of understaffing, underfunding and inadequate training.

Some of the complaints already aired in the commission include unacceptably high rates of malnutrition among residents, lack of individualised care and cost-cutting that results in rationing necessities such as incontinence pads.

While the development of “assistance robots” promises to help improve services and the quality of life for those in aged care facilities, there are concerns that technology should not be used as a substitute for human contact.

Connection and interactivity

Human interaction is a critical source of intangible value for the development of human beings, according to Dr Costantino Grasso, Assistant Professor in Law at Coventry University and Global Module Leader for Corporate Governance and Ethics at the University of London.

“Such form of interaction is enjoyed by patients on every occasion in which a nurse interacts with them. The very presence of a human entails the patient value recognising him or her as a unique individual rather than an impersonal entity.

“This cannot be replaced by a robot because of its ‘mechanical’, ‘pre-programmed’ and thus ‘neutral’ way to interact with patients,” Grasso writes in The Corporate Social Responsibility And Business Ethics Blog.

The loss of privacy and autonomy?

An overview of research into this area by Canada’s McMaster University shows older adults worry the use of socially assistive robots may lead to a dehumanised society and a decrease in human contact.

“Also, despite their preference for a robot capable of interacting as a real person, they perceived the relationship with a humanoid robot as counterfeit, a deception,” according to the university.

Older adults also perceived the surveillance function of socially assistive robots as a threat to their autonomy and privacy.

A potential solution to the crisis

The ElliQ, a “home robot” now on the market, is a device that looks like a lamp (with a head that nods and moves) that is voice activated and can be the interface between the owner and their computer or mobile phone.

It can be used to remind people to take their medication or go for a walk, it can read out emails and texts, make phone calls and video calls and its video surveillance camera can trigger calls for assistance if the resident falls or has a medical problem.

The manufacturer, Intuition Robotics, says issues of privacy are sorted out “well in advance”, so that the resident decides whether family or anyone else should be notified about medical matters, such as erratic behaviour.

Despite having a “personality” of a helpful friend (who willingly shoulders the blame for any misunderstandings, such as unclear instructions from the user), it is not humanoid in appearance.

While ElliQ does not pretend to be anything but “technology”, other assistance robots are humanoid in appearance or may take the form of a cuddly animal. There are particular concerns about the use of assistance robots for people who are cognitively impaired, affected by dementia, for instance.

While it is a guiding principle in the artificial intelligence community that the robots should not be deceptive, some have argued that it should not matter if someone with dementia believes their cuddly assistance robot is alive, if it brings them comfort.

Ten tech developments in Aged Care

1. Robotic transport trolleys:
The Lamson RoboCart delivers meals, medication, laundry, waste and supplies.

2. Humanoid companions:
AvatarMind’s iPal is a constant companion that supplements personal care services and provides security with alerts for many medical emergencies such as falling down. Zora,  a robot the size of a big doll, is overseen by a nurse with a laptop. Researchers in Australia found that it improved the mood of some patients, and got them more involved in activities, but required significant technical support.

3. Emotional support:
Paro is an interactive robotic baby seal that responds to touch, noise, light and temperature by moving its head and legs or making sounds. The robot has helped to improve the mood of its users, as well as offers some relief from the strains of anxiety and depression. It is used in Australia by RSL LifeCare.

4. Memory recovery:
Dthera Sciences has built a therapy that uses music and images to help patients recover memories. It analyses facial expressions to monitor the emotional impact on patients.

5. Korongee village:
This is a $25 million Tasmania facility for people with dementia, comprising 15 homes set within a small town context, with streets, a supermarket, cinema, café, beauty salon and gardens. Inspired by the dementia village of De Hogeweyk in the Netherlands, where residents have been found to live longer, eat better, and take fewer medications.

6. Pub for people with dementia:
Derwen Ward, part of Cefn Coed Hospital in Wales, opened the Derwen Arms last year to provide residents with a safe, but familiar, environment. The pub serves (non-alcoholic) beer, and has a pool table, and a dart board.

7. Pain detection:
PainChek is a facial recognition software that can detect pain in the elderly and people living with dementia. The tool has provided a significant improvement in data handling and simplification of reporting.

8. Providing sight:
IrisVision involves a Samsung smartphone and a virtual reality (VR) headset to help people with vision impairment see more clearly.

9. Holographic doctors:
Community health provider Silver Chain has been working on technology that uses “holographic doctors” to visit patients in their homes, creating a virtual clinic where healthcare professionals can have access to data and doctors.

10. Robotic suit:
A battery-powered soft exoskeleton helps people walk to restore mobility and independence.