In the midst of a coming elder care shortage, the case for robot caregivers

[The prospect of robots being used to care for elderly patients suggests many benefits but also raises a variety of concerns including of course those of the people who would receive the care. This story from Slate’s Better Life Lab blog provides a review; see the Pew Research Center study, and a related story in VC Daily, for more information. –Matthew]

[Image: Photo illustration by Lisa Larson-Walker.]

In the Midst of a Coming Elder Care Shortage, the Case for Robot Caregivers

By Amanda Lenhart
November 11, 2017

An elderly woman nestles a white, fluffy baby seal in her arms. She murmurs happily to it, petting it and delighting as it responds to her touch and voice. This baby seal is a robot, a cuddly bot named PARO. And research suggests PARO has therapeutic value, calming and engaging agitated and anxious patients with memory loss. PARO, which can be seen in action on YouTube, is one of the earliest of the therapy bots. He arrived on the scene back in 2004. Since then, simpler, though still interactive, catbots (and dogbots) have democratized the world of therapy bots by bringing down the price to below $100.

Marianna Blagburn, program director at a memory care assisted living facility in Maryland, talks about Sam, a telepresence robot the facility helped pilot at one of the broader network of sites affiliated with her memory care unit: “On our main campus nearby, they had a visiting robot—Sam. They were a beta site for the robot. The bot would come in and ask how people were doing. It was very well-received in that environment—it had value and people got a kick out of it.”

Researchers aren’t just building social and companion bots—they’re hard at work building bots that can dispense medication, lift people, assess their vital signs, and connect them to family. A decade from now, PARO and other companion animal robots and telepresence bots like Sam may be seen as the progenitors of the robots that are caring for us all.

And caregiving is likely to become urgently needed—the Bureau of Labor Statistics suggests that between 2016 and 2026, we will need nearly 1.2 million more professional caregivers to care for our aging population. A recent Pew Research Center study suggests that while a majority (59 percent) of Americans are unenthusiastic about the thought of being cared for or having a loved one cared for by a robot, roughly 40 percent of Americans are open to the idea and even encouraging about its potential positives. But first, we may have to get over our own fears about robots as caregivers. These fears rest on two prejudices: first, that robots would necessarily be bad at caring for us, and second, that humans are particularly good at it.

The main hurdle for most of us around robot caregiving is the machine’s lack of empathy and its inability to forge an emotional connection with patients. Dr. William Leahy, a recently retired neurologist who developed a program that trains interested high schoolers to become certified nursing assistants, says, “When you look at the limitations of artificial intelligence—it’s really the empathy, the decision making, the things based on emotions, which are all limitations of machine learning. The pattern recognition, the verbal skills can all be done by computer, but I think the emotional aspect of care is something that is going to be distinctly human.”

But what if that lack of humanity is actually the feature and not the flaw? There’s a dark side to humans as caregivers that often gets lost in discussions of automation. While people may be more able to be emotionally attuned to their patients, that emotional connection can go awry and not just because the human caregiver is inept. What if you’re a woman of color caring for an individual with dementia who is comfortable expressing racist and sexist sentiments to you? While many dedicated professional caregivers focus on getting through their shifts by managing difficult or offensive patients, other caregivers acknowledge that sometimes difficult emotional relationships compromise care.

In the Pew study, a young woman notes: “I used to work in nursing homes and assisted livings. Human caregivers are often underpaid and overworked. Humans have bias, and if they don’t like a patient that affects their care.” Furthermore, unlike people, a robot never gets tired or tired of hearing your stories. “It wouldn’t get tired, or bored, or forget, or just not care,” says a 53-year-old man in the Pew study. He adds a caveat: “Unless, of course, it’s a high-level AI, in which case it may care.”

Monica Anderson, one of the authors of the Pew report, also notes that alleviating the burden on families and allowing elders to have more independence were important selling points for those who were positive about robots providing care: “People who indicated that they were more interested in a robot caregiver were more likely to cite that it was reducing a burden on family [and] talked about the expensive care that it takes to care for an elderly relative or time constraints that people have in having enough time to take care of one of their older family members. A smaller share also said that it would allow older Americans to be more independent.”

While lack of an emotional connection to a machine is the primary complaint against robots giving care, others point to the limits of the mechanics of the technology. Former certified nursing assistant Priscilla Smith says, “There are too many malfunctions with a machine. A machine can break down at any time,” leaving patients in the lurch. “Sometimes even our wheelchairs won’t roll correctly.”

The Pew report showed that side-by-side caregiving with a human in the mix was instrumental in helping those who felt less comfortable with the idea of robots providing care feel more comfortable. “People would feel better about the concept if there was a human who monitored all actions via camera. About half of all Americans said they would feel more comfortable if there was a human involved,” says Anderson. “That’s what we see with driverless cars and when we asked about using an algorithm for sorting job [candidates]—when you introduce a human component to the automated technologies, people were more positive about it and felt better about the concept.”

Let’s be honest—our future is unlikely to be limited to either human or robot caregivers alone. We’re more likely to find ourselves in a future where we’re cared for by both people and their helping robots. Blagburn suggests that humans and machines working in tandem can complement each other. “Life is very busy. Some workers are doing the work of three and four people, and that’s where we should use robotics to our advantage. That’s where I’d place the importance of robots—lightening the load.”

This may be the messaging needed to convince caregivers they have nothing to fear in the automation of care. Robots can be their companions, not their competition. As for care receivers? The biggest barrier is imagination. Getting patients used to the idea of robot caregivers will happen incrementally—as we demonstrate in small and eventually bigger ways how this could work and what we actually mean when we talk about robots today. That means replacing the unfeeling automatons of our sci-fi nightmares with the increasingly intuitive robots of our present.

Better Life Lab is a partnership of Slate and New America.

Amanda Lenhart is the deputy director of the Better Life Lab and a researcher focusing on the intersection of work, families, and technology.


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