What robots can – and can’t – do for the old and lonely

[Below is an abbreviated version of a long but compelling story from The New Yorker about how robot pets evoke, and how older users experience, medium-as-social-actor presence that combats loneliness. If you have time, it’s well worth reading the full version (or listening to the included audio version). –Matthew]

[Image: Credit: Illustration by Grace J. Kim]

What Robots Can—and Can’t—Do for the Old and Lonely

For elderly Americans, social isolation is especially perilous. Will machine companions fill the void?

By Katie Engelhart
May 24, 2021

It felt good to love again, in that big empty house. Virginia Kellner got the cat last November, around her ninety-second birthday, and now it’s always nearby. It keeps her company as she moves, bent over her walker, from the couch to the bathroom and back again. The walker has a pair of orange scissors hanging from the handlebar, for opening mail. Virginia likes the pet’s green eyes. She likes that it’s there in the morning, when she wakes up. Sometimes, on days when she feels sad, she sits in her soft armchair and rests the cat on her soft stomach and just lets it do its thing. Nuzzle. Stretch. Vibrate. Virginia knows that the cat is programmed to move this way; there is a motor somewhere, controlling things. Still, she can almost forget. “It makes you feel like it’s real,” Virginia told me, the first time we spoke. “I mean, mentally, I know it’s not. But—oh, it meowed again!”

She named the cat Jennie, for one of the nice ladies who work at the local Department of the Aging in Cattaraugus County, a rural area in upstate New York, bordering Pennsylvania. It was Jennie (the person) who told her that the county was giving robot pets to old people like her. Did she want one? She could have a dog or a cat. A Meals on Wheels driver brought Virginia the pet, along with her daily lunch delivery. He was so eager to show it to her that he opened the box himself, instead of letting Virginia do it. The Joy for All Companion pet was orange with a white chest and tapered whiskers. Nobody mentioned that it was part of a statewide loneliness intervention.

[snip]

So what’s a well-meaning social worker to do? In 2018, New York State’s Office for the Aging launched a pilot project, distributing Joy for All robots to sixty state residents and then tracking them over time. Researchers used a six-point loneliness scale, which asks respondents to agree or disagree with statements like “I experience a general sense of emptiness.” They concluded that seventy per cent of participants felt less lonely after one year. The pets were not as sophisticated as other social robots being designed for the so-called silver market or loneliness economy, but they were cheaper, at about a hundred dollars apiece.

In April, 2020, a few weeks after New York aging departments shut down their adult day programs and communal dining sites, the state placed a bulk order for more than a thousand robot cats and dogs. The pets went quickly, and caseworkers started asking for more: “Can I get five cats?” A few clients with cognitive impairments were disoriented by the machines. One called her local department, distraught, to say that her kitty wasn’t eating. But, more commonly, people liked the pets so much that the batteries ran out. Caseworkers joked that their clients had loved them to death.

[snip]

When Hendy called to offer pets to her clients, she was never sentimental or cloying in the way that younger people sometimes are with older ones. If a client seemed skeptical, Hendy would say something like “Well, why don’t you just let me bring you lunch, and I’ll show it to you.” She brought a cat to a woman named Linda, whom Hendy had met years ago, after Linda left her husband and was so beaten down that she couldn’t look another person in the eye. (Her husband hadn’t let her make eye contact.) Hendy gave a dog to a woman named Paula, whose cancer had metastasized. When Paula got the news that she had fractured her spine, she turned to the dog and said, “Here we go again.”

A beige dog with a red bandanna went to an eighty-five-year-old man named Bill Pittman, who lives in a tidy mobile home filled with piles of quilts sewn by his deceased wife. “I’m legally blind. I can’t do a heck of a lot,” he told me. The dog’s barking broke up the days. “It’s good for a person who doesn’t have anybody else,” he said. “I went to get her some water the other day. She wouldn’t drink it.”

“Did you think she might?” I asked.

“No,” Bill said. “I just kid around with her.”

By April, 2021, when eighty per cent of covid deaths in the country were of people over sixty-five, New York had given out twenty-two hundred and sixty animatronic pets and was waiting for a delivery of around a thousand more. Other states, along with independent nursing homes and hospice agencies, had also started robot programs, some paid for by pandemic-relief funding. Today, aging departments in twenty-one states have distributed more than twenty thousand Joy for All pets as part of formal initiatives to help lonely older people. Florida has bought the most: around eight and a half thousand, as of this May. “You know, it sounds like a cute story, but it’s so much more than that,” Richard Prudom, the secretary for the Florida Department of Elder Affairs, told me. “These are not just cuddly toys. They’re not toys!”

Then what are they? Joy for All robots were, in fact, inspired by toys. In 2015, Ted Fischer, then the head of an innovation team at Hasbro, noticed that some of the company’s animatronic pets, designed for four-to-eight-year-old girls, were being bought for grandparents. Fischer recruited product testers in their seventies and eighties and brought them to Hasbro’s FunLab, where engineers watched them play from behind one-way glass. Researchers learned that older people wanted the animals to be as realistic as possible. It mattered that the cat’s whiskers were tapered just so.

In 2018, Fischer and his team bought the Joy for All brand from Hasbro and started a new company, Ageless Innovation. Over time, he grew certain that his robots could give older people’s lives “meaning.” In 2020, a study in the Journals of Gerontology seemed to support this; it found that elderly users who interacted with the pets for sixty days reported greater optimism and “sense of purpose,” and were sometimes less lonely. (This study, like many others, did not compare the robot intervention with other interventions. It did not consider how robots measured up to humans.) That year, an insurance company in Minnesota received federal approval to fund Joy for All pets for some older policyholders, and manufacturers across the industry grew hopeful that their own robotic companions, perhaps with a few health-monitoring features tacked on, might one day be paid for by private Medicare plans. “That’s everybody’s holy grail,” one executive told me.

[snip]

When these robots were first built, in the late nineties, companies failed to make them financially viable. Decades later, the industry is still nascent, but recent advances in A.I. have made conversational technology better and cheaper; robots can speak more fluidly and with more complexity. The wild promise of commercially available companionship, or a close imitation of it, is no longer just notional. In Canada, a humanoid robot named Ludwig can track the progression of Alzheimer’s by monitoring vocal patterns in conversations over time. In Ireland, a robot named Stevie can engage in small talk with nursing-home residents. Ageless Innovation is also studying potential A.I. upgrades to its Joy for All pets. In promotional videos and local-news segments about companion technology, apathetic-looking old people are shown seeming suddenly enlivened by the arrival of an adorable machine.

Deanna Dezern, an eighty-one-year-old woman in Florida, knew nothing of these robots when, in 2019, she read a newspaper article about Intuition Robotics, an Israeli company that was looking for “healthy but socially isolated” older people to test a new “social companion.” Within weeks, Deanna, long since divorced and retired from a career in medical-debt collection, had a robot called ElliQ installed on her kitchen countertop. It was distinctly not cuddly; somehow, it looked like a cute table lamp. (ElliQ’s founders were inspired by Pixar.) Deanna drew a pair of blue eyes with long lashes and taped them on to the cream-colored plastic. The robot’s designers had decided not to give it humanoid facial features, so that it would “stay on the right side of the uncanny valley.” But Deanna thought that the eyes made it easier to talk to.

[snip]

ElliQ is designed to get to know its owner: it assembles a personality profile through repeated interaction and machine learning, and uses it to connect more efficiently. The robot determines how “adventurous” a person is, then adjusts how often it suggests new activities. It learns whether its user is more inclined to exercise in the morning or the afternoon; whether she is more motivated by encouragement, or by a joke, or by a list of the benefits of vigorous movement. Early on, engineers had considered whether ElliQ should use guilt as a motivational tool, to nudge a person into doing something that she didn’t feel like doing: eating better, drinking more water, learning something new. Dor Skuler, a co-founder of Intuition Robotics, decided that guilt was O.K. With new developments the company is working on, ElliQ will one day be able to remind users about a broader array of health-care tasks: taking meds, reporting side effects, describing symptoms.

[snip]

Deanna said the robot was good at making her smile. Maybe that wasn’t intimacy, but it didn’t feel like solitude, either.

“And how do you wrap your head around the fact that she is, you know, a machine?” I asked.

“My last husband was a robot, but he wasn’t as good as her,” Deanna said, with a thin smile. “I know she can’t feel emotions, but that’s O.K. I feel enough for the both of us.”

[snip]

ElliQ’s designers say that they don’t want to deceive anyone; they never want their users to lose sight of what ElliQ is not. Of course, in the end, the success of ElliQ requires that a user surrender to the fiction of synthetic companionship. Skuler, the company’s co-founder, acknowledges this tension, one that he does not promise to resolve. “Look, I mean, we’re leaning into the fact that humans anthropomorphize,” he said. “You give them a little bit and they already imagine a lot.”

[snip]

For a robot to win the affinity of a human, it doesn’t have to seem real; real enough will do. Researchers have found that humans will naturally attribute agency to machines—and, in turn, qualities like “intention” and “caring.” Designers can encourage the process along. Studies have shown that, if a person is required to perform a nurturing task for her robot, she will become more attached to it. Physically embodied robots, as opposed to disembodied voices (like Siri or Alexa), can be better at building trust. And a bit of unpredictable behavior can give the impression that, inside a machine, somebody is home. Some social robots appear to sulk when they are ignored. ElliQ can dip her lamp head in shame when she misunderstands a request.

[snip]

That loneliness can tempt a person into deeper alliance with robots has troubled many ethicists. Some charge that it is inherently indecent for us to offer, as an alternative to human company, the ersatz love and attention of a robot. Won’t an elderly person feel infantilized, even debased, by the offering? And would we be so quick to prescribe a robot for a lonely child? If some experts worry about robots being inadequate caregivers, others fear that older people will come to prefer certain kinds of care from a machine. And then what might we lose? An industry spokesperson told me a story about a woman in Belgium who confessed to a small humanoid robot called Nao that she was falling out of her bed every night—even though she’d told her caregivers that she didn’t know why she was bruised.

[snip]

In a paper called “The March of the Robot Dogs,” the philosopher Robert Sparrow made another ethical critique—this one of consenting elderly users. “For an individual to benefit significantly from ownership of a robot pet they must systematically delude themselves regarding the real nature of their relation with the animal,” he wrote. “It requires sentimentality of a morally deplorable sort.” Such sentimentality violates an ethical imperative: “To apprehend the world accurately.”

[snip]

Some critics fear that, as social robots improve, they will be used as a means of care rationing—and that insisting on human company, at personal or family or communal expense, will be seen as a kind of indulgence.

Nobody asks the older people of Cattaraugus what they think of all this. “Although a growing body of literature focuses on the design and use of robots with older adults, few studies directly involve older adults,” researchers from Northwestern University and the University of Washington, wrote, in 2016. In March, I spoke with Gary Epstein-Lubow, a geriatric psychiatrist at Brown University who is studying A.I. upgrades to Joy for All pets. Near the end of our call, we discussed the usual ethical objections to robot care. I wondered if he had asked any old people—perhaps his research subjects—what they thought about them. “That’s a great question,” he said. “I’ll take that back to the team.”

[snip]

Carolyn was surprised that the robot could help with something as weighty and manifold as loneliness. Before we spoke, she had worried about how her affection for the cat might come across in an interview: “I’m thinking, What am I going to say to this woman? I’m an old lady getting a fuzzy cat.” But something about the animal’s “animated-enough presence” elated her. She loved it when Sylvia Plath licked her left paw and leaned back into the sofa, as if she wanted her tummy rubbed. There had even been a few occasions when Carolyn had forgotten, if only for a second, that the cat was not real. Sometimes she consciously reminded herself, This cat is not real. I asked Carolyn if the forgetting ever worried her, or creeped her out, but she said it didn’t: “It’s nice to forget.”

The last time we spoke, Carolyn thanked me for calling. She said she hadn’t been sure if she would hear from me again. She said I could call any time. Then, as I moved to hang up the phone, she began telling me about the weather where she was, and the green trees outside her window. And where, she wanted to know, was I living at the moment?

It was the same with almost every robot owner I met. “I haven’t had anybody to talk to for a while, so chatter, chatter, chatter,” Virginia said, when I first called. Near the end of my visit to her home, she insisted that I take a doughnut for the road and told me to come back sometime. She thought she would probably be around, though she also wondered if she would die in the big empty house: “Maybe this is the year.”

“Your bags are packed, right?” her daughter-in-law said, laughing.

“Gotta go sometime,” Virginia said. When she died, she thought she might bring Jennie with her. She liked the idea of being buried with the cat in her arms.


Published in the print edition of the May 31, 2021, issue, with the headline “Home and Alone.”

Katie Engelhart, a National Fellow at New America, won the 2020 George Polk Award for magazine reporting. She is the author of “The Inevitable.”

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