“It’s just a robot” — Perspectives of the elderly on assistive robots in care

Picture this situation: your parents are getting older, and you start worrying about them. Of course, you want them to live independently for as long as possible, but you also start noticing little incidents that make you realise they will need care at some point. This is difficult, because you have a job, a family, and many other obligations, so you won’t be able to care for them yourself. At the same time, you’ve heard stories about understaffing and stress in nursing homes, so you feel worried because you want the best for your loved ones. Sound familiar? It does to many people.

By now, it has become common knowledge that society is aging rapidly and there is an alarming shortage of professional caregivers. The World Health Organization is projecting the global lack of caregivers to amount to ten million by 2030(1). This leads to an imbalance between seniors in need of care and available nurses.

There is hope — if we do it right
Care robots could be part of a solution for this problem, ideally through taking over routine service tasks and assisting caregivers. Thus, they can free up capacities in nurses for more personal interactions with seniors and deeper emotional contact, both of which are amongst the core needs of seniors. This ideal situation is nicely illustrated in this quote by an 86-year-old interview participant:
“The machine does all the routine tasks. Humans are creative, just as creative as their creator; thus the human does the sophisticated tasks. Humans are too valuable for any routine.”

It is crucial to focus on the interaction between seniors and caregivers instead of seniors and robots. According to my findings from my master thesis project, robots should be viewed as tools which help caregivers in performing their tasks, but the role of the nurse remains fundamental. In other words, and this was stated very often by interview participants, robots shouldn’t perform care tasks on their own. A human caregiver must be present and in control of the situation at all times.
A human being in charge and the robot being a tool is critical in order to respect the human’s personhood and preserve their dignity, primarily that of the senior. Robots telling seniors what to do would be an ethically questionable paradigm shift. Another senior participant explained this very clearly:
“I think this is a fine line, the people must be able to decide, or at some point someone has to decide for them, when they can’t think for themselves anymore. In principle the seniors must be able to decide how things proceed, who may do what with them. Then I could imagine that this may be helpful.”

So what now?
Assistive robots can provide valuable relief for caregivers and have the potential to complement the nurse-senior relationship in a synergetic way. To achieve this, it is important to take the views of both seniors and caregivers into account during robot development(2). This is especially true because issues surrounding this matter, such as human dignity, interpersonal contact, or senior’s emotions are highly individual and nuanced. Privacy however, a matter that is frequently discussed when it comes to digital technologies, was not an issue for the elderly participants in this study. Quite often, they prioritised health and safety benefits, or pointed out that there are already plenty of places where their personal data is stored, such as the databases of doctors and care homes.
It should be noted that those findings apply mainly to institutional care settings and may vary for seniors living autonomously at home using social robots.

(1)See also
Schulze S, Holmberg C. (2021). Bedeutung und Belastung von Pflegekräften während der Corona-Krise. Public Health Forum;29:32–5
and
Deutscher Bundesverband für Pflegeberufe (2021). Pflegeberuf: Kein Grund zu bleiben — Treibt die Pandemie weltweit Pflegefachpersonen aus dem Beruf? Pressemitteilung. (11.03.2021). https://www.dbfk.de/de/presse/meldungen/2021/Treibt-die-Pandemie-weltweit-Pflegefachpersonen-aus-dem-Beruf.php

(2)See also
Ienca et al., M. (2018). Health professionals’ and researchers’ views on intelligent assistive technology for psychogeriatric care. Gerontechnology, 17(3), 139–150
and
Lukasik, S., Tobis, S., Kropinska, S., & Suwalska, A. (2020). Role of assistive robots in the care of older people: survey study among medical and nursing students. Journal of Medical Internet Research, 22(8). doi:https://doi.org/10.2196/18003