<p>Each time I make a house call, I stay much longer than I should. I can’t leave because my patient is holding my hand, or because she’s telling me, not for the first time, about when Aunt Mabel cut off all her hair and they called her a boy at school, or how her daddy lost his job and the lights went out and her mother lit pine cones and danced and made everyone laugh. <br /><br />I can, and do, write prescriptions for her many medical problems, but I have little to offer for the two conditions that dominate her days: loneliness and disability. Like most older adults, she doesn’t want to be “locked up in one of those homes.” <br /><br />What she needs is someone who is always there, who can help with everyday tasks, who will listen and smile. What she needs is a robot caregiver.<br /><br />That may sound like an oxymoron. In an ideal world, it would be: Each of us would have at least one kind and fully capable human caregiver to meet our physical and emotional needs as we age. But most of us do not live in an ideal world, and a reliable robot may be better than an unreliable or abusive person, or than no one at all.<br /><br />Problems with caregiving<br /><br />Caregiving is hard, tedious, awkwardly intimate and physically and emotionally exhausting. Sometimes it is dangerous or disgusting. Almost always it is 24/7 and unpaid or low wage, and has profound adverse health consequences for those who do it. It is women’s work and immigrants’ work, and it is work that many people either can’t or simply won’t do.</p>.<p>Many countries have acknowledged this reality by investing in robot development. Last year in Japan, where robots are considered iyashi, or healing, the health ministry began a programme designed to meet workforce shortages and help prevent injuries by promoting nursing-care robots that assist with lifting and moving patients.<br /><br /> A consortium of European companies, universities and research institutions collaborated on Mobiserv, a project that developed a touch-screen-toting, humanoid-looking “social companion” robot that offers reminders about appointments and medications and encourages social activity, healthy eating and exercise. </p>.<p>In Sweden, researchers have developed GiraffPlus, a robot that monitors health metrics like blood pressure and has a screen for virtual doctor and family visits.<br /><br />Researchers in the United States are developing robot-caregiver prototypes as well, but we have been slower to move in this direction. Already, we have robots to assist in surgery and very basic “walking” robots that deliver medications and other supplies in hospitals. </p>.<p>Robots are increasingly used in rehabilitation after debilitating events like strokes. But a robot that cleans out your arteries or carries linens isn’t the same as a robot meant to be your friend and caregiver. Even within the medical community, this idea that machines could help fulfill more than just physical needs meets largely with skepticism, and occasionally with outrage.<br /><br />Search YouTube and you can watch developmentally delayed children doing therapy with a cute blue-and-yellow CosmoBot that also collects information about their performance. Or you can see older Japanese people with dementia smiling and chatting happily with a robot named Paro that looks like a baby seal and responds to human speech. <br /><br />Sherry Turkle, an MIT professor and technology skeptic, questions such artificial emotional relationships in her book Alone Together: Why We Expect More From Technology and Less From Each Other. Yet after watching a 72-year-old woman named Miriam interact with Paro, she noted that the woman “found comfort when she confided in her Paro. Paro took care of Miriam’s desire to tell her a story.”<br /><br />The biggest argument for robot caregivers is that we need them. We do not have anywhere near enough human caregivers for the growing number of older Americans. Robots could help solve this workforce crisis by strategically supplementing human care. Equally important, robots could decrease high rates of neglect and abuse of older adults by assisting overwhelmed human caregivers and replacing those who are guilty of intentional negligence or mistreatment.</p>.<p><br />In the next decade, robot caregiver prototypes will become much more sophisticated. Imagine this: Since the robot caregiver wouldn’t require sleep, it would always be alert and available in case of crisis. <br /><br />Are there ethical issues we will need to address? Of course. But I can also imagine my patient’s smile when the robot says comforting words, and I suspect she doesn’t smile much in her current situation, when she’s home alone, hour after hour and day after day.</p>
<p>Each time I make a house call, I stay much longer than I should. I can’t leave because my patient is holding my hand, or because she’s telling me, not for the first time, about when Aunt Mabel cut off all her hair and they called her a boy at school, or how her daddy lost his job and the lights went out and her mother lit pine cones and danced and made everyone laugh. <br /><br />I can, and do, write prescriptions for her many medical problems, but I have little to offer for the two conditions that dominate her days: loneliness and disability. Like most older adults, she doesn’t want to be “locked up in one of those homes.” <br /><br />What she needs is someone who is always there, who can help with everyday tasks, who will listen and smile. What she needs is a robot caregiver.<br /><br />That may sound like an oxymoron. In an ideal world, it would be: Each of us would have at least one kind and fully capable human caregiver to meet our physical and emotional needs as we age. But most of us do not live in an ideal world, and a reliable robot may be better than an unreliable or abusive person, or than no one at all.<br /><br />Problems with caregiving<br /><br />Caregiving is hard, tedious, awkwardly intimate and physically and emotionally exhausting. Sometimes it is dangerous or disgusting. Almost always it is 24/7 and unpaid or low wage, and has profound adverse health consequences for those who do it. It is women’s work and immigrants’ work, and it is work that many people either can’t or simply won’t do.</p>.<p>Many countries have acknowledged this reality by investing in robot development. Last year in Japan, where robots are considered iyashi, or healing, the health ministry began a programme designed to meet workforce shortages and help prevent injuries by promoting nursing-care robots that assist with lifting and moving patients.<br /><br /> A consortium of European companies, universities and research institutions collaborated on Mobiserv, a project that developed a touch-screen-toting, humanoid-looking “social companion” robot that offers reminders about appointments and medications and encourages social activity, healthy eating and exercise. </p>.<p>In Sweden, researchers have developed GiraffPlus, a robot that monitors health metrics like blood pressure and has a screen for virtual doctor and family visits.<br /><br />Researchers in the United States are developing robot-caregiver prototypes as well, but we have been slower to move in this direction. Already, we have robots to assist in surgery and very basic “walking” robots that deliver medications and other supplies in hospitals. </p>.<p>Robots are increasingly used in rehabilitation after debilitating events like strokes. But a robot that cleans out your arteries or carries linens isn’t the same as a robot meant to be your friend and caregiver. Even within the medical community, this idea that machines could help fulfill more than just physical needs meets largely with skepticism, and occasionally with outrage.<br /><br />Search YouTube and you can watch developmentally delayed children doing therapy with a cute blue-and-yellow CosmoBot that also collects information about their performance. Or you can see older Japanese people with dementia smiling and chatting happily with a robot named Paro that looks like a baby seal and responds to human speech. <br /><br />Sherry Turkle, an MIT professor and technology skeptic, questions such artificial emotional relationships in her book Alone Together: Why We Expect More From Technology and Less From Each Other. Yet after watching a 72-year-old woman named Miriam interact with Paro, she noted that the woman “found comfort when she confided in her Paro. Paro took care of Miriam’s desire to tell her a story.”<br /><br />The biggest argument for robot caregivers is that we need them. We do not have anywhere near enough human caregivers for the growing number of older Americans. Robots could help solve this workforce crisis by strategically supplementing human care. Equally important, robots could decrease high rates of neglect and abuse of older adults by assisting overwhelmed human caregivers and replacing those who are guilty of intentional negligence or mistreatment.</p>.<p><br />In the next decade, robot caregiver prototypes will become much more sophisticated. Imagine this: Since the robot caregiver wouldn’t require sleep, it would always be alert and available in case of crisis. <br /><br />Are there ethical issues we will need to address? Of course. But I can also imagine my patient’s smile when the robot says comforting words, and I suspect she doesn’t smile much in her current situation, when she’s home alone, hour after hour and day after day.</p>