healthcare_robotics

Use of robotics in healthcare is steadily rising. New applications ranging from exoskeletons and prosthetics to surgical and nano-robotics have already flooded the market. In fact, healthcare robotics is expected to become a US$ 32.5 Bn industry by 2027 with a CAGR of around 21.3% from 2020 to 2027.  

The COVID-19 pandemic further highlighted the need for robots as integral members of our healthcare workforce. Robots were used for maintaining hospital sanitization through disinfection robots or for fetching medicines.

They were also used as telepresence robots to keep patients’ company during isolation.

The application domain of healthcare robotics is only going to expand as sensors and actuators become smaller and more precise, and artificial intelligence is used to expand the robot’s learning and interaction capabilities.

Despite their vast applications a primary demographic that robots can benefit are ageing adults.

healthcare_robotics_for_elderly

The Case for Introducing Robots in Healthcare:

Countries like Japan, USA, Italy, and Denmark are facing a change in their population demographics as the figures skew in favor of the ageing population.

In the USA alone, the number of people over the age of 65 will make 21% of the population by 2030 as opposed to just 15% in 2018. 

This shift in demographics places substantial burden on healthcare facilities and care providers which may include medical workers as well as family members.  

Most people prefer to age-in-place instead of leaving their lives behind to age in a care facility. However, ageing imposes a significant challenge on a person’s ability to live independently owing to declining health which can affect mobility, memory and may lead to social isolation.

Additionally, for a majority ageing in place the primary caregiver is also an ageing partner or an adult child. Therefore, taking care of another dependent may impose mental and physical side effects on the caregiver as well. 

Caring for elderly in nursing or community homes also poses a challenge due to a shortage of healthcare workers with respect to demand. Research suggests that the addition of each patient to a nurse leads to 23% increase in nurse burnout.

Furthermore, the cost of accessing these care benefits can add significant financial stress to patients or their families. Therefore, digital twin healthcare robotics can play a significant role in supporting the quality of life for ageing adults, allowing them to age with dignity and reducing the stress on care providers. 

There is an abundance of literature available outlining the different services that robots may provide when caring for an elderly person. You can find some of these roles below.

Robotic Involvement in Activities of Daily Living to Improve Quality of Life:

Activities of daily living (ADL) include tasks such as mobility, eating, drinking, dressing, hygiene, and sleep. These tasks are necessary to meet the basic physiological needs of a person. Additionally, robots can support instrumental activities of daily living which are not essential to the person’s survival but significantly add to the quality of life. These activities include tasks such as cooking and house cleaning.  

CRUZR and Pepper

Robots such as Cruzr and Pepper have been deployed at hospitals, private and nursing homes to monitor individuals especially during the COVID19 pandemic. The robots were equipped with sensors to monitor vitals such as blood pressure, oxygen saturation and body temperature and therefore can perform temporal monitoring of the individual’s health.

This allows robots to provide elderly with the requisite health monitoring while keeping the caregivers aware of any emergency that may arise.  

Additionally, robots can set reminders for medicines, meals, and doctor appointments, sometimes even allow the elderly to virtually attend these appointments through telemedicine robots, reducing the need for a caregiver to be physically present to provide care.

This can be critical during pandemics such as the COVID-19 where reducing human-to-human contact can be pivotal in ensuring the health and safety of the elderly without compromising care. Post COVID-19 these robots can continue to perform interventions, as deemed necessary, significantly reducing the burden on the care provider.

Case Study: Improving Remote Elderly Care with Chatbots

Other Robots 

Furthermore, developers have designed some robots to provide physical support to the elderly. 

  • My Spoon has been designed to help individuals with motor control disabilities to eat or get dressed, with minimal dependance on their caregiver.  

Similarly, there are countless examples of robots that can assist elderly in activities of daily living and instrumental daily living such as  

  • HERB- a robot butler that can cook, clean and perform other household functions,  
  • Care-O-bot 3, that can facilitate elderly by fetching objects for them and can alert the police in case of emergency, and  
  • Cody which is designed to give baths to the elderly. 2 

The robots can facilitate elderly with everyday tasks ranging from health monitoring and recovery to physical tasks. And they are just scratching the surface of the potential that robots hold with mediating a decline in elderly health.

robotics_interactions
USC Interaction Lab

Breakthroughs and Potential in Managing Social Isolation, Depression, and Mental Health:

Social Healthcare Robots 

Developers have designed the social healthcare robotics to facilitate interaction between humans-robot and human-human. And they can be significantly helpful in providing emotional and psychological support to the elderly. Unlike robots designed to facilitate activities of daily living, where the appearance of the robot is primarily motivated by robot function, robots designed to provide emotional support can vary in form factor ranging from animal inspired (PAROAIBO) to humanoid robots such as Pepper. 

PARO

Depending on their form factor the support that these robots can provide also varies significantly. For e.g., studies done with the PARO robot which is designed as a therapy robot discuss the positive effect on mood of the elderly, alleviation of loneliness as well as increased interaction among the study participants. 

Pepper and CRUZR

Humanoid robots such as Pepper can guide exercise programs for the elderly in care homes. And they have resulted in longer compliance by the elderly in continuing their routines. Robots such as Pepper and CRUZR are also capable of reducing social isolation for the elderly by keeping them connected with their relatives through video call. However, in providing healthcare and emotional support for the elderly, they act as a mediator between human-human interaction.  

Potential in Dementia and Alzheimer

People with dementia and Alzheimer’s are affected by memory loss and may need to be reminded of the same thing multiple times. This persistent repetition can be exhausting for the care provider who may have other responsibilities. The care taker might therefore respond with short replies that express their frustration.

This can have a significant toll on the elderly’s wellbeing who might not even remember the question.

In these situations, robots can become exemplary mediators as their sole goal can be to facilitate the elderly. Robots bring additional advantages of being patient and unjudgmental about the elderly’s condition or requests for repetition. 

As a result of these benefits, researchers and cognitive scientists are doing investigation to facilitate the elderly through robots.

They imagine the robots benefitting the elderly by preventing social isolation, providing therapeutic support, and other necessary interventions. 

The Challenges of Robot Adoption and Deployment:

Robots hold in enormous potential to provide support to the elderly. However, a fully autonomous robot capable of replacing a nurse or a human caregiver is still some time away. Developers face three separate categories of challenges in robot adoption and deployment. 

Technological Challenges:

Improvements in artificial intelligence, sensors, actuators, embedded computing as well as control strategies have significantly advanced the capabilities of robots. Robots are now capable of learning new techniques through transfer learning and inverse-reinforcement learning to suit user needs.

However, robots still have limited ability to sense nuances in human behaviors. And users need to do significant research to mitigate this gap.  

There are still limitations on power required by a robot to perform all the care work for an ageing individual. Furthermore, developers need to address issues of robot safety, reliability and long-term learning.

Users need to address them before they design fully autonomous healthcare robots to replace human caregivers.  

Commercial Challenges:

Robot commercialization is an additional challenge. Financial barriers to robot adoption for elderly care can be significant. A Paro robot can cost up to $6000, and a Pepper robot can incur a cost of around $23000.

Developers might also come across additional costs for maintenance and training for the system.  

Such steep costs can render robots inaccessible for many or diminish the cost effectiveness when considered against their value. 

Furthermore, there is a need to run mass trials with end users to verify robot safety and operation before successful commercialization and adoption of these healthcare robotics become possible.  

Ethical Concerns:

The biggest concerns that arise from using robotics for elderly care are ethical concerns regarding deception, social substitution and user privacy and dignity. Robots that can express emotions that suggest concern for the elderly can mislead them.

It might lead the elderly into thinking that the robot genuinely cares about them. Similarly, robots capable of providing emotional support may have the negative consequence. Instead of facilitating human social interaction, they might end up substituting for it.  

Furthermore, robots equipped with sensors such as cameras and microphones can also lead to a violation of the individual’s privacy. This is because the elderly might be unaware that the robot is collecting their data in a situation.

Lastly, elderly may feel that they are relying on a mechanical object to take care of themselves. And it might compromise their dignity. 

Conclusion and future outlook:

Despite these challenges, the value that healthcare robotics can add to the system and care of the elderly is undeniable. The COVID-19 pandemic has highlighted several roles in which robots can facilitate elderly to live a more independent life.

It can also enable them to age with dignity through both physical and non-physical support. The benefits of robot intervention also include alleviation of stress of care provision on care providers and healthcare workers.  

To overcome challenges to robot adoption, policies should accelerate robot commercialization and facilitate mass long-term testing. This will enable users to generate the requisite data for verifying robot usability.

Additionally, end-robot users and other stakeholders should engage themselves in the design of the robot. It can lead to valuable dialogue when privacy outweighs concerns over safety, security, and vice-versa.  

Such a process of co-designing with the end user can also help tackle challenges with robot deception and social isolation. This is because the end user develops the detailed description of robot behavior.  

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Rabeya Jamshad

Rabeya Jamshad has a Master's in Electrical and Computer Engineering from Georgia Institute of Technology. Her research interests lie at the intersection of human-robot interaction, control systems and learning. Currently, she is working as the Senior Robotics Engineer at Xavor Corporation where her work is focused on developing rehabilitation facilitation technology for the elderly. You can reach her at: https://www.linkedin.com/in/rabeya-jamshad/