Can robots help care for us as we age?
In fifteen years there will 50% more over 65s than there are today, and the proportion of older people in our society will continue to grow for some time after that. The 2013 House of Lords report Ready for Ageing? looked at the likely consequences of this on-going demographic shift and stated the problem plainly: ‘The UK population is ageing rapidly, but the Government and our society are woefully underprepared’.
On 5th March politicians from all parties will appear at an eventin London, organised by the Guardian newspaper, to explain their policies for addressing the ageing challenge. I hope they offer some ambitious proposals: the status quo is not an option.
The Ready for Ageing Alliance, a coalition of charities and think-tanks, has already produced its eleven-point manifesto for action. Its focus is primarily on what we as individuals can do to meet the coming challenge, emphasising healthy living, active lifestyle, saving for retirement, forward planning, being part of social networks, staying positive.
Of course we can each play our part, but that won’t solve the problem. Our pension, health and social care systems are already under severe strain. How will they cope as the pressure mounts?
I’ll be looking to see how much thought the politicians have given to how new technologies could help. I was amazed how little the House of Lords Committee said about this. In over a thousand pages of material there is barely a mention of the potential of new developments such as the internet of things, smart homes, and robotics. Of course, as the Lords report points out, new technologies are not a panacea. However, we are a nation of inventors, designers and entrepreneurs, and in the past we have often used these talents to help us out of tight situations. Given the current challenge, we would do well to sharpen our vision and look where human ingenuity could take us.
My interest in this is both as an ageing UK citizen and as a technologist. I have spent much of the last 25 years trying to solve problems in artificial intelligence and robotics. In 2011 I was invited to lead a European working group on the potential societal impacts of robotics. We quickly decided to focus on the possible use of robots to address the Europe-wide demographic shift. Ever since then I’ve been convinced that there’s an opportunity here that is too important to let pass.
The current telehealth technologies are mainly about monitoring and providing healthcare advice. The underlying digital computer and telecommunications technologies have a fundamental limitation: they can’t physically act in the world. This is where robots are different and can make a game-changing contribution.
In a recent blog piece for Wired magazine I described a number of ways that assistive robots could help us as we age: maintaining our environments by doing chores like cleaning, and helping us with eating, toileting, and dressing. In that piece, I make it clear that these robots are unlikely to be human-like or ‘humanoid’. Rather, many of them will be home appliances that simply do more by themselves. The current generation of robot vacuum cleaners exemplifies this possibility. We shouldn’t feel surprised or threatened by this development: it continues a long-term trend. After all, look at what happened with the first form of automation to enter the home – the washing machine. We no longer wash clothes by hand or squeeze out water with a mangle. Assistive robotic technologies will evolve along similar trajectories. By 2030, robot cleaners and helpers will be part of a larger ecology of smart devices that will have transformed the way we perform household tasks, making our living spaces easier to manage as we grow old.
Assistive robots can also help at a more personal level. Together with the designer, Sebastian Conran, and with advice from occupational therapists and ex-patients from Sheffield Teaching Hospitals, I am currently developing a robotic over-bed table. If disability confines you to bed or to a wheelchair, our table will come to you rather than you go to it. When you are finished with the table it will move back to a safe place and recharge. This is a not major breakthrough in robotics – the AI required is similar to that of the robot vacuum cleaner – but our main challenge is to make the table completely safe and genuinely useful. We imagine that one situation where people will use these tables is within hospital wards so they need to be able to move around safely within the ward without bumping into people or other objects. Once they are in position over a bed they also need to self-adjust safely, and to ensure that any objects placed on the table top do not fall off. Each of these challenges requires appropriate sensing and some significant artificial intelligence.
At a still more intimate level, consider personal hygiene. Smart toilets that can provide cleaning and drying of intimate areas are already in widespread use in parts of the world such as South Korea and Japan. In the coming decade, we can extend the functionality of intelligent bathroom fittings so that they are more useful to people with age-related disabilities. For many people, being helped with their personal hygiene by a carer – potentially a complete stranger – is embarrassing and demeaning. Assistive robots can help us retain control over our lives and our bodies, allowing us to live independently for longer.
People also worry that using technology in this way might increase the isolation that is already often a problem for older people. The current generation of telehealth technologies puts some aspects of care at a distance, and assistive robots will replace some tasks that human carers do now. We need to take this issue seriously and in my view we should protect access to face-to-face human support by legislation.
However, I don’t think it’s inevitable that using new technologies to support our independence will lead to other people drawing back. Indeed I think that the reverse might happen. Research on loneliness shows that lack of control over your life can lead to passivity and learned helplessness, feeding low self-esteem and social withdrawal. Becoming more independent through technology might enable us to feel better about ourselves, get out of the house more, seek and maintain human contact, and enjoy positive relationships that are not all built around a carer-client dynamic.
There is already evidence that companion robots could help us in our social lives. The Paro seal, an animal-like robot developed in Japan, is currently being evaluated in Sheffield for its capacity to promote social interaction in patients with dementia. Preliminary results show that Paro can increase socialisation in people who are withdrawn by encouraging them to converse with others and by eliciting non-verbal interactions, such as touch and stroking, with the robot.
Some are concerned about how assistive robots might impact on the caring professions. However, good professional carers are already scarce and are becoming scarcer. The UK has a shortage of nurses and residential care workers, and this will only worsen as the number of care jobs increases by up to one million by 2025. Robots can help compensate for this skills shortage by assisting professional carers in their work, and by reducing work-related injuries, such as chronic back-strain, that otherwise lead some experienced carers to retire early. Working with teams of assistive robots, the role of a professional carer will become more skilled and respected, less physical, less routine, and more focused on the people being cared for. Wages and working conditions for care workers are often scandalously poor: introducing more technology into care work could raise its status.
Across Europe, we are moving from a situation where we have three working people for every one potential dependent (someone either over sixty-five or below eighteen) to one where, by 2060, that ratio could be one-to-one. The world in 2060 will be very different, and it is not unrealistic to imagine that assistive technologies will be very advanced by that time. This is good to know, because otherwise families will be faced with what looks like an impossibly high burden.
The House of Lords is right to think that technology can’t fix all of the issues arising from this demographic shift. However, I believe that it can and should be a part of the solution, and robotic technologies will have an important role to play. The problems arising from our ageing population won’t happen overnight, but as we look around and see more of our older citizens miserable and neglected, we need to think about what actions we can take and to start rethinking how our society cares for older people. As part of the mix, I believe we would be doing a disservice to both ourselves and our children, to ignore the opportunity provided by assistive robots.
About the author
Tony Prescott is a Professor of Cognitive Neuroscience at the University of Sheffield, a Fellow of the British Psychological Society, and the Director of Sheffield Robotics (http://www.sheffieldrobotics.ac.uk) a cross-institutional robotics facility with over one hundred active researchers. He regularly speaks and writes about the potential societal impacts and risks of advanced technologies such as AI and robotics. You can follow him on Twitter @tonyjprescott.