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What makes sense for caregiving -- UberHealth or Caregiving Robots?

That clanking you hear is media drum-banging and robots walking. While the robotics world is literally rocking industries from manufacturing to surgery -- as caregiving robotic technology, there is still nothing much in our time, Paro, Jibo, and other media magnets not withstanding, still on the drawing board or at a price point that only a grant-funded pilot could love. Stated convictions that robots will be here because 'we need them' -- are just that -- stated. As every single article about robots and caregiving has concluded for the past oh-so-many-years, these marvels are in the future and when the caregiving variants do finally arrive, will be accompanied by an interesting set of challenges. Like electric and self-driving cars, the concept precedes the reality of distribution and resellers, battery charging configuration, maintenance and repair processes, rent or buy? And actually, consumers put caregiving robots in the same skeptical category as Google Glass and drones, which means even if they were available, marketing may be a challenge. And while robots as a concept keep popping up in senior housing publications -- nothing much has happened beyond the talk and the concept.

What problem are we solving? The perceived future need for caregiving robots is related to another well-understood problem -- the availability of people to care for the aging baby boomers when they get to that presumed care-needing age of 80+. The premise of this AARP Public Policy report is that there is a care gap and it will get worse, maybe, as boomers age. The gap is 7:1 now (available people aged 46-64 for the population aged 80+), shrinking to 4:1 by 2030.  That report triggers some though about the concept of availability. The projection is based on the population that is statistically available, but are these alleged people (not necessarily family members) actually available to provide care to those who need it?  What if based on a weak job market, the paid job categories of caregiving become more appealing? And finally, even if a population is statistically available to provide care, would they?  

Looking at today's caregiving statistics -- the care gap is closed by family and low paid work.  As of 2012, more than 40 million people provided unpaid caregiving support to older adults -- are they candidates for caregiving robots? The median pay of a professional caregiver is below $25,000 per year, lower than the median pay for all occupations ($33,000). Like fast food work, the pay is so low that many workers have 2 (or more) jobs to support their families. And even with high demand for home care and long-term care Certified Nursing Assistants (CNAs) in Florida, the pay is even lower, even though job growth is good (outpacing all other occupations in the state through 2020). So what if there are plenty of people are available and willing to work at low wages, especially as an on-ramp to the multiple steps of a nursing career? And what if there are plenty of people behind them? Will a future care gap (if there is one) need to be mitigated by robots? Let's imagine 2030, when the baby boomers turn 80 and beyond.  Given changes in life style and longevity, will they need as much care, what kind of care will they need and how will they obtain it? 

En route to mitigating the care gap, alternatives proliferate.  Baby boomers are thinking about their future care, partly in the context of their own parents -- as in the Silicon Valley-startup example of UberHealth, but also for themselves. See regional development of co-housing, the village-to-village network approach, or the concept of virtual assisted living. Innovation is making its way s-l-o-w-l-y into traditional CCRCs and assisted living -- but tech companies, while hopeful, would likely agree that the senior housing providers have yet to fully embrace sensor-based or video remote monitoring.  And the industry is now competing unfavorably with the perceived benefits of aging in place, perhaps supplemented by home care and unpaid family caregivers -- for at least as long as that approach works.  Is there room in the house for a robot? At the right price point (hundreds, not thousands of dollars), the right surrounding infrastructure and processes, and  the right oversight -- as is now happening in some hospitals -- maybe.  In the next decade for caregiving? Unlikely.

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Robots are yet another example of technology chasing a market - as a caregiver and technologist I know first hand that loved ones want to interact with humans. They don't want a robot to remind them to take their pills, monitor their movements, etc. They want someone who really cares to be there for them, hug them, respect them and be a companion - don't think robots can do that now or ever.

Here is an article that was written to rebut the article Laurie originally sited @Laurie - great discussion - this is a very important issue in the age in place arena

While I would tend agree with the sentiment of considering recent announcements more modestly, and there tends to be too much hype, I would suggest caution in downplaying the idea as senior companions too quickly. First, remember that the recent announcements of Pepper and Jibo are some of the earliest forms of a new form of personal robots (i.e. something more than a cleaning bot), and they will not even be delivered until 2015. It may be a fair comparison to think of them more analogous to the Apple II and Commodore PET. In those days, many questioned the real value of the machines, but within 10 years the market did evolve such that they because a pervasive form of our lives; even later to evolve in to forms that we can now hold in our hands.

Existing consumers, and even pundits of the industry, are not always the best to anticipate the need or impact for technology. Many people consider automobiles an unlikely form of transport and that only a single telephone would be sufficient for an entire community. Even execs at computer pioneers like IBM and DEC alleged dismissed the idea that people would want personal computers. More recently former Microsoft CEO, Steve Ballmer, laughed at the introduction of the iPhone, and later admitted to missing the significance that tablets would have. In contrast the late Steve Jobs did not rely on market surveys or focus groups to determine what products Apple would create.

It is reasonable to ask whether these latest robots will address the needs of our growing population of seniors, though this is not how they are being specifically targeted. If eldercare is mentioned, it is typically only one of many potential applications these vendors suggest.

As to the availability, speaking for myself (and I have repeatedly mentioned in interviews I have done) that the task of creating a senior companion robot far exceeds what anyone realizes. Even as I have worked on the development of our product, the scope of the effort has exceeded expectation, in large part because it requires an interaction model and user experience that we have yet to see in any product to date. If it were simply a matter of putting a PC on wheels, then we'd have them already. Significant funding in Asia and Europe have already resulted in millions of dollars of research being spent, yet there has yet to be an example of a successful commercial product yet. Why? Because it takes a significant evolution of existing technologies and time. We are only seeing the beginning, not yet the tipping point of a new industry.

Also while there may indeed be examples of robotics chasing the market, there are also equally misapprehensions of what the objectives might be. Speaking again for myself (and my company), the goal is NOT to replace caregivers. I would be the first to agree that robots cannot substitute for human contact. But even if the caregiver gap is not as severe as projections suggest it could be, it is not a reason to dismiss the viability of a companion robot. Most of us use an increasingly sophisticated set of technology everyday to help us remember important events, communicate more effectively, keep informed, and even entertain ourselves. However, conventional forms because an increasing challenges due to the inevitable effects of aging. My objective is not to replace human contact, but to better enable it, by empowering seniors with a more evolved form of technology that does not require that they carry it with them, walk across the room to use, or require that they use devices like keyboards or mice that may become increasingly challenging to use. I chose to create a technology that like a great administrative assistant or sidekick in augmenting their ability to communicate and stay involved in the lives of their families and community. If such human-augmentation/empowerment seems to imply reducing the dependency for others, then I am guilty, but no more than whatever the brand of the smartphone you are carrying.

There have also been numerous studies about the positive affect of pets on seniors.  Should everyone  be incorporating animal therapy rather than relying on robots for company and caregiving?


Yes, numerous studies confirm that pets can have a positive effect, but not only real pets, robot pets like Paro too. But there may be many reasons why pets are not a practical solution and certain don't fulfill all requirements for an aging senior.

Again, per my other post, the goal should not be to see robots as a replacement for a human caregiver or a substitute for human interaction. As I have stated that is not my company's goal at all. That said, most of us do have hobbies or other activities that make us feel good that might not involve another person. That does not necessarily a bad thing, provided that we don't isolate ourselves.

The right way to think of a robot for seniors is to think more of it as a device that empowers the senior, just as your smartphone extends your physical and cognitive abilities. That said, you are right that it can be used as a substitute for human interaction. Whether that's a detriment somewhat depends on the person and their circumstances, not the device.

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