Why Robots Are the Future of Elder Care

Illustration by Tom Eichacker

It’s no secret that Japan is facing severe socio-economic pressures due to its aging, shrinking population. Nowhere is this more apparent than in the field of elder care. Many in the nation are aging out of their working years, without enough children born to replace them in the workforce. This means elder care will require an increasing amount of resources and workers out of a progressively smaller total pool. As of 2012, 22 percent of Japan was already over 65 and by 2060 the government expects the population to shrink from 127 million people to 87 million, as the over-65 demographic grows to almost 40 percent of the nation. In 2010, Japan already had 30 million elderly and infirm individuals in care facilities, but had substantially fewer than the projected 2 million caregivers needed to look after them—and turnover amongst those employees was already 17 percent per year.

Some have suggested that the best way to overcome these labor pressures would be for Japan to back off on its restrictive-to-xenophobic immigration policies, welcoming in foreigners to take care of its elderly. But this ignores the issue of cost, with elder care expenses set to rise exponentially as the number of people able to pay into the system declines. The immigration plan also ignores the fact that, while these issues are accentuated in Japan, they’re a global concern as well. As of 2050, the United Nations estimates that the global over-65 population will rise by 181 percent while the 15-to-65 population will rise only 33 percent. In America, that translates to at least a doubling of our geriatric population. The U.S. proportion of elderly-to-workers will still be half as bad as Japan’s, but the fact remains that the whole world is aging, and losing the manpower and money to pay for this monumental demographic shift.

Chart showing declining trend in total Japanese population

But there is one solution to both the human and financial pressures of an aging globe: robotic caregivers. It’s a concept Japan’s been pushing for a while now—in 2013 and 2014 especially, the Japanese government poured millions into incentivizing eldercare robotics development. Many have looked at Japan’s kawaii and cuddly droids and rolled their eyes, questioning whether or not such technologies could ever really gain traction with the rest of the world. But over the past couple of years, elder care robot research and development has grown more conventional and cheaper, producing products with greater functionality and broader consumer acceptance. And it’s started to take hold in companies beyond Japan too, suggesting a growing wave of acceptance and support for the concept. So no matter how uncomfortable we may be with robots, it seems like it’s high time for all of us to accept, if not enthusiastically embrace, the dawning of the Asimov era.

In the early stages of elder care robotics development, there was good cause to be suspect of the technology. Some of the first robots, like Paro, a touch-reactive electronic harp seal developed to keep dementia patients occupied, really just seemed like glorified, overpriced Furbies. After selling for $6,000 apiece in the early 2000s, their price had only dropped to about $3,000 by 2011, and many nursing homes found that their patients initially weren’t very engaged with the robot seal. Other inventions were basically just unexciting variations on existing technologies—like baby-shaped versions of Paro and touch screens that would help patients communicate with doctors and loved ones.

Many worried that the slow takeoff of Paro and other early robots was a clear sign that the elderly were rejecting robotics in favor of a human touch (even in robot-happy Japan). Others worried that the elderly would not be able to manipulate the physical or vocal controls for these robots. Some companies, like the robotics firm Tmsuk, began to scrap their electronic caregiver projects due to lack of interest. At times, the attitude towards elder care robots even descended into dread and skepticism, as exemplified by a delightfully terrifying fake story about a cold-yet-cuddly assisted suicide robot, shaped like a giant, fluffy bear and named SeppuKuma.

Yet some firms pushed forward, and in recent years have succeeded in developing a bevvy of robots that can do much more than Paro, and for far lower prices. Robots like Palro don’t just coo and chirp like Paro, but instead offer to play games and dance with the elderly, keeping their minds active with trivia. Meanwhile, ChihiraAico has been designed to look like a 32-year-old Japanese woman (perhaps living a little too close to the uncanny valley), aiming to make people more comfortable talking to a robot about their problems. And just earlier this year, SoftBank released Pepper, one of many personal robots, a humanoid creature with the power to read and respond to human emotions. A massive breakthrough in our ability to connect with robots, Pepper could do wonders for the mental engagement and continual monitoring of those in need. On June 20 this year, the first crop of consumer-ready Pepper robots went on sale in Japan for $1,600 each—the whole supply of 1,000 robots sold out in less than a minute.

As robots develop and proliferate, many caregivers note that, despite initial reservations amongst their charges, they are surprised by how quickly the elderly are warming to these technologies. This acceptance is even reflected in the continued relevance of Paro, who’s been increasingly welcomed into nursing homes after a rocky start, and seems to be doing some good.

And now it’s not just companion robots—over the past few years, new machines have been developed with the potential to alleviate the physical strains of elder care as well. Last year RT Works of Osaka developed the Encore Smart, an assisted walker that can take the elderly across rugged terrain. And this year the Riken Institute and Sumitomo Riko Company in Nagoya released their latest Robear, a robotic nurse in the shape of a bear (and the model for the SeppuKuma hoax) capable of gently lifting a patient of up to 176 pounds and carrying them around.

But more promising than these limited-use robots, which wash people’s hair or watch for breathing or movement, the unfortunately named Cyberdyne has started to develop Hybrid Assistive Limbs (even more unfortunately abbreviated as HALs), which stabilize and magnify the strength of the wearer. These HALs react to electrical impulses in the skin without the need for actual movement, working a powerful exoskeleton with a series of small motors. Not only can these exoskeletons help reduce the back injuries that up to 70 percent of professional Japanese caregivers encounter on the job, but they can also, potentially, give the elderly their mobility and freedom back. For now, the key focus is on getting full-body suits developed and approved by national governments and insurance bodies so they can be made readily available throughout the eldercare industry.

As these technologies have developed in Japan, foreign companies have embraced them as well, with everyone from the European Union to Carnegie Mellon University to iRobot (the Roomba company) sinking money into the development of robotic monitors, nurses, and companions for the elderly. In part, these firms are recognizing that so long as robots are accepted, they are necessary. But some are just recognizing how profitable the eldercare robotics market could be. Japan alone expects their market to grow from $140 million to $1 billion a year within a few decades. And Cyberdyne attracted a great deal of attention with its initial public offering last spring, raising $89 million to continue their work with exoskeletons.

Most Western robots are a little less humanoid and innovative than their Japanese counterparts, but as research accelerates on this side of the globe, it will likely spur the development of the industry as a whole. And if recent years are any indication, as the products improve, so will acceptance of robots in facilities dedicated to the treatment of the elderly. Caregivers already seem to be firmly on the side of this kind of technology—not just to make elder care viable and affordable in an otherwise bleak future, but because robots can give the elderly the level of attention and mobility they deserve (and that humans can’t really provide them). So no matter how cold or instinctively wrong a Robot and Frank future may feel to those who can’t imagine anything replacing the human touch, it increasingly seems both inevitable and our best option for maintaining the aging human race.