Companion type robots: Addressing the Future of Social Rehabilitation for Older Adults

Commentary

By Ilakkiah Chandran & Anuijan Chandran

Rehabilitation services have significantly advanced to meet the needs of diverse populations using innovative tools. Amongst these are Socially Assistive Robots (SARs) that are used to support older adults, individuals with neurodegenerative disorders (i.e., dementia), children with autism spectrum disorder and motor disabilities (1). SARs works to address the gap in current rehabilitation by offering social interaction to users while encouraging recovery and well-being (1). Companion-type robots are SARs that display pet-like qualities (1). They aim to enhance users’ psychological health by increasing social functioning, interaction and acknowledging unmet needs (1). Companion-type robots are currently being employed to support the rehabilitation needs of the world’s older adult population (1,2,3). Although research has attempted to assess the effectiveness of these robots amongst older adults, there are underlying challenges related to its suitability, accessibility, and effectiveness. This commentary will highlight the limitations of companion-type robots and make recommendations that address the rehabilitation needs of older adults.

Limitations of Companion-Type Robots

Companion-type robots have been shown to enhance feelings of belongingness; however, they are not suitable for older adults. Previous literature identifies that older adults with cognitive and memory decline experience challenge operating everyday technologies (i.e., refrigerators) (4). Robots are technology-based so their operation by older adults is anticipated to be a challenge. Those who reside alone and do not have access to assistance may experience further challenges when operating the companion robot. The unsuccessful operation also impacts an individual’s desire to interact and develop an attachment with companion-type robots as they feel foreign and inanimate. This prevents companion-type robots from effectively promoting psychological well-being and social rehabilitation amongst older adults who have had limited experience and access to technology.

“The average cost of companion-type robots is about $6000.00 USD, placing a significant barrier to lower socioeconomic statuses (7,8).”

Aside from the limited suitability, the effectiveness of companion robots is uncertain. The Center for Disease Control and Prevention (CDC) suggested that 25% of adults aged 65 and older report feeling socially isolated (5). Feelings of social isolation are related to living alone, losing family and friends, and chronic illness(es). Furthermore, the CDC also suggests that social isolation perpetuates health risk behaviours such as smoking and physical inactivity, increasing neurodegeneration by 50%, heart disease by 29%, stroke by 32%, and risk for hospitalization by 68% (5). Companion-type robots do not mitigate these issues. The current models of companion-type robots lack sensitivity to users’ personal needs. Moreover, Companion type robots lack human-like physical features and critical traits such as loyalty and empathy. The current models of companion-type robots are not yet sensitive to the personalized social needs of users and remain impersonal.

This is a black and white image of an elderly man walking with a can in a par. The man is carrying a package.
Vlad Chețan (Pexels). This is a black and white image of an elderly man walking in a park with a can and carrying a package. The street is paved and covered with trees.

Accessibility is another significant limitation of companion-type robots. Companion-type robots lack cross-cultural effectiveness as they have only been tested in specific subsets of populations and are not available in regions of the Global South (6). These robots have not been programmed in a wide range of languages or with cross-cultural values in mind (6). In addition, the average cost of companion-type robots is about USD 6000.00, placing a significant barrier to lower socioeconomic statuses (7,8). Companion-type robots also neglect the needs of people of colour and Indigenous people, despite being the most adversely impacted by social isolation (2,5,7).

Recommendations

To overcome the barriers associated with companion-type robots, we must prioritize the users’ needs and ensure accessibility. The limited effectiveness and suitability can be improved through research and advancing current technology. Recognizing the various facets of technology for older adults can promote usability and increase the value of this innovative tool (9). Technology adaptation emphasizes the role of a device’s features, the user, social and cultural context, and its ability to engage older adults (9). Informing users of the usefulness and benefit while improving the usability of the companion-type robots can encourage older adults’ adaptation (9). Older adults’ confidence with the companion robots will improve if they are guided through a standardized setup and have accessible technical support. Increased confidence can encourage older adults to see the robots’ value and purpose. Companion-type robots should also be designed to be socially and culturally sensitive. To solve this, their availability and affordability must be attainable. Companion-type robots should be cheaper or subsidized for lower-income populations to ensure that they are accessible to everyone. They should be made globally available to ensure equitable access. However, prior to launching them globally, focus groups should be conducted with varying community members to assess cultural sensitivity. Efforts should also prioritize adding human-like qualities to the companion robots. This may include eye contact, maintenance, and mirroring of the user’s actions to create a good quality social connection. Additionally, it is important to ensure the robots can be personalized to the user’s needs to support individualized social rehabilitation and psychological well-being.

This is a photo of a woman working on a computer. The screen reads "DESIGNERS SHOULD ALWAYS KEEP THEIR USERS IN MIND."
Fauxels (Pexels). This is a photo of a woman with dark hair working on a laptop. The screen reads “DESIGNERS SHOULD ALWAYS KEEP THEIR USERS IN MIND.” Three people working on their computers are in the background of the photo and the background is blurred.

Companion-type robots are an innovative technology that addresses social rehabilitation amongst older adults. However, the current robots pose challenges that limit their accessibility, suitability, and effectiveness. Researchers and innovators should focus on prioritizing the user and their needs. By improving the usability, affordability, accessibility and human-like features, companion-type robots can become a more effective rehabilitation tool.

Acknowledgements

Featured image by nightwolfdezines (vecteezy.com)

To refer to this article, it can be cited as:

Chandran I, Chandran A. Improving Companion Type Robots to Support Social Rehabilitation of the Elderly. rehabINK. 2022:13. Available from: https://rehabinkmag.com


References

  1. Langer A, Levy-Tzedek S. Emerging roles for social robots in rehabilitation: current directions. ACM Transactions on Human-Robot Interaction (THRI). 2021 Jul 14;10(4):1-4.
  2. Bemelmans R, Gelderblom GJ, Jonker P, De Witte L. Socially assistive robots in elderly care: a systematic review into effects and effectiveness. Journal of the American Medical Directors Association. 2012 Feb 1;13(2):114-20.
  3. Pol LG. Rapid growth in the elderly population of the world. InBrain and Spine Surgery in the Elderly 2017 (pp. 3-15). Springer, Cham.
  4. Ikeda Y, Maruta M, Shimokihara S, Nakamura A, Han G, Tabira T. Difficulties in the Use of Everyday Technology among Older Adults with Subjective Memory Complaint and Cognitive Decline. Gerontology. 2021 Sep 2:1-9.
  5. Centers for Disease Control and Prevention. Loneliness and social isolation linked to serious health conditions [Internet]. Centers for Disease Control and Prevention. U.S. Department of Health & Human Services; 2021 [cited 2022May18]. Available from: https://www.cdc.gov/aging/publications/features/lonely-older-adults.html
  6. Cortellessa G, Scopelliti M, Tiberio L, Svedberg GK, Loutfi A, Pecora F. A Cross-Cultural Evaluation of Domestic Assistive Robots. InAAAI fall symposium: AI in eldercare: new solutions to old problems 2008 Nov (pp. 24-31).
  7. Cooper S, Di Fava A, Vivas C, Marchionni L, Ferro F. ARI: The social assistive robot and companion. In2020 29th IEEE International Conference on Robot and Human Interactive Communication (RO-MAN) 2020 Aug 31 (pp. 745-751). IEEE.
  8. Hung L, Liu C, Woldum E, Au-Yeung A, Berndt A, Wallsworth C, Horne N, Gregorio M, Mann J, Chaudhury H. The benefits of and barriers to using a social robot PARO in care settings: a scoping review. BMC geriatrics. 2019 Dec;19(1):1-0.
  9. Lee C, Coughlin JF. PERSPECTIVE: Older adults’ adoption of technology: an integrated approach to identifying determinants and barriers. Journal of Product Innovation Management. 2015 Sep;32(5):747-59.