The interest in using various digital technologies, including service robots, is increasing in elderly care. Technological solutions aim to cope with the challenge of growing imbalance between the amount of caregivers and care receivers. Technology use in work is often a major change, but when planned carefully, it may provide a welcome addition and support at work. Attitudes towards robotics in elderly care are often mixed. They concern, for instance, quality of care, ethical issues as well as work division between human beings and robots. The term care robotics encompasses “all machines that operate partly or fully autonomously performing care-related activities for people with physical and/or mental handicaps” that are related to age and/or health-related restrictions (Goeldner et al. 2015, p. 115). Care robots may, for instance, simplify tasks of the daily life for aged and/or handicapped people, increase the quality of life of their users by giving them more autonomy (Herstatt et al., 2011), or protect them or perform certain tasks with a certain quality standard (for example, serving medication, drinks or food). (Goeldner et al. 2015)
Within Lahti Living Lab, a case study was conducted in 2016 to identify the impacts and acceptance of care robot implementation among users in elderly care services – care personnel and elderly customers – with the help of the Human Impact Assessment (HuIA) approach. The data were collected in elderly care services in the city of Lahti (in two round-the-clock serviced care homes and a geriatric hospital) in December 2015 – April 2016, when the service robot ‘Zora’ was introduced to these organizations. Both care service personnel and customers are users of the robot, in different roles. The robot was mainly used for activity and recreation, but also for support in rehabilitation that improves and maintains social and cognitive abilities in addition to physical abilities. The data were collected during 27 sessions through ethnographic observation. In those sessions, the robot was either introduced to the customers in a special session or acted as part of the regular group activities (exercise or literature groups) of the care homes. Each session lasted for about an hour, and comprehensive notes and photos were taken. In addition, focus group interviews of the care personnel (34 people) and customers (5 people) were also conducted. The data were analyzed with the methods of qualitative content analysis.
According to the findings, the implementation of the robot has many kinds of impacts on the elderly customers, care personnel and care work. Part of the employees had a personal or professional interest in ‘novelties’ in care work that enable provision of better services and improve work ethics. Some of them were willing to act as ‘main operators’ of the robot in the work communities and even used their free time to get acquainted with the robot. The robot was perceived as a useful tool for providing wellbeing and activity to customers as well as new perspectives and contents to one’s work. On the other hand, for other employees, the robot in the work environment implied meanings of risk, even danger, and led to withdrawal and bypassing the whole issue. Some employees felt that the robot is just waste of money and causes additional work when work is already so busy. Moreover, there were concerns related to time use and commitment of the whole work community, and pottering about using robot versus ‘true’ care work. The care workers brought up also ethical concerns. Some felt the ‘childish’ robot as degrading towards the elderly, but positive reactions and interest of the elderly customers later affected the attitudes of the care personnel in a positive way.
The customers considered the robot as entertaining, funny and interesting. The robot stimulated moving and led to reminiscing because of its child-like character. An occupational therapist noted: “When people were supposed to raise their feet, someone who never does that, did it, because the robot shows exercises in a calm way.” The robot use also created various kind of interaction with the robot or between customers and care personnel. A care worker mentioned: ”Interaction was generated, as the operators of the robot could answer questions at the same time. People started to talk to a doll like this quite well.” Examples of negative impacts on the customers were irritation, reserve and fear. “Go away, this is silly”, as put by one of the customers. Some were confused when the robot addressed them and they didn’t know what was expected from them. A customer also noted that “This goes too technical. It is human contacts that I miss. Human to human, that is important, and not any toys.”
The attitudes towards robotics in care are thus twofold: both enthusiasm and fears exist. The ‘place’ of the robotics – a rather novel issue – in the field of care is still in many ways undefined. After the first steps of robot use, there is potential for true rehabilitative work and activities with the help of the robot, if its use is well planned. Implementation of robots in elderly care requires rethinking of the services and work practices. Implementation of robots is an issue of the whole (work) community. Reactions differ, and care personnel should know the customers well to be able to anticipate how they react. The role of ethics is a key issue. Orientation is of vital importance to highlight and deal with essential issues increasingly skillfully in these processes. Societal discourse on robots in care, based on practical experiences, is also needed.
This case study was part of the ROSE project supported by Academy of Finland, Strategic Research Council (Project name: “Robots and the Future of Welfare Services”; decision number: 292980) and the LUT Research Platform on Smart Services for Digitalisation. Videoclips concerning the case study, various stakeholders’ experiences, are forthcoming during the spring 2017. The user knowledge that was obtained via the Living Lab study is actively utilized by City of Lahti in plans concerning future use of robots.
Melkas, H., Hennala, L., Pekkarinen, S., Kyrki, V. (2016): Human impact assessment of service robot implementation in Finnish elderly care. ICServ2016. The 4th International Conference of Serviceology. Tokyo, Japan, September 6-8, 2016.
Goeldner, M., Herstatt, C., and Tietze, F. (2015). The emergence of care robotics – A patent and publication analysis. Technological Forecasting & Social Change, 92, 115-131.
Herstatt, C., Kohlbacher, F., and Bauer, P. (2011). Silver product design – product development for older people. Working Paper No. 65. Hamburg, Germany: Institute for Technology and Innovation Management, Hamburg University of Technology.
For further information, please contact Helinä Melkas, helina.melkas(at)lut.fi
Photo: Satu Pekkarinen