Robots for Elderly Care in the Home: A Landscape Analysis and Co-Design Toolkit

Analysis of community older adult care facility construction and demand differentiation based on residential area and population attribute differences

Currently, China has fully entered an aging society. The construction and efficient utilization of community older adult care facilities have become urgent issues that need to be addressed. To explore the differences in the needs of older adult people in the community for older adult care services, this study selected three basic needs: life care, medical security, and cultural and entertainment, as the primary indicators of community older adult care needs. A community older adult care demand indicator system was constructed, which included three primary indicators and 11 secondary indicators. Based on the indicator system, a survey questionnaire was designed, and validity analysis was conducted using Kaiser Meyer Olkin test and Bartlett sphericity test. 490 survey questionnaires were distributed to 22 communities in Wuhan, and 447 valid questionnaires were collected, with a response rate of 91.22%. The results indicated that there were significant differences in the distribution of older adult population in different communities. Different types of residential areas and housing prices affected its construction and use. The demand for home-based older adult care services in communities varied significantly. Through analysis of variance, the type of residential area did not show significant differences in older adult bathing assistance, daytime care, mental comfort, sports activities, etc. (p > 0.05), while there were statistical differences in nighttime care, medical care, rehabilitation care, older adult canteens, chess and card entertainment, artistic activities, etc. (p < 0.05). No significant difference existed in different housing prices for daytime care, nighttime care, mental comfort, and fitness activities (p > 0.05), but there was statistical difference for rehabilitation care, medical care, chess and card entertainment, senior dining halls, and artistic activities (p < 0.05). According to logistic regression analysis, the income level, self-care ability, and education level had obvious impacts on their basic needs for life care, with OR values of 11.68, 2.621, and 1.792, respectively. This study can provide effective reference for building diversified community home-based older adult care service facilities.

Gerontechnologies, ethics, and care phases: Secondary analysis of qualitative interviews

BACKGROUND

Gerontechnologies are increasingly used in the care for older people. Many studies on their acceptability and ethical implications are conducted, but mainly from the perspective of principlism. This narrows our ethical gaze on the implications the use of these technologies have.

RESEARCH QUESTION

How do participants speak about the impact that gerontechnologies have on the different phases of care, and care as a process? What are the moral implications from an ethic of care perspective?

RESEARCH DESIGN

Secondary analysis of semi-structure interviews, whose segments on specific technologies were analysed through reflexive thematic analysis.

PARTICIPANTS AND RESEARCH CONTEXT

Sixty-seven Swiss stakeholders involved in the use of gerontechnologies, including professional caregivers, informal caregivers, and older persons themselves.

ETHICAL CONSIDERATIONS

The research study was evaluated by the Ethics Commission of Northwest and Central Switzerland (EKNZ). All participants received an information document before the interview date detailing the purpose, procedure, and anonymization measures. After explaining the study during the agreed upon interview time and upon receiving their written informed consent, the interview process began.

FINDINGS/RESULTS

Four themes are identified: Identifying care needs, Taking responsibility, Hands-on work, Responding to care. As part of these themes, many codes highlighting the ambivalent impact of gerontechnologies are created, ranging from 'Expanded capacity for…identifying care needs' to 'Create new & (un)necessary…hands-on work'. The moral implications of these results from the care ethics perspective are discussed, through the ethical elements of: attentiveness, responsibility, competence, and responsiveness.

CONCLUSIONS

The moral implications of gerontechnologies on care phases from the care ethics perspective open up several questions on whether they actually help give care a central role in social life and provide more competent care.

How can robots facilitate physical, cognitive, and social engagement in skilled nursing facilities?

As people live longer, the population of older adults in need of support continues to expand relative to the available workforce of caregivers, necessitating new solutions to supplement caregiver availability for the physical, cognitive, and social needs of older adults. Robotics and automation present strong possible solutions. Past solutions have typically supported short-term rehabilitation and aging in place, yet many older adults live in skilled nursing facilities (SNFs), a setting reached by relatively little research to date. In this paper, we examine the unique needs of staff and residents at SNFs, after which we begin an iterative design process of robot-mediated wellness activities for the SNF space. We worked closely with domain experts in exercise science and physical therapy for older adults and a local SNF to design and test a series of robot-mediated activity prototypes with residents, visitors, and staff. We found that while both residents and staff highly value physical activity, there are nuanced challenges associated with supporting resident activity (one important element of overall wellbeing). As a result, we considered and tested a wide range of intervention options from usual approaches (e.g., mirroring movements) to creative approaches (e.g., social engagement via lewd humor). Our final design insights can inform practitioners who wish to use robots to support resident wellbeing in SNFs.

Socially assistive walker for daily living assistance in older adults

Introduction

This paper addresses the growing healthcare needs of an ageing population and the lack of advanced technologies with social capabilities that are cost effective, user friendly, and readily adopted. In response to this motivation, a socially assistive walker is designed to provide physical and cognitive support in activities of daily living for older adults.

Methods

Physical and cognitive support is provided by walker's structure, sensors, and feedback interfaces to assist users daily living activities, as well as, in navigating environment safely and efficiently. The walker's design arises from semi-structured interviews conducted with ageing experts, leading to the development of two levels or modes of social interaction, namely low and high interaction.

Results and discussion

In a cohort of 14 adults, the study found the device easy to use regardless of the interaction mode, with 78.5% expressing a preference for the version featuring embodiment, verbal feedback, and more proactive cues (p < 0.05). The results also prompted ideas and suggestions for new designs based on insights gleaned from the user. This research contributes to the field of socially assistive robotics by offering an example of a user centred approach to address the healthcare challenges an ageing population poses.

Promising directions for human-robot interactions defined by older adults

Introduction: Older adults are engaging more and more with voice-based agent and social robot technologies, and roboticists are increasingly designing interactions for these systems with older adults in mind. Older adults are often not included in these design processes, yet there are many opportunities for older adults to collaborate with design teams to design future robot interactions and help guide directions for robot development. Methods: Through a year-long co-design project, we collaborated with 28 older adults to understand the key focus areas that older adults see promise in for older adult-robot interaction in their everyday lives and how they would like these interactions to be designed. This paper describes and explores the robot-interaction guidelines and future directions identified by older adults, specifically investigating the change and trajectory of these guidelines through the course of the co-design process from the initial interview to the design guideline generation session to the final interview. Results were analyzed through an adapted ethnographic decision tree modeling approach to understand older adults' decision making surrounding the various focus areas and guidelines for social robots. Results: Overall, over the course of the co-design process between the beginning and end, older adults developed a better understanding of the robot that translated to them being more certain of their attitudes of how they would like a robot to engage with them in their lives. Older adults were more accepting of transactional functions such as reminders and scheduling and less open to functions that would involve sharing sensitive information and tracking and/or monitoring of them, expressing concerns around surveillance. There was some promise in robot interactions for connecting with others, body signal monitoring, and emotional wellness, though older adults brought up concerns around autonomy, privacy, and naturalness of the interaction with a robot that need to be further explored. Discussion: This work provides guidance for future interaction development for robots that are being designed to interact with older adults and highlights areas that need to be further investigated with older adults to understand how best to design for user concerns.

Immediate fall prevention: the missing key to a comprehensive solution for falling hazard in older adults

The world is witnessing an unprecedented demographic shift due to increased life expectancy and declining birth rates. By 2050, 20% of the global population will be over 60, presenting significant challenges like a shortage of caregivers, maintaining health and independence, and funding extended retirement. The technology that caters to the needs of older adults and their caregivers is the most promising candidate to tackle these issues. Although multiple companies and startups offer various aging solutions, preventive technology, which could prevent trauma, is not a big part of it. Trauma is the leading cause of morbidity, disability, and mortality in older adults, and statistics constitute traumatic fall accidents as its leading cause. Therefore, an immediate preventive technology that anticipates an accident on time and prevents it must be the first response to this hazard category to decrease the gap between life expectancy and the health/wellness expectancy of older adults. The article outlines the challenges of the upcoming aging crisis and introduces falls as one major challenge. After that, falls and their mechanisms are investigated, highlighting the cognitive functions and their relation to falls. Moreover, since understanding predictive cognitive mechanisms is critical to an effective prediction-interception design, they are discussed in more detail, signifying the role of cognitive decline in balance maintenance. Furthermore, the landscape of available solutions for falling and its shortcomings is inspected. Finally, immediate fall prevention, the missing part of a wholesome solution, and its barriers are introduced, and some promising methodologies are proposed.

ADAM: a robotic companion for enhanced quality of life in aging populations

One of the major problems of today's society is the rapid aging of its population. Life expectancy is increasing, but the quality of life is not. Faced with the growing number of people who require cognitive or physical assistance, new technological tools are emerging to help them. In this article, we present the ADAM robot, a new robot designed for domestic physical assistance. It mainly consists of a mobile base, two arms with grippers and vision systems. All this allows the performance of physical tasks that require navigation and manipulation of the environment. Among ADAM's features are its modularity, its adaptability to indoor environments and its versatility to function as an experimental platform and for service applications. In addition, it is designed to work respecting the user's personal space and is collaborative, so it can learn from experiences taught by them. We present the design of the robot as well as examples of use in domestic environments both alone and in collaboration with other domestic platforms, demonstrating its potential.

Beyond Human Detection: A Benchmark for Detecting Common Human Posture

Human detection is the task of locating all instances of human beings present in an image, which has a wide range of applications across various fields, including search and rescue, surveillance, and autonomous driving. The rapid advancement of computer vision and deep learning technologies has brought significant improvements in human detection. However, for more advanced applications like healthcare, human-computer interaction, and scene understanding, it is crucial to obtain information beyond just the localization of humans. These applications require a deeper understanding of human behavior and state to enable effective and safe interactions with humans and the environment. This study presents a comprehensive benchmark, the Common Human Postures (CHP) dataset, aimed at promoting a more informative and more encouraging task beyond mere human detection. The benchmark dataset comprises a diverse collection of images, featuring individuals in different environments, clothing, and occlusions, performing a wide range of postures and activities. The benchmark aims to enhance research in this challenging task by designing novel and precise methods specifically for it. The CHP dataset consists of 5250 human images collected from different scenes, annotated with bounding boxes for seven common human poses. Using this well-annotated dataset, we have developed two baseline detectors, namely CHP-YOLOF and CHP-YOLOX, building upon two identity-preserved human posture detectors: IPH-YOLOF and IPH-YOLOX. We evaluate the performance of these baseline detectors through extensive experiments. The results demonstrate that these baseline detectors effectively detect human postures on the CHP dataset. By releasing the CHP dataset, we aim to facilitate further research on human pose estimation and to attract more researchers to focus on this challenging task.

Robots for Elderly Care: Review, Multi-Criteria Optimization Model and Qualitative Case Study

This paper focuses on three areas: the first is a review of current knowledge about social and service robots for elderly care. The second is an optimization conceptual model aimed at maximizing the efficiency of assigning robots to serve the elderly. The proposed multi-criteria optimization model is the first one proposed in the area of optimization for robot assignment for the elderly with robot utilization level and caregiver stress level. The third is the findings of studies on the needs, requirements, and adoption of technology in elderly care. We consider the use of robots as a part of the ENRICHME project for long-term interaction and monitoring of older persons with mild cognitive impairment, to optimize their independence. Additionally, we performed focus group discussions (FGD) to collect opinions about robot-related requirements of the elderly and their caregivers. Four FDGs of six persons were organized: two comprising older adults, and two of the other formal and informal caregivers, based on a detailed script. The statements of older participants and their caregivers were consistent in several areas. The analysis revealed user characteristics, robot-related issues, functionality, and barriers to overcome before the deployment of the robot. An introduction of the robot must be thoroughly planned, include comprehensive pre-training, and take the ethical and practical issues into account. The involvement of future users in the customization of the robot is essential.

A Toolkit for Co-Designing towards Community-Based Active Ageing: Lessons Learned during Development

It is increasingly recognized that community-based interventions for active ageing are more lasting and effective, yet the tools and methods for developing these interventions are lacking. This study investigates how to co-design community-based active ageing with older adults via the development of a toolkit to support this goal. Rapid reviews were conducted to understand (i) the effective behavioural change techniques for older adults, (ii) how to co-design with older adults for community-based interventions, and (iii) how to design tools for behaviour change that are easy to use. These reviews served as the foundation for developing a toolkit to support the co-design of community-based active ageing, which was evaluated during an interdisciplinary hackathon with older adults. Quantitative data from the surveys suggested that the confidence levels of students in developing interventions for health behaviour change and in co-designing with older adults increased after the hackathon, and the enjoyment of participating in the hackathon and of using the toolkit were statistically significant factors influencing this increase. Qualitative data from interviews and observations revealed how the toolkit was (un)used by the participants and what aspects of the toolkit can be improved. We encourage future researchers and practitioners to apply and adapt our research findings to the communities of older adults that they are working with.

A Survey on Recent Advances in Social Robotics

Over decades, social robotics has evolved as a concept that presently covers different areas of application, and interacts with different domains in technology, education, medicine and others. Today, it is possible to envision social robots in tasks that were not expected years ago, and that is not only due to the evolution of social robots, but also to the evolution of the vision humans have for them. This survey addresses recent advances in social robotics from different perspectives. Different contexts and areas of application of social robots are addressed, as well as modalities of interaction with humans. Different robotic platforms used in social contexts are shown and discussed. Relationships of social robotics with advances in other technological areas are surveyed, and methods and metrics used for the human evaluation of the interaction with robots are presented. The future of social robotics is also envisioned based on surveyed works and from different points of view.

Some Characteristics and Arguments in Favor of a Science of Machine Behavior Analysis

Researchers and practitioners recognize four domains of behavior analysis: radical behaviorism, the experimental analysis of behavior, applied behavior analysis, and the practice of behavior analysis. Given the omnipresence of technology in every sphere of our lives, the purpose of this conceptual article is to describe and argue in favor of a fifth domain: machine behavior analysis. Machine behavior analysis is a science that examines how machines interact with and produce relevant changes in their external environment by relying on replicability, behavioral terminology, and the philosophical assumptions of behavior analysis (e.g., selectionism, determinism, parsimony) to study artificial behavior. Arguments in favor of a science of machine behavior include the omnipresence and impact of machines on human behavior, the inability of engineering alone to explain and control machine behavior, and the need to organize a verbal community of scientists around this common issue. Regardless of whether behavior analysts agree or disagree with this proposal, I argue that the field needs a debate on the topic. As such, the current article aims to encourage and contribute to this debate.

An analysis of design recommendations for socially assistive robot helpers for effective human-robot interactions in senior care

As the global population ages, there is an increase in demand for assistive technologies that can alleviate the stresses on healthcare systems. The growing field of socially assistive robotics (SARs) offers unique solutions that are interactive, engaging, and adaptable to different users’ needs. Crucial to having positive human-robot interaction (HRI) experiences in senior care settings is the overall design of the robot, considering the unique challenges and opportunities that come with novice users. This paper presents a novel study that explores the effect of SAR design on HRI in senior care through a results-oriented analysis of the literature. We provide key design recommendations to ensure inclusion for a diverse set of users. Open challenges of considering user preferences during design, creating adaptive behaviors, and developing intelligent autonomy are discussed in detail. SAR features of appearance and interaction mode along with SAR frameworks for perception and intelligence are explored to evaluate individual developments using metrics such as trust, acceptance, and intent to use. Drawing from a diverse set of features, SAR frameworks, and HRI studies, the discussion highlights robot characteristics of greatest influence in promoting wellbeing and aging-in-place of older adults and generates design recommendations that are important for future development.