Humanoid socially assistive robots in dementia care: a qualitative study about expectations of caregivers and dementia trainers

When a notification at the right time is not enough: the reminding process for socially assistive robots in institutional care

Reminding is often identified as a central function of socially assistive robots in the healthcare sector. The robotic reminders are supposed to help people with memory impairments to remember to take their medicine, to drink and eat, or to attend appointments. Such standalone reminding technologies can, however, be too demanding for people with memory injuries. In a co-creation process, we developed an individual reminder robot together with a person with traumatic brain injury and her care personnel. During this process, we learned that while current research describe reminding as a prototypical task for socially assistive robots, there is no clear definition of what constitutes a reminder nor that it is based on complex sequences of interactions that evolve over time and space, across different actions, actors and technologies. Based on our data from the co-creation process and the first deployment, we argue for a shift towards a sequential and socially distributed character of reminding. Understanding socially assistive robots as rehabilitative tools for people with memory impairment, they need to be reconsidered as interconnected elements in institutional care practices instead of isolated events for the remindee.

The Impact of Socially Assistive Robots on Human Flourishing in the Context of Dementia: A Scoping Review

Socially assistive robots are being developed and tested to support social interactions and assist with healthcare needs, including in the context of dementia. These technologies bring their share of situations where moral values and principles can be profoundly questioned. Several aspects of these robots affect human relationships and social behavior, i.e., fundamental aspects of human existence and human flourishing. However, the impact of socially assistive robots on human flourishing is not yet well understood in the current state of the literature. We undertook a scoping review to study the literature on human flourishing as it relates to health uses of socially assistive robots. Searches were conducted between March and July 2021 on the following databases: Ovid MEDLINE, PubMed and PsycINFO. Twenty-eight articles were found and analyzed. Results show that no formal evaluation of the impact of socially assistive robots on human flourishing in the context of dementia in any of the articles retained for the literature review although several articles touched on at least one dimension of human flourishing and other related concepts. We submit that participatory methods to evaluate the impact of socially assistive robots on human flourishing could open research to other values at stake, particularly those prioritized by people with dementia which we have less evidence about. Such participatory approaches to human flourishing are congruent with empowerment theory.

Use of a Humanoid Robot in Supporting Dementia Care: A Qualitative Analysis

Introduction

Cognitive impairment significantly affects independence in persons with dementia, and consistent supervision is often needed. While interest has arisen in using humanoid robots, such as Pepper, to assist with daily caregiving activities, little is known about the perceptions of using Pepper to assist people with dementia.

Objective

This study aimed to explore the perceptions of nonhealthcare workers, care partners, and healthcare workers on the use of a Pepper robot in dementia care.

Methods

This was a secondary qualitative analysis. Data were collected from a pilot study conducted from November 2020 to March 2021 using an online survey. The survey consisted of quantitative and qualitative questions; this study only focused on the qualitative responses. The detailed procedures and the quantitative results were published elsewhere. Participants included nonhealthcare workers, care partners, and healthcare workers.

Results

A total of 194 participants responded to the open-ended question. Participants described potential benefits of Pepper including assisting with daily activities, monitoring safety and medication use, initiating reminders, and promoting activities and social interactions. Participants had concerns about privacy, cost, poor acceptance/trust, Pepper making mistakes, limitations in environmental navigation and responding to emergencies, misuse of Pepper, and Pepper replacing humans. Participants suggested that Pepper should be tailored to each individual's background, preferences, and functions and recommended improving the logistics of using Pepper, offering more emotional support and responses, and using a more natural appearance and voice.

Conclusion

Pepper may support dementia care; yet some concerns need to be addressed. Future research should consider incorporating these comments when designing robots for dementia care.

Socially assistive robots for people with dementia: Systematic review and meta-analysis of feasibility, acceptability and the effect on cognition, neuropsychiatric symptoms and quality of life

BACKGROUND

There is increasing interest in using robots to support dementia care but little consensus on the evidence for their use. The aim of the study is to review evidence about feasibility, acceptability and clinical effectiveness of socially assistive robots used for people with dementia.

METHOD

We conducted a systematic review and meta-analysis. We searched MEDLINE, EMBASE, PsychINFO, CINHAL, IEEE Xplore Digital Library, and EI Engineering Village from inception to 04 - 02-2022 - included primary studies assessing feasibility, acceptability, or effectiveness of socially assistive robots for people with dementia. Two independent reviewers screened studies for eligibility, and assessed quality. Narrative synthesis prioritized higher quality studies, and random-effect meta-analyses compared robots with usual care (UC) or active control (AC) immediately after the intervention (short-term; ST) or long-term (LT) on cognition, neuropsychiatric symptoms, and quality of life.

FINDINGS

66 studies and four categories of robots were eligible: Companion robots (Pet and humanoid companion robots), telepresence communication robots, homecare assistive robots and multifunctional robots. PARO (companion robot seal) was feasible and acceptable but limited by its weight, cost, and sound. On meta-analysis, PARO had no ST or LT compared to UC or AC over 5-12 weeks on agitation (ST vs UC, 4 trials, 153 participants: pooled standardized mean difference (SMD) 0.25; - 0.57 to 0.06; LT vs UC; 2 trials, 77 participants, SMD = -0.24; - 0.94, 0.46), cognition (ST vs UC, 3 trials, 128 participants: SMD= 0.03; -0.32, 0.38), overall neuropsychiatric symptoms (ST vs UC, 3 trials, 169 participants: SMD= -0.01; -0.32, 0.29; ST vs AC, 2 trials, 145 participants: SMD =0.02, -0.71, 0.85), apathy (ST vs AC, 2 trials, 81 participants: SMD= 0.14; 0.29, 0.58), depression (ST vs UC, 4 trials, 181 participants; SMD= 0.08; -0.52, 0.69; LT vs UC: 2 trials, 77 participants: SMD =0.01; -0.75, 0.77), anxiety (ST vs UC: 2 trials, 104 participants, SMD= 0.24; -0.85, 1.33) and quality of life (ST vs UC, 2 trials, 127 participants: SMD=-0.05; -0.52, 0.42; ST vs AC: 2 trials, 159 participants, SMD =-0.36, -0.76, 0.05). Robotic animals, humanoid companion robots, telepresence robots and multifunctional robots were feasible and acceptable. However, humanoid companion robots have speech recognition problems, and telepresence robots and multifunctional robots were often difficult to use. There was mixed evidence about the feasibility of homecare robots. There was little evidence on any of these robots' effectiveness.

CONCLUSION

Although robots were generally feasible and acceptable, there is no clear evidence that people with dementia derive benefit from robots for cognition, neuropsychiatric symptoms, or quality of life. We recommend that future research should use high quality designs to establish evidence of effectiveness.

Humanoid Robot Use in Cognitive Rehabilitation of Patients with Severe Brain Injury: A Pilot Study

Severe acquired brain injury (SABI) is a major global public health problem and a source of disability. A major contributor to disability after SABI is limited access to multidisciplinary rehabilitation, despite evidence of sustained functional gains, improved quality of life, increased return to work, and reduced need for long-term care. Twelve patients with a diagnosis of SABI were enrolled and equally divided into two groups: experimental and control. Patients in both groups underwent intensive neurorehabilitation according to the severity of their disabilities (motor, psycho-cognitive, and sensory deficits). However, in the experimental group, the treatment was performed by using a humanoid robot. At baseline, the two groups differed significantly only in Severe Impairment Battery (SIB) scores. Results showed that the experimental treatment had a higher effect than the traditional one on quality of life and mood. In conclusion, this pilot study provides evidence of the possible effects of relational and cognitive stimulation in more severely brain-injured patients.