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EACH time I make a house call, I stay much longer than I should. I
can't leave because my patient is holding my hand, or because she's
telling me, not for the first time, about when Aunt Mabel cut off all
her hair and they called her a boy at school, or how her daddy lost
his job and the lights went out and her mother lit pine cones and
danced and made everyone laugh. Sometimes I can't leave because she
just has to show me one thing, but getting to that thing requires that
she rise unsteadily from her chair, negotiate her walker through the
narrow hallway, and find whatever it is in the dim light of her
bedroom.
I can, and do, write prescriptions for her many medical problems, but
I have little to offer for the two conditions that dominate her days:
loneliness and disability. She has a well-meaning, troubled daughter
in a faraway state, a caregiver who comes twice a week, a friend who
checks in on her periodically, and she gets regular calls from
volunteers with the Friendship Line.
It's not enough. Like most older adults, she doesn't want to be
"locked up in one of those homes." What she needs is someone who is
always there, who can help with everyday tasks, who will listen and
smile.
What she needs is a robot caregiver.
That may sound like an oxymoron. In an ideal world, it would be: Each
of us would have at least one kind and fully capable human caregiver
to meet our physical and emotional needs as we age. But most of us do
not live in an ideal world, and a reliable robot may be better than an
unreliable or abusive person, or than no one at all.
Caregiving is hard work. More often than not, it is tedious, awkwardly
intimate and physically and emotionally exhausting. Sometimes it is
dangerous or disgusting. Almost always it is 24/7 and unpaid or low
wage, and has profound adverse health consequences for those who do
it. It is women's work and immigrants' work, and it is work that many
people either can't or simply won't do.
Many countries have acknowledged this reality by investing in robot
development. Last year in Japan, where robots are considered "iyashi,"
or healing, the health ministry began a program designed to meet
work-force shortages and help prevent injuries by promoting
nursing-care robots that assist with lifting and moving patients. A
consortium of European companies, universities and research
institutions collaborated on Mobiserv, a project that developed a
touch-screen-toting, humanoid-looking "social companion" robot that
offers reminders about appointments and medications and encourages
social activity, healthy eating and exercise. In Sweden, researchers
have developed GiraffPlus, a robot that looks like a standing mirror
cum vacuum cleaner, monitors health metrics like blood pressure and
has a screen for virtual doctor and family visits.
Continue reading the main story
Researchers in the United States are developing robot-caregiver
prototypes as well, but we have been slower to move in this direction.
Already, we have robots to assist in surgery and very basic "walking"
robots that deliver medications and other supplies in hospitals.
Robots are increasingly used in rehabilitation after debilitating
events like strokes. But a robot that cleans out your arteries or
carries linens isn't the same as a robot meant to be your friend and
caregiver. Even within the medical community, this idea that machines
could help fulfill more than just physical needs meets largely with
skepticism, and occasionally with outrage.
Continue reading the main story

As Jerald Winakur, a San Antonio internist and geriatrician, put it,
"Just because we digitally savvy parents toss an iPad at our kids to
keep them busy and out of our hair, is this the example we want to set
when we, ourselves, need care and kindness?"
And yet, search YouTube and you can watch developmentally delayed
children doing therapy with a cute blue-and-yellow CosmoBot that also
collects information about their performance. Or you can see older
Japanese people with dementia smiling and chatting happily with a
robot named Paro that looks like a baby seal and responds to human
speech. Sherry Turkle, an M.I.T. professor and technology skeptic,
questions such artificial emotional relationships in her book "Alone
Together: Why We Expect More From Technology and Less From Each
Other." Yet after watching a 72-year-old woman named Miriam interact
with Paro, she noted that the woman "found comfort when she confided
in her Paro. Paro took care of Miriam's desire to tell her a story."
One proof of the social and emotional potential of robot caregivers is
probably right in front of you. If you have walked down any street
recently, or sat in a restaurant, or entered a workplace, you've
probably seen numerous people oblivious to the humans with or around
them, while fully engaged with the machines in their hands or on their
desks. Admittedly, such people are often interacting with other humans
via their machines, but the fact remains that the primary interaction
is between person and machine, and despite compelling protests that
such interactions do not constitute meaningful, empathic
relationships, they seem to provide stimulation and satisfaction to
millions, if not billions, of us. Maybe you are one of those people,
reading this article on a device.
But the biggest argument for robot caregivers is that we need them. We
do not have anywhere near enough human caregivers for the growing
number of older Americans. Robots could help solve this work-force
crisis by strategically supplementing human care. Equally important,
robots could decrease high rates of neglect and abuse of older adults
by assisting overwhelmed human caregivers and replacing those who are
guilty of intentional negligence or mistreatment.
In the next decade, robot caregiver prototypes will become much more
sophisticated. According to Jim Osborn, the executive director of the
Quality of Life Technology Center at Carnegie Mellon, the current
limitation is not the technology, but finding a viable business model
to make it affordable. He said, "I really expect there will be a robot
helping me out when I retire. I just hope I don't have to use all my
retirement savings to pay for it."
In that new world, my lonely, disabled patient's life would be
improved by a robot caregiver.
Imagine this: Since the robot caregiver wouldn't require sleep, it
would always be alert and available in case of crisis. While my
patient slept, the robot could do laundry and other household tasks.
When she woke, the robot could greet her with a kind, humanlike voice,
help her get out of bed safely and make sure she was clean after she
used the toilet. It -- she? he? -- would ensure that my patient took the
right medications in the right doses. At breakfast, the robot could
chat with her about the weather or news.
And then, because my patient loves to read but her eyesight is
failing, the caregiver robot would offer to read to her. Or maybe it
would provide her with a large-print electronic display of a book, the
lighting just right for her weakened eyes. After a while the robot
would say, "I wonder whether we should take a break from reading now
and get you dressed. Your daughter's coming to visit today."
Are there ethical issues we will need to address? Of course. But I can
also imagine my patient's smile when the robot says these words, and I
suspect she doesn't smile much in her current situation, when she's
home alone, hour after hour and day after day.
An associate professor of geriatrics at the University of California,
San Francisco, and the author of a collection of stories, "A History
of the Present Illness."
A version of this op-ed appears in print on July 20, 2014, on page SR4
of the New York edition with the headline: The Future of Robot
Caregivers.



-- 
Avinash Shahi
M.Phil Research Scholar
Centre for The Study of Law and Governance
Jawaharlal Nehru University
New Delhi India



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