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Inside Japan’s long history of automating elderly care

Inside Japan’s long history of automating elderly care

Inside Japan's long history of automating elderly care

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Japan has been developing robots to care for the elderly for more than two decades, with public and private investment accelerating markedly in the 2010s. By 2018, the national government alone had spent well over $300 million dollars to fund the research and development of such devices. At first glance, the reason for the race to robotize care may seem obvious. Almost every news article, presentation or academic article on the subject is preceded by a series of anxiety-provoking facts and figures about Japan’s aging population: birth rates are below replacement levels, the population has started to decline and, although in 2000 there were about four working-age adults for every person over 65, by 2050 the two groups will be close to parity. The number of older people in need of care is growing rapidly, as is the cost of caring for them. At the same time, the already significant shortage of social workers is expected to worsen over the next decade. There is no doubt that many people in Japan see robots as a way to replace these missing workers without paying higher wages or facing difficult questions about importing cheap immigrant labor, whether successive Japanese conservative governments have attempted to reduce.

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Care robots come in different shapes and sizes. Some are for physical care, including machines that can help lift older people if they are unable to get up on their own; help with mobility and exercise; monitor their physical activity and detect falls; feed them; and help them take a bath or go to the toilet. Others aim to socially and emotionally engage older people in order to manage, reduce and even prevent cognitive decline; they could also provide companionship and therapy for lonely older people, make the management of people with dementia-related illnesses easier for caregivers, and reduce the number of caregivers required for day-to-day care. These robots tend to be expensive to buy or rent, and so far most have been marketed to residential care facilities.

Growing evidence shows that robots end up creating Following work for caregivers.

In Japan, robots are often seen as a natural solution to the “problem” of elderly care. The country has extensive expertise in industrial robotics and has been the world leader for decades in humanoid robot research. At the same time, many Japanese seem, at least on the surface, to welcome the idea of ​​interacting with robots in everyday life. Commentators often point to supposed religious and cultural explanations for this apparent affinity, particularly an animistic worldview that encourages people to see robots as having some kind of mind of their own, and the enormous popularity of characters from robots in manga and animation. Robotics companies and supportive policymakers promoted the idea that care robots would ease the burden on care workers and become a major new export industry for Japanese manufacturers. The title of not one but two books (published in 2006 and 2011 and written by Nakayama Shin and Kishi Nobuhito respectively) sums up this conviction: Robots will save Japan.

Japan is a pioneer in healthcare automation. Among the well-known devices is this prototype lifting robot, Robear.

The reality, of course, is more complex, and the popularity of robots among Japanese people is largely based on decades of relentless promotion by the state, media and industry. Accepting the idea of ​​robots is one thing; being prepared to interact with them in real life is quite another. Moreover, their actual abilities are far behind the expectations shaped by their hype-up image. It is something of an inconvenient truth for robot enthusiasts that despite publicity, government support and subsidies – and the genuine technological achievements of engineers and programmers – robots do not really feature in any major aspect of the everyday life of most people in Japan, including care for the elderly.

A large national survey of more than 9,000 elderly care facilities in Japan showed that in 2019 only around 10% said they had introduced a care robot, while a 2021 study found that out of a sample of 444 people who provided care at home, only 2% had experience with a care robot. There is evidence to suggest that when robots are purchased, they often end up only being used for a short time before being locked away in a closet.

My research focused on this disconnect between the promise of healthcare robots and their actual introduction and use. Since 2016, I have spent more than 18 months conducting ethnographic field research in Japan, including in a nursing home testing three: Hug, a lifting robot; Paro, a robotic seal; and Pepper, a humanoid robot. Hug was intended to prevent caregivers from having to manually lift residents, Paro to provide a robotic form of animal therapy (while also acting as a distraction aid for some people with dementia who made repeated requests to staff throughout the day), and Pepper to organize recreational exercise sessions so that staff are freed up for other duties.

Paro, a fuzzy animatronic sigil, is intended to provide a robotic form of animal therapy.

KIM KYUNG HOON/REUTERS/ALAMY

But the problems quickly appeared. Staff stopped using Hug after just a few days, saying it was cumbersome and tedious to move from room to room, which reduced the time they had to interact with residents. And only a small number of them could be lifted comfortably using the machine.

Paro was received more favorably by staff and residents. Shaped like a fluffy and soft seal, it can make noise, move its head and wag its tail when users pet and talk to it. At first, the caregivers were quite satisfied with the robot. However, difficulties soon arose. One resident continued to try to “skin” Paro by removing her outer layer of synthetic fur, while another developed a very tight attachment, refusing to eat or go to bed without having her by her side. Staff ended up having to closely monitor Paro’s interactions with residents, and it didn’t seem to reduce the repetitive behaviors of people with severe dementia.

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