At a seminar hosted by the University of Brighton I was recently formally introduced to PARO, a therapeutic robotic seal from Japan, and his creator Dr. Takanori Shibata. The focus of the day was on the usage of therapeutic robots in dementia care settings. In keeping with the overall concept, whereby the individual or group name the robot, I chose to call him Hercule PARO. In doing so I have given the robot a gender and started to personify it. More about his “characteristics” later but his appearance is immaculate, his powers of observation are superb and he does have whiskers. Before further developing a relationship with the potential biohazard, NHS Infection Control protocol in the UK determines that I first stroke the fur all over with an anti-bacterial wipe. My hands of course are expected to also be freshly disinfected. Later on in the day I was also introduced to Justocat from Sweden. I named her “Purrfect” as she has a wonderfully vibrant purr. If you remove her electronic “innards”, she can go in the washing machine. Other creatures present were a parrot, two more cats, a doll and a recue seal from a charity shop.
Why am I asking the question is 3 the magical number? Well, because this is the third academic presentation I have attended relating to PARO and, after all my scepticism I now understand the contribution that therapeutic robots can make in the care of older people. Most importantly though, there are three participants in this “therapeutic” relationship, “Hercule”, his “handler”, and “the patient”. The therapeutic outcome is, to my mind, highly dependent on the personality, skill and commitment of the “handler”. Both a live animal and a robotic animal can be expected to awaken human interest and are consequently useful “tools” to initiate interaction between people. For someone living with dementia, whether at home or in a care home human interaction is invaluable and enhances an individual’s quality of life.
Why do I use the term “handler”? In a nutshell because the person introducing Hercule to a patient, whether an autistic child or an older person living with dementia, can be a highly qualified therapist or a care assistant who loves working with the robot and interacts well with both people and technology. To the best of my knowledge any research or evaluation of therapeutic robots pays little attention to this key third element in the relationship between a robot and a patient. A further reason for the use of the term is that visiting dogs, pigs, alpacas, ponies or cart horses coming to a care facility also have a vitally important “handler”.
Speaking of which, why a robot and not a live animal? Although seen as a potential biohazard as a carrier and transferor of germs on their artificial fur, neither Hercule nor Purrfect shed their fur or cause allergic reactions. Both would always be a trustworthy friend, regardless of what has been said or done.
Why is Hercule a seal and not a dog, cat or doll? Hercule’s development was initiated by engineers and in the development process, research findings indicated that a baby seal was a culturally and emotionally neutral animal that could awaken parenting emotions in adults. Its size and weight resemble that of a small child. The sounds it makes also evoke memories of a child calling for or reacting to attention. The findings also indicate that with live animals, the interest and interaction decreased whilst with the robotic seal it increased. The form of a more humanlike doll was perceived to be inappropriate as it is seen to infantilise the adult. The body shape also appears to accommodate the required technology very well. Hercule moves his head and opens or closes his eyes in response to sounds and handling. He also moves his tail fins.
Why is Purrfect a cat? The concept for Purrfect was developed out of a concept created by dementia care specialist Dr. Christine Gustafsson in Sweden, introduced to engineers and then jointly taken forward to its current version. Core principal here was to awaken realistic memories of having a pet cat in your life. Its weight also resembles that of a small child. As a reaction to stroking or handling, Purrfect has a deep resounding purr that vibrates through its body but she is otherwise inanimate.
What are the perceived potential advantages for an older person living with dementia? Both research findings presented at the seminar and anecdotal evidence from people I have spoken to, who work with therapeutic robots, indicate a calming effect is achieved and there is an improved sense of well being. The reason for the rescue seal from a charity shop being in the menagerie was that it was useful to exchange Hercule for the smaller seal so it could, after being cleansed, be passed on to others. A recurring aspect in the research findings appears to be that the therapeutic robots reduced anxiety. Findings from a study in Texas indicate that sleep improves, wandering decreases, sadness is reduced and the sense of isolation alleviated. Use of nurse call system was seen to go down and the amount of psychotic medication required was also seen to decline.
Do I think it is worth considering and purchasing? My opinion is that therapeutic robots do deserve to be considered as an optional tool to enhance the everyday life of older people living with dementia. However, I strongly believe that what works well for one person or group doesn’t necessarily succeed in the same way elsewhere. The decision needs to be made on an individual level and the human factor is key. It is not something that can be imposed on staff or residents, just as much as a visit by a live animal cannot be expected to be welcomed by all. How a therapeutic robot or animal is introduced and the relationship established and maintained between robot or animal and an older person is ultimately down to the third element, the all important human “handler”. Important is that at long last it is be acknowledged that there is more to life in care than washing and dressing someone and ensuring they eat regularly, take their medication and are warm and safe. Technological advancements can enhance human interaction but not replace the special bond and chemistry that develops between people.
Dr. Ingrid Eyers© 20th March 2016 CRaNe (Care Research Network)