Robots May Replace Human Healthcare Aides in the Senior Care Industry
By Don Drake, Connelly Law Offices, Ltd.
"Even before we experienced the pandemic and the hiring crisis, we discussed the growing need for home health aides and other health care professionals to provide services to an aging America," stated professional fiduciary and certified elder law Attorney RJ Connelly III. "This problem is not unique to this country; it is a problem facing many societies worldwide."
"According to the United States Census Bureau, just six years ago, 15 percent of Americans, which is almost one in six of the population, were aged sixty-five or older. This is an increase from 12 percent in 2000. Experts predict that by 2060, almost one in four Americans will belong to this age group, which means there will be an additional forty-eight million elderly people in the country in just forty years," Attorney Connelly said.
According to a National Center for Health Statistics report, the number of births in America has consistently declined since 2008. This downward trend is worrying as it could have serious implications for the demographics and economy of the country in the future.
"The birth rate of a society is a crucial indicator of its demographic balance. If the rate is too high, resources such as education and housing are overstretched, while if it is too
low, there will be difficulties in replacing the workforce and caring for the elderly," stated Attorney Connelly. "In this country, a decline in the working population leads to a reduction in the amount of money collected in social security and Medicare taxes, which in turn affects the ability to support an ever-increasing senior population. Furthermore, there will be a shortage of employees to provide services for the elderly who are living longer and requiring more care."
Using Robots in Healthcare Settings
In order to address the shortage of workers, many developed countries are turning to technology, specifically robots, to provide care for the elderly. However, before we celebrate this new development, we need to seriously consider some concerns regarding the use of robots. Before delving into these concerns, let's take a closer look at this technology.
"Most of us who work with seniors are aware of the new home innovations that enable them to maintain their independence," stated Attorney Connelly. "There are devices that are connected to phone lines to monitor medical hardware, such as pacemakers and defibrillators, to prevent the need for long-term care facilities. However, seniors living independently require assistance with medical issues and everyday tasks like cooking, light cleaning, and managing finances."
Family members are often not geographically close enough to assist with caregiving duties, and studies indicate that such caregiving is not sustainable or healthy for either party. This phenomenon has resulted in a significant rise in demand for professional home health care services. However, the industry is grappling with staffing issues and employee training, as demand continues to outpace supply while the workforce shortage is predicted to worsen.
As healthcare costs continue to rise and a shortage of healthcare workers becomes more apparent, healthcare providers are turning to robots to help fill the demand for these services. Investing in robots makes sense from a business perspective, as they are a one-time investment with minimal upkeep, never call out sick or quit, and provide consistent care without the emotional variability of human providers.
In the past, people were skeptical of robots being involved in human care. However, recent surveys show that attitudes are changing. Professionals and families seeking health aides for their elderly parents are now more open to the idea of robotic assistance in caregiving. A new electronic helper called GiraffPlus robot continues to undergo prototype testing in Europe.
This machine aims to aid elderly individuals who wish to continue living in their homes and maintain their independence despite physical or cognitive difficulties that may prevent them from living alone. It employs motion sensors that track movement in specific areas of the home, while pressure sensors installed under beds and sofas detect when someone is sitting. Additionally, sensors are activated when appliances are plugged in and can monitor whether doors and windows are open or closed. The machine can also measure room temperature and humidity and adjust heating or cooling systems accordingly.
The robot has multiple functions beyond its primary purpose. It can measure weight, blood pressure, and sugar levels while also monitoring seniors' movements during the night. Additionally, the robot is equipped with a screen that enables "virtual visits" from healthcare professionals, friends, and family.
The robot, however, has been encountering some issues, mainly its inability to differentiate between the unique characteristics of individual users. Additionally, users can unplug it or accidentally spill food or drink on it, resulting in sensor malfunction. The robot's creators believe these problems are fixable with ease and speed.
Although surveys indicate that some people in healthcare accept the use of robot technology, others have a significant concern, that being "warm hands versus cold hands." These concerns should not be dismissed as trivial. For many elderly individuals, daily visits from caregivers are their only opportunity for human interaction. Some argue that the absence of human touch could increase the isolation experienced by seniors and contribute to a rapid deterioration in their health.
There is a debate on whether robots have a place in senior care. Proponents of robots argue that those who oppose them are simply afraid of new technology and lack confidence. However, opponents of robots in senior care argue that human touch and interaction are essential for quality care. So, is the opposition to robots a result of insecurity or is it a legitimate concern? Let's delve into this issue further.
The Need for Human Touch
In the early 1900s, there were thousands of orphanages in the United States where unwanted babies were abandoned. Despite providing a warm and sanitary environment with appropriate food, almost all infants placed in these institutions died before they reached the age of seven months. Doctors observed that these children were not sick, and many ate normally, yet they seemed to "waste away," a condition known as "marasmus."
During the same period, a pediatrician named Luther Emmett Holt proposed an innovative approach to childcare that was considered revolutionary at the time. He suggested that parents should refrain from excessive cuddling and holding of their babies, as it would "spoil" them. Holt believed that a good parent should adopt a "hands off" approach to parenting. As a result, many new parents across the country followed his advice. However, pediatricians noticed a significant increase in infant mortality rates within a few years, even among healthy babies.
It became evident that the cause of death of these children was due to a condition commonly known as "failure to thrive". This condition was caused by lack of sufficient human touch. Studies conducted at the time by followers of Holt and on babies who passed away in orphanages discovered that babies deprived of touch were only half the size of normal children.
When Holt's methods were rejected and children were taken out of institutions and placed into environments where they received physical care, their condition of "marasmus" was reversed. As a result, they started gaining weight and began to thrive. The bottom line is that physical touch is essential for the survival of both the very young and the elderly.
"When we are children, we are exposed to a world full of new experiences, and during these times of vulnerability, we rely on the touch of a nurturing caregiver to provide us with a sense of safety. This touch helps us form patterns of consistency and allows us to feel valued by those around us. Our need for touch does not disappear as we grow, and we continue to benefit from human-to-human contact. As we age, this need becomes even more important, as we rely on those around us to provide us once again with a sense of safety and nurturing," explained Attorney Connelly.
Research seems to back this up. In a study conducted by the University of Miami’s Touch Research Institute, they found that hands-on care can:
Lessen pain.
Lower blood glucose levels.
Slow the heart rate.
Lower blood pressure.
Improve pulmonary function.
Improve the immune system.
Enhance alertness and performance.
Other studies show:
Hugs elevate mood, reduce stress, and may prevent Parkinson’s.
Eye contact and a pat on the back from a healthcare professional may increase the survival rate of patients with complex conditions.
Therapeutic touch calms people with dementia.
Touching makes you appear more trustworthy.
A light touch makes people more agreeable when you request something from them.
Attorney Connelly, who serves as a guardian for many clients, shares his perspective on the significance of touch. "During my regular visits to our wards, it is often an emotional experience for both of us. When I arrive and extend my hand for a handshake, they will grab my hand and hold it tightly, looking into my eyes and often tearing up. I can sense their loneliness and gratitude for someone caring about them. It's amazing how a small gesture can have a profound impact - not only on the senior but also on me."
Loneliness as a Healthcare Issue
Researchers in the United States reviewed 218 studies that examined the health effects of social isolation and loneliness on nearly four million older adults. The findings were astounding. Lonely individuals have a 50% higher risk of early death compared to those who regularly interact with others and lead an active lifestyle. Similar studies conducted in Europe have also yielded comparable results.
According to The Telegraph, a British newspaper, Britain has been named the “loneliness capital” of Europe. The report suggests that the citizens of the UK are less likely to have strong friendships or know their neighbors. The United Kingdom’s Local Government Association was deeply concerned about the results of this report and petitioned the government to treat loneliness as a significant health issue. In addition, the non-profit agency Age UK issued a press release, calling this issue a blight on the lives of over one million elderly people.
Recent studies have raised concerns about the new reality of seniors staying in their homes. While they seem to thrive when connected with others and having an active social life, those without such support may suffer from depression and chronic illness. Even though we may prefer to keep our seniors at home, the lack of human interaction may lead to more problems and increased costs for the healthcare system through physical and mental illness. In these cases, robots may not be able to fulfill their needs.
Human Touch as Therapy
After a six-month pilot program on massage therapy for Alzheimer's patients, correlations were found between gentle touch and easing anxiety and angry outbursts.
According to a study, back rubs benefit people confined to wheelchairs, those experiencing chronic pain, and those exhibiting irritability or even anger. Foot massages are helpful for those who exhibit hyperactive behavior or restlessness and those who tend to wander. Hand massages or face stroking have a calming effect on people who experience anxiety, worry, sadness, and fearfulness. Massaging the temples, scalp, and forehead can help alleviate headaches and tension, while shoulder and neck massages can be useful in reducing tiredness, irritability, or mild upset.
Using touch as a nonverbal communication and therapeutic modality, such as massage, proved successful in inducing relaxation and reducing anxiety and frustration for people with dementia who struggle to communicate with language.
Study results also found that individuals with Alzheimer's disease who received hand massages and were spoken to in a soothing manner experienced decreased pulse rates and inappropriate behaviors. Healthcare experts have suggested that massage therapy could be advantageous in dementia care because it promotes relaxation and provides a form of social interaction often absent for these individuals.
It is unclear whether robots can provide the same level of interaction that seniors rely on from human caregivers. Can robot companions offer a comforting touch, understand the concerns of those with dementia, or express empathy on their own? Additionally, there are further concerns regarding robotic care for the elderly.
Ethics and Electronics
Multiple ethical concerns have been brought to light by Attorney Connelly regarding the use of robots in senior care. "The reduction in human touch is a significant factor, but there are also other issues to consider. These include the potential loss of privacy and personal choice, the possibility of feeling objectified and losing control, and the risk of outsiders hacking into the control systems and accessing sensitive patient records or financial information," he stated.
He advises that while using robots for service delivery is beneficial, it should be balanced with the individual's need for human caregivers. "How far we are willing to go to meet numerical targets. Though the use of robots can provide a better quality of life for our seniors by delivering the services they need, we should ask ourselves whether we are willing to sacrifice human touch and social interactions for this purpose. Is this the quality of life we want for our loved ones, and ultimately for ourselves?"
While the reality of robotic care is still emerging, experts predict it could be a possibility within the next decade. As we approach this potential future, weighing the advantages of robotic care against ethical considerations is crucial. It's important to keep in mind that the decisions we make now regarding care for our elderly population will directly affect our own care in the future. How at ease will we feel knowing that a mechanical, unemotional object is providing our care with a programmed smile and scripted greetings?
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