2020 is a catastrophic year for the elderly in the United States; not only are they categorized as a high-risk group of the Coronavirus, but are also exposed to more serious problems in the nursing home system including group infection, abuse and accidents caused by negligence and ignorance due to caregiver shortage created by the death of nursing home care workers and the wave of resignation (the wave of resignation for fear of infection). This situation has resulted in a lengthy report published by ABC News in March 2021, “The United States Knows that Nursing Homes Are Broken,” which exposed the reality that more than 170,000 elderly residents in nursing homes died alone without accompaniment of family members during the COVID-19 period. Moreover, the report deeply dug out the well-known neglected management problems of nursing homes for a long time, including the serious shortage of caregivers and poor service, and denounced that no one really cares about this serious social problem.

In fact, the reason for the problem of nursing home service in the United States is not only the shortage of caregivers in quantity, but also the quality of service provided by the caregivers. There are no mandatory unified laws and regulations for the training, supervision and management of caregivers. This is understandable, because no one is willing to do it and it is difficult to recruit. Of course, nursing homes have to lower the recruitment standards. Who dares to ask for any training and certificates? Different from Japan, the United States does not require caregivers to have certificates to work, nor does it have Japanese-style care insurance or care managers. Caregivers in nursing homes are basically regarded as blue-collar workers with dirty and tired heavy physical work. For example, it is well-known that in 2014, an 83-year-old woman in a nursing home in Minnesota was also raped for a long time. The criminal was a refugee from Celia, and he had raped other old men and women; In 2019, a 50-year-old disabled woman and another 93-year-old woman in Seattle nursing home were repeatedly raped by caregivers in their 20s; In the same year, two female caregivers whipped an elderly with a whip, and three female caregivers beat an elderly violently.

In the United States, because the 50 states have their own governance, the authority of government supervision of nursing homes are different in each state. Although they are mainly in charge of the state's health department, they do not often publish investigation reports on nursing home abuse, and some do not at all. When conducting annual investigations, the federal government will be alerted to investigate nursing homes only after major casualties have occurred. In 2006, the New York State Department of Health issued an investigation report on nursing homes, which announced that 48 nursing homes had the problem of elder abuse. However, in 2019, because of the consecutive rapes and homicides in nursing homes, it triggered media reports on the abuse of elders in nursing homes. Concerned, some media asked the Ministry of Health in many states to ask for survey data on abuses in nursing homes but was told that they had not conducted this survey and no statistics were available. It can be seen that the problem of elder abuse in nursing homes has not been taken into consideration for inclusion in regular supervision projects.

Many old people turn pale when talking about nursing homes. They would rather die alone at home than go, but loneliness and danger also exist in living at home. The rapid popularity and soaring sales of nursing robots prove the huge demand and expectation of the elderly for nursing robots - Is this a human tragedy? Old people have been afraid of human care workers, can only seek the help of robot care workers! "Can be completely trusted, 24-hour guard, due diligence, no mood, easy to get along with, no abuse, let the family rest assured, save money" the evaluation given by the elderly customers is positive, and the facts also prove that so far there has been no bullying, abuse or killing of the elderly by nursing robots. So, can nursing robots really completely replace human nursing workers??

The number of caregiver robots in the U.S. market comes from all over the world, and there are more brands than those in the Japanese market:

The first category is caregiver robots for small family caregivers. A certain kind of caregiver robot is currently the largest in sales, accounting for more than half of the market share. The users are mainly elderly people at home. Because the elderly are the most dependent on medicine, but forgetfulness, depression caused by loneliness and inactive treatment make most of them unable to complete the course of treatment planned by the doctor, especially among the elderly living alone. Therefore, caregiver robots have become very popular as soon as they are on the market. These caregivers mainly supervise and remind the elderly to take medication, rest and exercise on time, and accurately urge and supervise the elderly to carry out and implement medical or rehabilitation plans. They will have simple conversations such as asking, "Do you feel uncomfortable?" "Do you need me to call a doctor?" Of course, they all have the function of automatically dialing the alarm or emergency call and connected to the display and camera. The elderly can communicate with doctors or family members through video. These dialogues not only helps the elderly, but also reduced the burden of caregiving for family members, especially for those children who do not live together or are busy with work, it is a great savior. It feels more at ease to see the situation of the elderly at any time, which helps them to get back to their daily tasks with peace of mind.

Because of the difference in prices, there are currently cheaper models with display, and there are also more expensive humanoid models. They can walk freely, follow the elderly and take care of them 24 hours a day. Although they have no facial expressions, they can express their concerns through dialogue. More expensive robots have more functions, for example, helping to grab water, take medicine and fetch some simple and lighter items and so on.

For example, the Swedish robot giraffe (Giraffe) is equipped with basic functions. The American robot Rudy, and Irish Stevie are also economical. The more advanced ones are Pepper and Nao from Japan. They are more exquisite in appearance, have flexible fingers for accurate grab, and are equipped with AI and can talk smartly. More advanced robots can do auxiliary tasks such as picking up and delivering items, drawing curtains, and so on. There is the HSR (Human Support Robot) made by Toyota in Japan and ASIMO made by Honda which manage physical tasks as well as human interaction; the most advanced robot is T-HR3 made by Toyota whose movement is synced to a human operating from a distance. (Please look at the pictures, they are separated in order)

The second category is companion caregiver robots. These robots are mainly used to chat with the elderly. They will find topics to chat, dialogue, sing and dance by themselves. The purpose is to solve the problem of loneliness, and at the same time, by stimulating the elderly to talk and think, thus keeping their brain active. There are also pet-type robot dogs, cats, baby sea lions, rabbits, cartoon characters, etc. which will act as coquettish to stimulate emotional bond with the elderly. Similar robots have been widely used in Parkinson’s syndrome and other amnesia, autism, and depression. During the treatment of the disease, and there are research reports that the active time of brain cells activated by robot conversation and emotional communication is on average 2 hours longer than that of traditional physical therapy methods such as calculation, finger games, etc.; From an economic point of view, this one-time investment can save the follow-up long-term average monthly physiotherapy fee of 1,200 US dollars.

These robots are small in size, rich in facial and motional expressions, some can speak, and some just make small animal sounds, but they all use the AI technology, which can recognize faces and voices, and are smart and have their own personality, so they are quick to be loved by the elderly and become the safest, most trusted, and most worry-free partner for the elderly.

However, some objections point out that this will cause the elderly and depressed patients to break away from and escape from the real society of human beings and become immersed in the society of fictional robots, in which robots 100% obey their orders. No quarrel or contradiction, once they develop the habit of issuing commands one-way, it will cause them to treat humans in the same way, creating misunderstanding and conflict, causing them to be harder to adapt to the real society, and lose the ability to communicate and get along with humans!

Currently on the market, there are Chinese-made MarsCat (MarsCat), Japanese-made Aibo, furry MOFLIN, and little sea lion Parochial, desktop naughty EMO and so on.

When performing tasks for the first time, the robots need to be trained first, and then they will execute the commands accurately and precisely in accordance with the instructions and schedule to ensure that the work is completed on time. Because there is no temper and emotions, robotic caregivers can effectively reduce doctor-patient conflicts, and because robots do not breathe or speak, they can reduce the spread of air-borne diseases in hospitals, especially during the Coronavirus pandemic. The advantage of caregiver robots are even more obvious that the use of robot caregivers to care for patients with highly infectious diseases can prevent human caregivers from being infected, thereby reducing the illness and death of human caregivers, and also reducing infection to other patients and families from infected human caregivers.

During the period of the new crown epidemic from 2020 to the present, the healthcare industry in the United States has been hit hard. There is a shortage of nurses. Cities and states are competing for nurses. Not only have medical staff died and committed suicide, but many people have resigned to protect themselves. More than 80% of them have resigned. The nurses who stick to their posts also suffer from depression and post-traumatic stress disorder (PTSD) because they have witnessed too many deaths suddenly. The American Nurses Association called for attention to the mental health of nurses and set up a special hotline urgently. Medical staff provide support through talking and asking for help. In contrast, robot nurses will not produce these emotional and psychological pressures, and will not have problems such as illness, suicide or death. Therefore, the demand for such robot nurses has surged, and the market space is huge.

At present, there are some nurses on the market, such as Moxi, a diligent nurse from the American diligent robot company. She has a simple appearance, a manipulator that can grasp objects, and a round foot that can be used to place and transport objects. Although her face is a display screen, she can only make simple eye expressions, which can be said as simple greetings. Her other functions have yet to be upgraded, but she has already worked in some hospitals, and her working ability has been recognized. In addition, the robot nurse Tommy mainly helps doctors and patients to talk and transfer information, because his face is a video, and his chest has a display screen that can display text. Tommy constantly patrols patients, and can connect doctors and nurses to help patients communicate instantly through the video. Tommy was popular during COVID-19, because it helped reduce the chance and time for doctors to speak directly to each other, thereby protecting medical staff from infection. In addition, cruzr, made in Belgium, has intelligent navigation and dialogue functions. It has simulated human arms and hands. It can shake hands and greet. It is a smart hall manager.

➾ Original Published Article Link

The author Yoko Marikawa is an expert in the elderly care industry in Japan and a pioneer in the elderly care industry. She has long been committed to ensuring and improving the well-being of the elderly by improving the management of nursing homes and the quality of elderly care services. In recent years, in order to find effective solutions to the problems of poor medical services for the elderly, elder abuse, the surge of elderly dementia patients, and the shortage of eldercare workers, Yoko Marikawa has devoted a lot of energy in researching how to use high technology to help solve these serious and urgent social issues, including the use of nursing robots, quantitative management and monitoring systems, etc. This article is an article in Yoko Marikawa's newspaper column "Yoko Marikawa Talks about Eldercare".