Japan has been developing robots to care for the elderly for more than two decades, and public and private investment increased significantly in the 2010s. In 2018, the national government alone had spent more than $300 million on research and development for such devices. At first glance, the reason to race to robotize healthcare seems obvious. Virtually every news article, presentation, or academic article on the subject is preceded by a series of frightening facts and figures about Japan’s aging population: the birth rate is below replacement, the population has begun to shrink, and although in 2000 there were about four adults in the working age for every person over 65, the two groups will be nearly equal by 2050. The number of elderly people requiring care is increasing rapidly, as is the cost of caring for them. At the same time, the already serious shortage of healthcare personnel is expected to become even greater in the next ten years. There is little doubt that many people in Japan see robots as a way to fill in for these missing workers without paying higher wages or asking difficult questions about importing cheap immigrant labor, which successive conservative Japanese governments have tried to curb .
Care robots come in different shapes and sizes. Some are for physical care, including machines that can help the elderly lift if they are unable to get up on their own; help with mobility and exercise; track their physical activity and detect falls; feed them; and help them take a bath or go to the toilet. Others focus on engaging older people socially and emotionally to manage, reduce, and even prevent cognitive decline; they can also provide companionship and therapy for lonely elderly people, make people with dementia-related conditions easier for healthcare workers to access, and reduce the number of caregivers needed for day-to-day care. These robots are usually expensive to buy or lease, and so far most have been marketed for care homes.
There is mounting evidence that robots tend to create Lake work for carers.
In Japan, it is often assumed that robots are a natural solution to the ‘problem’ of elder care. The country has extensive expertise in industrial robotics and has been a leader in humanoid robot research for decades. At the same time, many Japanese seem – at least at first glance – to welcome the idea of interacting with robots in everyday life. Commentators often point to supposed religious and cultural explanations for this apparent affinity, most notably an animistic worldview that encourages people to view robots as humans with minds of their own, and the huge popularity of robot characters in manga and animation. Robotics companies and supporting policy makers have promoted the idea that healthcare robots will ease the burden on human caregivers 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 belief: Robots will save Japan.
The reality is, of course, more complex and the popularity of robots among the Japanese depends in large part on decades of relentless promotion by the state, media and industry. Accepting the idea of robots is one thing; being willing to deal with them in real life is quite another. Moreover, their actual capabilities fall far short of the expectations formed by their hyped image. It’s a bit of an inconvenient truth for robot enthusiasts that despite the publicity, government aid and subsidies – and the real technological achievements of engineers and programmers – robots don’t really feature in any major aspect of most people’s daily lives in Japan, including elder care. .
A large national survey of more than 9,000 aged care facilities in Japan found that in 2019 only about 10% reported introducing a care robot, while one Study from 2021 found that of a sample of 444 people who provided home care, only 2% had experience with a care robot. There is some evidence that when robots are purchased they are often only used for a short time before being locked in a closet.
My research has focused on this decoupling between the promise of care robots and their actual introduction and use. Since 2016, I have spent over 18 months doing ethnographic fieldwork in Japan, including time spent in a nursing home trying out three of them: Hug, a lifting robot; Paro, a robotic seal; and Pepper, a humanoid robot. Hug was intended to avoid caregivers 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 make repeated demands of staff throughout the day), and Pepper to conduct recreational practice sessions so that staff would be freed up for other duties.
But the problems quickly became apparent. Staff stopped using Hug after just a few days, as it was cumbersome and time-consuming to move from room to room, reducing their time to interact with the residents. And only a small number of them could be lifted comfortably using the machine.
Paro was more favorably received by both staff and residents. Shaped like a fluffy, soft toy seal, it can make noises, move its head and wiggle its tail when users pet and talk to it. Initially, rescuers were quite satisfied with the robot. However, difficulties soon arose. One resident kept trying to “skin” Paro by removing the outer layer of synthetic fur, while another developed a very close bond and refused to eat or go to bed without him with him. Staff eventually had to keep a close eye on Paro’s interactions with residents, and it didn’t seem to reduce the repetitive behavior patterns of people with severe dementia.