Companies are creating robots that can complete household and caregiver tasks, provide comfort in the shape of a cat, as well as call 9-1-1 in an emergency. But where do we draw the line?

According to the Alzheimer's Association, more than five million Americans are living with Alzheimer's disease. In the absence of any medical breakthroughs to prevent, slow or stop the disease, that number is predicted to rise to 13 million by 2025.

The last two generations have produced far fewer children than our grandparents' generation. This translates into a lack of people who can provide care for our ever-growing aging population. Additionally, as people live longer they often need more care for a longer period of time than in the past. This includes nearly all elders; not just those with Alzheimer's.

To ease this crunch, companies are experimenting with robots that can be programmed to complete a number of household and caregiving tasks, as well as call 9-1-1 in an emergency.

Robotic pets: furry and functional

The Front Porch Center for Innovation and Wellbeing, where researchers identify and test new elder care technologies, has conducted a significant amount of analysis of animal-based therapy for aging adults.

"We tested two PARO robot pets for a pilot project at the Sunny View Care Center and Memory Care Unit in the San Francisco Bay Area," says Davis Park, director of the Front Porch Center. "The purpose of the pilot is to gauge resident reaction when interacting with the life-like robot."

The pilot ended last month and the initial findings suggest that engaging with the pet robot reduced pacing and anxiety, and helped calm older residents. "The robots were even used in place of psychotropic drugs," Parks said. "The average amount of time people spent with the robots was up to 25 minutes, which is usually enough time for people to pay attention to it and become socially engaged, whether they're talking to PARO or engaging with people around them."

More robotic pets are becoming available. Polly the Talking Parrot has received rave reviews from several family caregivers on Alzheimer's sites. Polly repeats in a high-pitched parrot voice whatever she hears—twice—mimicking the actions of a real parrot. While repeating, Polly moves her beak and flaps her wings. Her head turns and she shifts from side-to-side with her legs. The people I've heard from have said the life-like Polly was well worth the investment.

Should robots replace real caregivers?

The medical community may accept robotic pets without worry; and I would agree. But the idea of robotic care represents a slippery slope.

Susan (Claffey) Madlung, gerontologist and Clinical Educator for Regional Programs and Home Health Re-Design at Vancouver Coastal Health was surprised to be asked about robots, though she said she shouldn't be, "given these times of advanced technology and limited resources (human as well as financial)." Madlung continued:

"Social isolation of seniors is a significant concern amongst gerontologists and caregivers alike. Robot care, in my mind, would only compound that issue. It will be a long time and the aging of several generations before seniors would feel comfortable and competent with this type of approach to care. Although robots might seem like a good response to the growing need for caregivers, I could see this as being quite detrimental to the emotional and psychosocial well being of anyone, not just seniors. Human need humans."

Daniel C. Potts, M.D., neurologist and Medical Director for Dementia Dynamics, a training program for dementia caregivers, is uncertain about robots. Potts says, "I have mixed feelings about the use of robotics in eldercare. On the positive side, I certainly realize that our 21st century lifestyle has made in-person caregiving more challenging, especially for children caring for aging parents.

"I also feel that technologies that allow remote monitoring to occur, such as medication systems that monitor med dosing, reminder systems for appointments, etc., can be very useful and reduce some of the anxieties of remote caregiving. Furthermore, I feel that some of the robotic systems that help with some of the rote, physical tasks of caregiving, like lifting and turning may prove to be of great use in some cases. I have also heard of the Japanese baby seal robot that has been associated with reduced cortisol levels in autistic persons and dementia patients, suggesting reduced stress levels in response to holding and interacting with it.

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"Having said this, I am concerned, in general, with the level of personal disconnection in our society today, especially between the younger generations and elders. I think this is weakening our culture. Story and personal sharing is so important for all of us, an essential for human life. Relationship is critical to maturity, and I think it becomes even more important as we age. If we think that we can provide adequate care and support to an aging population through technology alone, we are misguided.

"Nothing can take the place of human touch, eye contact, warmth, reminiscence, presence, compassion and empathy—bearing one another's burdens through real relationships. So I think we have to be careful that we use technology wisely. But in summary, I think it will prove to be helpful in certain situations. In general, I think we have a society which seeks to avoid pain rather than being transformed through it."

Protecting the human element as we embrace the future of caregiving

Potts' commentary gave me food for thought. I'd considered that some people may rely on robots too much and not give needed personal attention to their elders. However, I hadn't considered that a robot could provide people with a type of barrier against personally witnessing too much of the decline of a loved one.

When I'm asked about the future of robotic care, I always say that, while there is certainly a place for it, I think we need to guard against dehumanizing caregiving. I'm happy to say that both Madlung and Potts stated much the same idea in their own words.

No machine will ever replace human touch or the warmth of human love. When our loved ones are at their most vulnerable, those are the elements that are most needed for their wellbeing. As with most things, balance and caution should be used if we are to successfully blend robotic assistance with human care.