Using robots to combat the nursing shortage: can love be programmed?

There are too few skilled workers in the nursing field. Robots could alleviate the shortage. What do seniors think of the idea?

Human closeness and compassion: Robots cannot take on every task in care. Photo: dpa

Living together with a robot still sounds like science fiction. But taking your smartphone to bed is different from being lifted out of bed by a humanoid-looking metal creature with legs, arms and a face. Nevertheless, care robots are the future – at least if you ask people in politics and business. But what do those who may soon be cared for by machines say?

"The robot can make coffee and eat, for all I care. But care robots certainly can’t replace the human attention that everyone needs at some point," says Axel Birsul. He and four other senior citizens are sitting around a long table in the meeting room of the Deutscher Senioren-Computer-Club e. V. in Berlin-Lichtenberg. The 69-year-old is the president of the club, where many retirees spend their mornings and afternoons – editing videos, simulating flights or updating their PC knowledge. Today they are here to philosophize about care robots. Because their generation could be the first to use these robotics.

Already, many caregivers are overworked. In a 2017 analysis, the German Federal Employment Agency found a nationwide shortage of skilled workers and specialists in elderly care. Although the specific number of missing workers varies from study to study, many speak of a "nursing shortage." This is one of the reasons why research is currently being carried out on care robots. Politicians are promoting these projects. The economy sees a growing market. There are currently almost 3 million people in Germany in need of care – and the number is growing. Many are 65 and older.

What do seniors in Lichtenberg think of care robots? "Even the term ‘care robot’ – you’d have to think of something else," says Stefan Streicher, 68, who is responsible for organizational matters at the computer club. In front of him are pictures of three robots: Robear from Japan, which can lift heavy objects, including bedridden patients. Giraff, a mobile communication device that allows people to talk to each other via a screen, similar to Skype. And Care-O-bot, a household helper that can bring a glass of water but also move toward a person who has fallen and establish a video link to an emergency center. "At least this one has a face, not unsympathetic," thinks Gabi Bothin, 65. She worked as a sociologist until three years ago and points to Robear, who looks like a bear. "After all, there used to be robots that had no face at all."

It depends on the task

"I have a split relationship with the subject," says Hans-Peter Specht; he is 75 years old and sat in front of a PC for the first time in 1986 in the GDR. "My mother died five years ago in a nursing home in Dresden. How an old woman who is incontinent has to be treated to maintain at least a certain level of hygiene, a robot can’t do that at all."

Many of these robots are being or have already been tested in nursing homes or other caregiving facilities. Acceptance of care robots varies widely among seniors here in Lichtenberg, but also across Germany. According to a survey conducted by the German Federal Ministry of Research in 2015, one in four people in Germany can imagine care being provided by a robot. However, it depends on what the robot does – as a Forsa study from 2017 shows. While 68 percent of respondents find lifting and repositioning by a robot okay, acceptance for tasks such as handing meals or washing is only 25 percent.

Senior computer club member

"A robot never says, ‘You messed up the bed again.’ But that’s what a caregiver says when she’s overworked."

"I looked around a bit on the Internet," says Hans-Peter Specht. "In Japan, they had invented a machine where the old person was put in, lid closed. Then he was cleaned like in a dishwasher. But the people there think it’s good because the robot also cleans the intimate area and not a nurse. Gabi Bothin thinks that people can also feel shame when confronted with a robot. Several at the table disagree: "I noticed this with my mother. Especially when a young nurse is supposed to clean an older woman’s intimate area – there’s a sense of shame. Besides, a robot will never say: You’ve made a mess of the bed again. But that’s what a nurse says when she’s overworked," says Specht.

Protection of private data must be guaranteed

Another aspect is the issue of data protection. Data protection is very important to the seniors in the computer club – they ask themselves with regard to Giraff and the Care-O-bot: Can the robots and machines protect health information from access by unauthorized persons? How do the companies behind the machines handle the data? "Even if I let a computer wash me," explains Hans-Peter Specht, "I’m not sure that my intimate pictures won’t be on the Internet the day after tomorrow. And I can’t do anything about it! So there’s also a technical and legal gray area that needs to be considered."

Some seniors around the table say that they give up a lot of their privacy anyway when it comes to care in old age, but a certain amount of control is necessary. Axel Birsul adds, "As long as I am self-determined in my home, I also want to have control over the technology. That means I need to know that it can keep what happens in my home to itself." Stefan Streicher points to the picture with the Robear. "In addition, there is another legal component. Let’s take the picture here, with the young woman and the robot. The robot now suddenly has a short circuit, sags and the woman slams down. Who assumes liability? There are already lawyers lurking around."

This text comes from the taz am wochenende. Always on newsstands from Saturday, in the eKiosk or in the practical weekend subscription. And on Facebook and Twitter.

Especially in home care, the robots can actually be helpful, the five find. With the help of technology, it is possible to live autonomously for longer. They know from other club members how quickly that can happen, how quickly people can physically decline in old age and need help. "I can imagine that there are robots that help the contacts of the person being cared for," explains Marianne Birsul, Axel Birsul’s wife. "For example, I would refuse to do such heavy work if my husband were to become a nursing case. But if I had someone to do the heavy lifting for me, lifting, standing up, sitting in the chair, those things – I would find that to be quite a big help."

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