Elder care at home | A robotic old age stick

(Washington) More and more technologies exist to help seniors stay in their homes. But emotional needs are often poorly taken into account by these technological advances. At the last annual meeting of the American Association for the Advancement of Science (AAAS), in early March in Washington, speakers reported on the latest advances in home support.

Falls

Between 20% and 30% of nursing home placements in Canada occur after a fall. The spectrum of hip fractures is central to the work of George Demiris. This “medical computer scientist” from the University of Pennsylvania has developed the Sense4Safety system, which follows the gait of patients throughout the house to detect the symptoms of instability.

“It could be due to cognitive deterioration, physical problems with inflammation, for example, or a new drug. If we solve the problem before a fall, one of the main reasons for placement in a retirement home is prevented,” said Mr. Demiris in an interview on the sidelines of the conference.

Sense4Safety’s infrared sensors are located on the ceiling and are being tested in nursing homes. Demiris estimates that the technology, which will cost less than US$1,000, will be marketable within half a dozen years.

Exoskeletons

Another approach is to physically prevent falls. “Several companies are working on walkers or canes that detect obstacles and alert the patient,” says Demiris. Another approach would be to use an exoskeleton that extends from the feet to the waist. “It would really be an ideal solution, because the exoskeleton could stabilize a patient who loses balance,” says Demiris. But we are probably a decade or two away from the goal, if we want to have reliable technology, which the patient can put on himself in the morning, at an affordable cost. Falls cause significant health costs, but current exoskeleton technology is still very expensive. A few such exoskeletons, including one from Quebec company B-Temia, are FDA-approved in the United States for walking aids, but they cost tens of thousands of dollars.

Showers

Another major reason for placement, the inability to wash, is in the crosshairs of Cecilia Laschi, an Italian mechanical engineer who teaches at the University of Singapore. “For personal care, the challenge is to develop “soft robotics” (soft robotics) that has the necessary strength without hurting the patient,” explains Ms.^me Lashi. It has developed, as part of a European project, i-support, a robotic shower.

“We tested it in two German retirement homes, but we are still at the prototype stage. The challenge is to have a robust mechanism that is not too expensive to install. I think that within three years, I will be able to test another prototype in retirement homes in Singapore. » M^me Laschi wants to integrate into the robotic shower, for the moment a fixed seat surrounded by two strategically placed water jets, instruments allowing the patient to be scrubbed using “soft robotics”, based on his work on a robotic model of octopus.

Conversation

Two other speakers in Washington, Anne Turner, from the University of Washington in Seattle, and Robin Brewer, from the University of Michigan, are bioinformaticians specializing in communication with the elderly. “One of the big issues for seniors is managing their health issues,” said Ms.^me Brewer. We believe chatbots can help organize their medical records in a way that’s understandable to them, says Ms.^me Brewer. Thus, they could make their own health decisions. Often relatives and doctors do not know how to communicate this information well, or do not have the time to explain the same information several times. »

M^me Brewer was surprised to see the candor of older participants in her health chatbot clinical trials. “One of the participants said, ‘If Alexa [l’agent conversationnel d’Amazon] knew what state I am reduced to, she would cry. For me, this means that there is openness to the use of these conversational agents, with which the fear of being a burden or of asking too many questions disappears. We can also set up a logbook that will contain useful information for caregivers. Another project by M^me Brewer is a robotic shopping bag for slow grocery shopping. “Seniors often worry about taking too much time to shop for groceries for accompanying caregivers. »

Cognitive problems

M^me Turner specializes in communicating with patients with cognitive issues. “There are better ways than others to communicate with these patients,” says Ms.^me Turner. For example, we can ask them questions about their past to see what types of decisions they have made, and be inspired by them for decisions to be made in the present. You can also use visual aids, simple drawings, for example. Chatbots help codify these best practices. » M^me Turner leads a US government National Institute on Aging (NIA) project on the subject, Decision Making in Alzheimer’s Research.

Artificial intelligence

A big challenge is the use of artificial intelligence. “In all the trials of chatbots that use artificial intelligence, you always see the same fear,” says Demiris. Are we going to lock the elders in a parallel world where social interactions are subtly but radically different from those with humans? This is a big ethical problem, it will take several years, even a decade, to resolve. »

Workforce

Does this mean that the labor shortage in elder care will be solved by robotics? “Certainly not in the short term,” says Demiris. It will take us several years to be sure that chatbots can be introduced in a systematic, ethical and truly useful way. But for the most difficult tasks, we will see in the next decades a real revolution with exoskeletons. It should make these types of jobs less hard and more attractive. »

Do you have a scientific question? Ask Mathieu Perreault.