Would you really trust a robot to care for you in old age?

"We’re not trying to build Terminator," jokes Rich Walker, director of Shadow Robot, the innovative firm behind these sophisticated appendages. With a relaxed, almost bohemian appearance, Walker exudes an enthusiasm for technology that seeks to uplift rather than overpower. He proudly showcases his firm’s ambition: "We set out to build the robot that helps you, that makes your life better, your general-purpose servant that can do anything around the home, do all the housework…"

Yet, beneath this vision of domestic assistance lies a far deeper, more urgent ambition: to tackle one of the United Kingdom’s most pressing societal challenges – the escalating crisis in social care. The statistics are stark: last year, a report by the charity Skills for Care revealed a staggering 131,000 vacancies for adult care workers in England. Concurrently, Age UK estimates that approximately two million people aged 65 and over in England are living with unmet care needs. By 2050, projections suggest that one in four people in the UK will be aged 65 or over, placing an unimaginable strain on an already stretched care system.

This demographic time bomb is precisely where robots are being positioned as a potential lifeline. The previous government, recognizing the gravity of the situation, committed a significant £34m investment towards developing robots for care. In 2019, it boldly predicted that "within the next 20 years, autonomous systems like… robots will become a normal part of our lives, transforming the way we live, work and travel." This "techno-solutionism," a term that conjures images straight from a sci-fi blockbuster, prompts a critical inquiry: can these advanced machines truly provide the nuanced, compassionate care required? And more fundamentally, can we, or our most vulnerable elderly relatives, truly place our trust in what is, at its core, a highly complex machine?

Workouts with Pepper the robot: Lessons from Japan

To understand the practical implications of integrating robots into care, one need only look to Japan, a nation that offers a preview of a future where robots might become commonplace companions. A decade ago, the Japanese government, spurred by its own rapidly aging population and a critical shortage of care staff, began offering substantial subsidies to robot manufacturers. The aim was to accelerate the development and widespread adoption of robots in care homes across the country.

Dr. James Wright, an AI specialist and visiting professor at Queen Mary University of London, immersed himself in this nascent robotic care landscape, spending seven months observing their efficacy within a Japanese care home environment. His study focused on three distinct types of robots. The first, named HUG and developed by Fuji Corporation, resembled a highly sophisticated walking frame. Designed to alleviate the physical burden on carers, it featured support pads that allowed individuals to lean in, facilitating the difficult task of lifting residents from beds to wheelchairs or toilets.

The second robot, Paro, took on the appearance of a baby seal. Its purpose was to provide therapeutic stimulation for dementia patients, trained to respond to gentle stroking with comforting movements and sounds, aiming to evoke emotional engagement. The third, a small, approachable humanoid robot called Pepper, was tasked with leading exercise classes, demonstrating routines with its moving arms and providing instructions.

Dr. Wright confessed that, prior to his observations, he had harbored a degree of optimism regarding the robots’ integration. "I was expecting that the robots would be easily adopted by care workers who were massively overstretched and extremely busy in their work," he recounted. "What I found was, almost the opposite."

His detailed observations revealed a critical flaw in the initial deployment: the robots, far from saving time, became a significant drain on staff resources. The biggest demands on care workers’ time were not the direct care tasks the robots were designed to assist with, but rather the mundane yet necessary tasks of cleaning and recharging the machines, and, most notably, troubleshooting when they inevitably malfunctioned.

"After several weeks the care workers decided the robots were more trouble than they were worth and used them less and less, because they were too busy to use them," Dr. Wright explained. He cited specific examples: HUG, despite its lifting capabilities, often had to be laboriously moved out of residents’ paths. Paro, while intended to soothe, inadvertently caused distress to one resident who developed an unhealthy over-attachment to it. Pepper, despite its friendly appearance, proved problematic for exercise routines as its stature was too short for many residents to properly see, and its high-pitched voice was difficult for those with hearing impairments to understand.

The developers of these robots have since responded to Dr. Wright’s findings. Fuji Corporation, the creators of HUG, confirmed they have refined the design, making it more compact and user-friendly. Takanori Shibata, Paro’s creator, highlighted its two decades of use and pointed to trials demonstrating "clinical evidence of [its] therapeutic effects." Pepper, now under new ownership, has undergone substantial software updates, addressing some of the operational issues. While Dr. Wright’s study highlighted early challenges, it undeniably provided invaluable insights for future development.

From labs to the real world: User-centric design

Rich Walker of Shadow Robot, while acknowledging the initial hurdles, remains steadfast in his belief that robots have a crucial role to play in care, arguing that the next generation will be significantly more capable and user-centric.

Leading the charge in making these robots truly practical and effective is Praminda Caleb-Solly, a professor at the University of Nottingham. Her mission is clear: "We are trying to get these robots out of the labs into the real world." To achieve this, she established Emergence, a vital network designed to foster collaboration between robot manufacturers, businesses, and, crucially, the elderly individuals who will ultimately use these technologies. This direct engagement seeks to understand precisely what features and functionalities older people desire from robotic assistance.

The feedback gathered through Emergence has been illuminating. While some requests align with intuitive expectations, such as robots with natural voice interaction and a non-threatening, perhaps even "cute," appearance, many others highlight practical demands that speak to genuine independence. Users want robots that can adapt seamlessly to their changing needs over time. Critically, there’s a strong consensus on one point: the robot must be self-sufficient. As one participant succinctly put it, "We don’t want to look after the robot – we want the robot to look after us," underscoring the need for automated charging and cleaning.

Some UK businesses are already venturing into these trials. Caremark, a home care provider, has been testing "Genie," a small voice-activated robot, with clients in Cheltenham. One gentleman with early-onset dementia found particular joy in asking Genie to play Glenn Miller songs, demonstrating the robot’s potential for simple, yet meaningful, engagement and entertainment. However, reactions to Genie have been, in the words of director Michael Folkes, "like Marmite," indicating a varied reception among users. Folkes is keen to emphasize that these devices are not about replacing human carers, but rather about "building a future where carers have more time to care," focusing their invaluable human touch on tasks that truly require it.

Robot hands: Learning from evolution for unparalleled dexterity

Back in the London laboratory of the Shadow Robot Company, Rich Walker outlines another monumental challenge in creating truly effective care robots: mastering the perfect robotic hand. "For the robot to be useful, it needs to have the same ability to interact with the world as [a] human does," he explains. "And for that it needs human-like dexterity." This is not merely about grasping, but about the nuanced manipulation of objects, from the delicate handling of a teacup to assisting with personal hygiene – tasks that demand extraordinary precision, force control, and tactile feedback.

The robotic hand Walker demonstrates is a marvel of engineering: crafted from metal and plastic, it is equipped with 100 sensors, granting it both the dexterity and strength to rival a human hand. Each finger moves with fluid grace to meet the thumb, executing precise gestures, even forming an ‘OK’ sign. Remarkably, this hand can even solve a Rubik’s Cube with a single limb, a testament to its intricate programming and mechanical prowess.

Yet, as Walker readily admits, it remains a considerable distance from mastering the most delicate and complex human tasks, such as skillfully using a pair of scissors or gently picking up fragile, irregularly shaped objects. "The way we use a pair of scissors is quite mind-blowing when you think about it," he muses. "If you try and analyse what happens, you’re using your sense of touch in subtle and precise ways and receiving feedback, which makes you adjust the way you cut. How do you tell a robot how to do that?" This highlights the profound complexity of human sensory integration and motor control, which evolution has perfected over millennia.

Walker’s team is not alone in tackling this challenge. They are part of a consortium of 26 engineering firms collaborating on the Robot Dexterity Programme, an ambitious initiative funded by the Advanced Research and Invention Agency (ARIA). ARIA is a government agency established to support high-risk, high-reward scientific research with the potential to fundamentally transform society. The project’s leader, Professor Jenny Read, is guiding a radical rethink of robot design, drawing inspiration from biology. "One of the very striking things about animal bodies is their grace and efficiency," she observes, noting how evolution has naturally optimized these traits. "I think gracefulness really is a form of efficiency." This biomimetic approach aims to infuse robots with the innate fluidity and adaptability seen in the natural world.

Replicating human muscles for a softer touch

Further pushing the boundaries of robotic capability is Guggi Kofod, a Danish engineer and entrepreneur, whose firm Pliantics is developing artificial muscles for robots, intended as a revolutionary alternative to traditional motors. Though still in its early stages, Pliantics has made a significant breakthrough in identifying a durable material that convincingly mimics the extension and contraction of real muscles when an electric current is applied.

Kofod’s drive is deeply personal: "Several people near me died from dementia very recently," he shares. "I see from the people who are caring for dementia patients, and it is very challenging. So, if we could build systems that help them to not be scared, and that help them live at least a decent level of life… That’s incredibly motivating for me." This personal connection underscores the profound human imperative behind the technological pursuit.

Pliantics is collaborating with Shadow Robot as part of the ARIA project, specifically to develop a human-sized robotic hand powered by these artificial muscles. The ultimate goal is to enable the hand to detect minute pressure changes when gripping an object, allowing it to "know" precisely when to stop squeezing, much like the sensitive nerve endings in human fingertips. This delicate touch is paramount for tasks involving fragile items or direct interaction with vulnerable individuals, promising a future where robots can perform care tasks with unparalleled gentleness and precision.

What robots mean for carers: A future with complexities

Despite the technological advancements and optimistic visions, Dr. James Wright, the observer of Japan’s robotic care experiment, raises a crucial final concern regarding the broader societal implications of widespread robot adoption. He posits that if robots become truly prevalent, they could paradoxically worsen the conditions for human carers.

"The only way that economically you can make this work is to pay the care workers less and have much larger care homes, which are standardised to make it easy for robots to operate in," Dr. Wright argues. "As a result, there would be more robots taking care of people, with care workers being paid a minimum wage to service the robots, which is the opposite of this vision that robots are going to give time back to care workers to spend quality time with residents, to talk." This dystopian outlook warns against a future where human care becomes commodified and depersonalized, with humans reduced to mere overseers of machines.

However, other experts maintain a more positive outlook. Gopal Ramchurn, a professor of artificial intelligence at the University of Southampton and CEO of Responsible AI, believes that "It’s going to be a huge industry, given the deficit we have in the workforce right now. The demand for carers as our population ages will be huge." Responsible AI focuses on ensuring that artificial intelligence systems are developed to be safe, reliable, and, crucially, trustworthy.

Ramchurn points to the rapid advancements in robotics, citing Elon Musk’s Optimus humanoid robot – which last year served drinks and mingled at a Tesla event – as a clear signal that, whether we like it or not, advanced robots are an inevitable part of our future. "We are trying to anticipate that future, before the big tech companies come in and deploy these things without asking us what we think about them," he emphasizes.

The consensus among forward-thinking experts is clear: the time for proactive engagement is now. We must collectively develop the right regulations, ethical frameworks, and user-centric design principles to ensure that these burgeoning robotic systems genuinely work for us, enhancing human well-being and freeing up human carers for more meaningful interactions, rather than creating a future where we merely serve the machines. "We need to be ready for that future," Ramchurn concludes, urging a collaborative and responsible approach to this transformative technology.

Additional reporting: Florence Freeman. Top image credit: Jodi Lai/BBC (Picture is illustrative and not representative of any specific robots in the article)

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