The Perceptions of People with Dementia and Key Stakeholders Regarding the Use and Impact of the Social Robot MARIO

People with dementia often experience loneliness and social isolation. This can result in increased cognitive decline which, in turn, has a negative impact on quality of life. This paper explores the use of the social robot, MARIO, with older people living with dementia as a way of addressing these issues. A descriptive qualitative study was conducted to explore the perceptions and experiences of the use and impact of MARIO. The research took place in the UK, Italy and Ireland. Semi-structured interviews were held in each location with people with dementia (n = 38), relatives/carers (n = 28), formal carers (n = 28) and managers (n = 13). The data was analyzed using qualitative content analysis. The findings revealed that despite challenges in relation to voice recognition and the practicalities of conducting research involving robots in real-life settings, most participants were positive about MARIO. Through the robot’s user-led design and personalized applications, MARIO provided a point of interest, social activities, and cognitive engagement increased. However, some formal carers and managers voiced concern that robots might replace care staff

Socially assistive robots for people with dementia: systematic review and meta-analysis of feasibility, acceptability and the effect on cognition, neuropsychiatric symptoms and quality of life

BACKGROUND: There is increasing interest in using robots to support dementia care but little consensus on the evidence for their use. The aim of the study is to review evidence about feasibility, acceptability and clinical effectiveness of socially assistive robots used for people with dementia. METHOD: We conducted a systematic review and meta-analysis. We searched MEDLINE, EMBASE, PsychINFO, CINHAL, IEEE Xplore Digital Library, and EI Engineering Village from inception to 04 -02-2022 - included primary studies assessing feasibility, acceptability, or effectiveness of socially assistive robots for people with dementia. Two independent reviewers screened studies for eligibility, and assessed quality. Narrative synthesis prioritized higher quality studies, and random-effect meta-analyses compared robots with usual care (UC) or active control (AC) immediately after the intervention (short-term; ST) or long-term (LT) on cognition, neuropsychiatric symptoms, and quality of life. FINDINGS: 66 studies and four categories of robots were eligible: Companion robots (Pet and humanoid companion robots), telepresence communication robots, homecare assistive robots and multifunctional robots. PARO (companion robot seal) was feasible and acceptable but limited by its weight, cost, and sound. On meta-analysis, PARO had no ST or LT compared to UC or AC over 5-12 weeks on agitation (ST vs UC, 4 trials, 153 participants: pooled standardized mean difference (SMD) 0.25; -0.57 to 0.06; LT vs UC; 2 trials, 77 participants, SMD =-0.24; -0.94, 0.46), cognition (ST vs UC, 3 trials, 128 participants: SMD= 0.03; -0.32, 0.38), overall neuropsychiatric symptoms (ST vs UC, 3 trials, 169 participants: SMD= -0.01; -0.32, 0.29; ST vs AC, 2 trials, 145 participants: SMD =0.02, -0.71, 0.85), apathy (ST vs AC, 2 trials, 81 participants: SMD= 0.14; 0.29, 0.58), depression (ST vs UC, 4 trials, 181 participants; SMD= 0.08; -0.52, 0.69; LT vs UC: 2 trials, 77 participants: SMD =0.01; -0.75, 0.77), anxiety (ST vs UC: 2 trials, 104 participants, SMD= 0.24; -0.85, 1.33) and quality of life (ST vs UC, 2 trials, 127 participants: SMD=-0.05; -0.52, 0.42; ST vs AC: 2 trials, 159 participants, SMD =-0.36, -0.76, 0.05). Robotic animals, humanoid companion robots, telepresence robots and multifunctional robots were feasible and acceptable. However, humanoid companion robots have speech recognition problems, and telepresence robots and multifunctional robots were often difficult to use. There was mixed evidence about the feasibility of homecare robots. There was little evidence on any of these robots' effectiveness. CONCLUSION: Although robots were generally feasible and acceptable, there is no clear evidence that people with dementia derive benefit from robots for cognition, neuropsychiatric symptoms, or quality of life. We recommend that future research should use high quality designs to establish evidence of effectiveness

Enablers and barriers to the implementation of socially assistive humanoid robots in health and social care: a systematic review

Objectives: Socially assistive humanoid robots are considered a promising technology to tackle the challenges in health and social care posed by the growth of the ageing population. The purpose of our study was to explore the current evidence on barriers and enablers for the implementation of humanoid robots in health and social care. Design: Systematic review of studies entailing hands-on interactions with a humanoid robot. Setting: From April 2018 to June 2018, databases were searched using a combination of the same search terms for articles published during the last decade. Data collection was conducted by using the Rayyan software, a standardised predefined grid, and a risk of bias and a quality assessment tool. Participants: Post-experimental data were collected and analysed for a total of 420 participants. Participants comprised: older adults (n=307) aged ≥60 years, with no or some degree of age-related cognitive impairment, residing either in residential care facilities or at their home; care home staff (n=106); and informal caregivers (n=7).Primary outcomes Identification of enablers and barriers to the implementation of socially assistive humanoid robots in health and social care, and consequent insights and impact. Future developments to inform further research. Results: Twelve studies met the eligibility criteria and were included. None of the selected studies had an experimental design; hence overall quality was low with high risks of biases. Several studies had no comparator, no baseline, small samples, and self-reported measures only. Within this limited evidence base, the enablers found were enjoyment, usability, personalisation and familiarisation. Barriers were related to technical problems, to the robots’ limited capabilities and the negative preconceptions towards the use of robots in healthcare. Factors which produced mixed results were the robot’s human-like attributes, previous experience with technology and views of formal and informal carers. Conclusions: The available evidence related to implementation factors of socially assistive humanoid robots for older adults is limited, mainly focusing on aspects at individual level, and exploring acceptance of this technology. Investigation of elements linked to the environment, organisation, societal and cultural milieu, policy and legal framework is necessary

Robot companion cats for people at home with dementia: a qualitative case study on companotics

The use of robot companion pets for people in care homes has been extensively studied. The results are largely positive, and suggest that they are valuable in enhancing wellbeing, communication and behavioural aspects. However, there has been little research in people’s own homes, possibly due to the cost and complexity of some of the robot pets currently available. As dementia affects people in different ways, this study explores the effects of a robot cat for people in their own homes, without specifically investigating the effects on a particular symptom. We utilised a case study design to investigate the proposition that various factors influence the impact of a robot cat on the person living with dementia and their carer, including acceptability of the robot pet and acceptance of dementia and its symptoms. The qualitative analysis explores the similarities and differences within the data which were gathered during interviews with people with dementia and their families. This analysis revealed four themes: Distraction, Communication, Acceptance and rejection, and Connecting with the cat and connecting with others. These themes were synthesized into two overarching themes: The effect of the cat on mood and behaviour, and The interaction with the cat. We present the acceptability and impact of the robot cat on symptoms of dementia, with data presented across and within the group of participants. Our analysis suggests that benefits of the robot pet were evident, and although this was a small-scale study, where they were accepted, robot pets provided positive outcomes for the participants and their families

Conversational affective social robots for ageing and dementia support

Socially assistive robots (SAR) hold significant potential to assist older adults and people with dementia in human engagement and clinical contexts by supporting mental health and independence at home. While SAR research has recently experienced prolific growth, long-term trust, clinical translation and patient benefit remain immature. Affective human-robot interactions are unresolved and the deployment of robots with conversational abilities is fundamental for robustness and humanrobot engagement. In this paper, we review the state of the art within the past two decades, design trends, and current applications of conversational affective SAR for ageing and dementia support. A horizon scanning of AI voice technology for healthcare, including ubiquitous smart speakers, is further introduced to address current gaps inhibiting home use. We discuss the role of user-centred approaches in the design of voice systems, including the capacity to handle communication breakdowns for effective use by target populations. We summarise the state of development in interactions using speech and natural language processing, which forms a baseline for longitudinal health monitoring and cognitive assessment. Drawing from this foundation, we identify open challenges and propose future directions to advance conversational affective social robots for: 1) user engagement, 2) deployment in real-world settings, and 3) clinical translation

Robot companion cats for people at home with dementia: A qualitative case study on companotics

Pike J., Picking R., & Cunningham S. (2021). Robot companion cats for people at home with dementia: A qualitative case study on companotics. Dementia, 20(4), 1300-1318. Copyright © [2021] (The Authors). Reprinted by permission of SAGE Publications.The use of robot companion pets for people in care homes has been extensively studied. The results are largely positive and suggest that they are valuable in enhancing wellbeing, communication and behavioural aspects. However, there has been little research in people’s own homes, possibly due to the cost and complexity of some of the robot pets currently available. As dementia affects people in different ways, this study explores the effects of a robot cat for people in their own homes, without specifically investigating the effects on a particular symptom. We utilised a case study design to investigate the proposition that various factors influence the impact of a robot cat on the person living with dementia and their carer, including acceptability of the robot pet and acceptance of dementia and its symptoms. The qualitative analysis explores the similarities and differences within the data which were gathered during interviews with people with dementia and their families. This analysis revealed four themes: Distraction, Communication, Acceptance and rejection, and Connecting with the cat and connecting with others. These themes were synthesised into two overarching themes: the effect of the cat on mood and behaviour, and The interaction with the cat. We present the acceptability and impact of the robot cat on symptoms of dementia, with data presented across and within the group of participants. Our analysis suggests that benefits of the robot pet were evident, and although this was a small-scale study, where they were accepted, robot pets provided positive outcomes for the participants and their families

Longitudinal diary data: Six months real-world implementation of affordable companion robots for older people in supported living

Companion robots have potential for improving wellbeing within aged care, however literature focuses on shorter-term studies often using relatively expensive platforms, raising concerns around novelty effects and economic viability. Here, we report ecologically valid diary data from two supported living facilities for older people with dementia or learning difficulties. Both sites implemented Joy for All robot animals and maintained diaries for six months. Entries were analysed using thematic analysis. We found robot use increased over the six months, changing from short, structured sessions to mainly permanent availability. Thus previously reported concerns on novelty were not warranted. Both sites reported positive outcomes including reminiscence, improved communication and potential wellbeing benefits (reduced agitation/anxiety). Incidences of negative responses included devices described as 'creepy.' Devices appeared sufficiently robust for prolonged daily use with multiple users. Overall, we provide insight into real-world implementation of affordable companion robots, and longitudinal development of use

Longitudinal Diary Data: Six Months Real-world Implementation of Affordable Companion Robots for Older People in Supported Living

Companion robots have potential for improving wellbeing within aged care, however literature focuses on shorter-term studies often using relatively expensive platforms, raising concerns around novelty effects and economic viability. Here, we report ecologically valid diary data from two supported living facilities for older people with dementia or learning difficulties. Both sites implemented Joy for All robot animals and maintained diaries for six months. Entries were analysed using thematic analysis. We found robot use increased over the six months, changing from short, structured sessions to mainly permanent availability. Thus previously reported concerns on novelty were not warranted. Both sites reported positive outcomes including reminiscence, improved communication and potential wellbeing benefits (reduced agitation/anxiety). Incidences of negative response included devices described as ‘creepy.’ Devices appeared sufficiently robust for prolonged daily use with multiple users. Overall, we provide insight into real-world implementation of affordable companion robots, and longitudinal development of use

A Narrative Approach to Human-Robot Interaction Prototyping for Companion Robots

© 2020 Kheng Lee Koay et al., published by De Gruyter This work is licensed under the Creative Commons Attribution 4.0 International License. https://creativecommons.org/licenses/by/4.0/This paper presents a proof of concept prototype study for domestic home robot companions, using a narrative-based methodology based on the principles of immersive engagement and fictional enquiry, creating scenarios which are inter-connected through a coherent narrative arc, to encourage participant immersion within a realistic setting. The aim was to ground human interactions with this technology in a coherent, meaningful experience. Nine participants interacted with a robotic agent in a smart home environment twice a week over a month, with each interaction framed within a greater narrative arc. Participant responses, both to the scenarios and the robotic agents used within them are discussed, suggesting that the prototyping methodology was successful in conveying a meaningful interaction experience.Peer reviewe