In Japan, despite the hiking single elderly population, there is a chronic shortage of caregivers for home visit. As many single seniors struggle to find a conversation partner, what about interacting with a robot instead of a human? Recently, the United States introduced communication robots to minimise medical costs incurred from the elderly’s social isolation. What can the world learn from Japan?
On 1 October 2021, the total population of Japan was 125.5 million. The population aged 65 and over was 36.21 million, accounting for 28.9% of the total population (ageing rate) . By sex, the population aged 65 and over consisted of 15.72 million males and 20.49 million females, with a male-to-female ratio of approximately 3:4.
Recent trends have shown an increase in the number of men and women aged 65 and over living alone. In 1980, men and women aged 65 and over accounted for 4.3% and 11.2% of the population respectively, but by 2020, among the one-person households with the member being 65 years old or over, men accounted for 15.0% and women 22.1% of Japan’s total population of 126.15 million.
The biggest problem in an ageing society is the increase in the number of dementia patients. The number of people over 65 years old with dementia in Japan was estimated to be about 6 million in 2020, and it is predicted that about seven million people (about one in five elderly people) will have dementia by 2025. Mild Cognitive Impairment (MCI) is a condition in which memory loss is neither normal nor dementia, although it does not interfere with daily living. About half of those with MCI will transition to dementia within five years, and it is believed that starting preventive activities at this stage can delay the onset of dementia.
Engaging in interactions such as having conversations has a significant effect on dementia prevention. However, according to the “Survey on Livelihoods and Support" published by the National Institute of Population and Social Security Research in 2017, the frequency of conversation for single elderly men is considerably lower than that for single elderly women. Owing to Japan’s company-centric culture, most men struggle with building new relationships after retirement, and hence fewer conversation partners. Also adding to the strain is the chronic shortage of caregivers who can visit elderly people at their homes to assist them with daily living and strike conversations.
How, then, should the Japanese society support the elderly who live alone?
Robots that can communicate with humans through conversations and movement can be found in restaurants and electronics stores across the country nowadays. Whereas for households, Aibo, a dog-type robot that was redesigned in 2018, and Paro, a baby seal, are some of the common models.
Aibo, which looks like a digital gadget, has built-in communication with a cloud software that realises the character and intelligence of a pet. The more you see it, the more it learns about you and recognises your face; and the more gently you treat it, the more affectionate it becomes. The first model of AIBO, sold from 1999 to 2006, costed Japan yen (JPY) 250,000 (USD 2,380). It was so popular that the first 3,000 units ordered were sold out within 20 minutes, and a total of about 150,000 units were shipped. The current model of Aibo sold more than 20,000 units over the first six months since its launch in January 2018.
The release of new communication robots is no longer a rare occasion these days. LOVOT, one of the most popular communication robots developed by GROOVE X Corporation, is more than just a cuddly, lovable figure. Its 360-degree hemispheric and temperature cameras allow it to keep an eye on the entire room and quickly find out where its owner is. The behaviour of a LOVOT is not programmed in a fixed manner, but processed by deep learning and other machine learning methods to create real-time movement. The company made headlines when billionaire entrepreneur Yusaku Maezawa acquired all its shares in March 2022.
PALRO, marketed by FUJISOFT, was created with the mission to “help people lead richer lives”. The conversational humanoid records and accumulates information on people's behaviours and tastes during conversations, so as to deepen its understanding and convey topics and information of interest at the perfect moment. In addition, it replies around 0.4 seconds after the other person finishes speaking, allowing for smooth conversation.
Different Attitude toward Robots in Japan and the West
From a global point of view, Japan is undoubtably a pioneer of communication robots. With most of the suppliers from Japan, communication robots are mainly found in the domestic market. In fact, a one-month survey conducted in December 2019 suggested that Japanese of all ages and both sexes seemed to accept communication robots as a comfortable conversation partner. Among the 1155 respondents in their 20s to 60s, 40% were male and 60% were female. In the question “Would you like to use a communication robot when you are in a hospital or medical facility?”, 17.2% answered “Yes, I would like to use a communication robot” and 36.6% said “Somewhat I would like to use a communication robot”, meaning over half of the respondents were open to the option. As for the reasons for wanting to use a communication robot, 55.1% respondents said they wanted “to relieve loneliness”, 53.9% hoped “to relieve free time”, and 44.5% had the “prevention of dementia” on mind.
Why has the communication robot boom not occurred outside Japan? This difference may be attributed to the differences in the popular understanding of robots in Japan and Western countries.
The word “robot” is derived from the Czech word Robota, which meant “forced labour” and was used to classify peasants who were obliged to do forced labor under the feudal system. A common view of the West is that robots should be subservient to humans, who are in the constant fear of a robot uprising. The “three laws of robotics” devised by science-fiction writer Isaac Asimov already in 1942 have pervaded the genre as well as popular culture. They prohibit robot injury to humans and establish robots’ obedience to human instructions and protection of human existence.” Such rules have taken firm root and continue to dominate popular imagination, despite the rapid development and much wider application of robotics technology over the past decades.
In Japan, by contrast, popular culture has long cultivated the idea that humans and robots could coexist in harmony. In the 1960s, Osamu Tezuka’s Astro Boy was animated for television, after which Japanese children have since been gripped by the weekly episodes of a story where robots work with humans to defeat social evils. Another much-loved character is Doraemon – a robotic cat who lives in a Japanese family’s house and shares meals daily as equal friends – has been enjoying its popularity since the 1970s. The generations who watch Astro Boy and Doraemon from a young age recognise robots as their friends, a conception that may be passed on to the future.
Robots and Ageing: Different Strategies
On 30 May 2022, the New York State Office on Aging (NYSOFA) announced plans to distribute communication robots to more than 800 seniors across the state, with the mission to maximise the ability of seniors to receive non-medical support services and to age well and independently in their communities. The Pew Research Center reported that more than a quarter of adults over the age of 60 live alone in the United States, which was picked up by Fortune magazine and entitled the article “New York is turning into Japan by giving robots to old people as companions”.
ElliQ, the communication robot distributed by NYSOFA, was developed by an Israeli company with approximately USD12 million in funding from the Toyota Research Institute, Inc. (TRI). Unlike Japanese robots, it is not humanoid in shape. The robot body is made of two parts, and only the upper part can nod and rotate, a concept rather similar to a smart speaker. The main difference between Amazon Echo and ElliQ is that the former does not talk to people actively or at all – unlike most communication robots developed in Japan.
The living arrangements of the elderly in Japan and the US are consistent with countries with relatively developed economies, where people tend to have fewer children and live longer beyond their childbearing years.
NYSOFA's efforts to launch EliQ aim to address the growing social isolation of older adults in the US. Efforts to quantify the cost of loneliness have shown that for Americans aged 65 or above, social isolation costs the government approximately USD7 billion annually in additional health care costs. Lonely elderly people are more likely to suffer from health problems such as depression and heart disease and longer hospital stay.
In Japan, the eight million born during the baby boom after World War II will be aged 75 or over in 2025, sparking fears for social consequences. In view of the increase of MCI patients from 2.56 million in 2000 to 6.69 million in 2019, the surge is likely to persist well beyond 2025 and the MHLW estimated that 2.43 million care workers would be needed by then. In 2017, care workers were added to the foreign technical training programme, which was expected to significantly increase the number of foreign care workers, but even now it is not sufficient. Furthermore, the current depreciation of the Japanese Yen is accelerating the outflow of foreign workers.
Under these circumstances, the use of communication robots to care for the elderly is believed to be the one and only solution, and hence the shift of Japan’s national policy to focus on promoting the use of nursing care robots. If nursing-care robots, including communication humanoids, are utilised under the cooperation of the public and private sectors, a solution to the healthcare worker shortage may not be as far away as it is assumed after all.