Robo-seals invade U.S. nursing homes — perhaps a gadget too far?

Stuffed seal

Image by matsuyuki via Flickr

What with human affection so hard to come by these days, wouldn’t Granny be happy with a fuzzy mechanical toy? That, presumably, was the reasoning behind Japanese inventor Takanori Shabata’s idea for the nursing home’s new best friend, Paro the robo-seal. $15 million dollars later, Paro had hummed and buzzed his (her?) way into the hearts and homes of some 1300 Japanese adults who don’t want the hassle of real, live pets. Now cleared as a Class 2 medical device — a category enjoyed by his brethren the motorized wheelchair and similar less-cuddly items — Paro’s newest destination is U.S. nursing homes.

“Some of our residents need more than we as human beings can provide,” says Marleen Dean, activities manager at Vincentian Home, one of four facilities run by Pittsburgh-based Vincentian Collaborative System. Vincentian Collaborative recently used a $55,000 grant to purchase eight Paros and finds them especially comforting to patients with dementia. “We’ve tried soft teddy bears that talk and move. But they don’t have the same effect.”

Bill Thomas thinks it’s inhumane to entrust the task of emotional support to a gadget.

“If you give me a robot that helps perform mundane tasks associated with caregiving, such as vacuuming or doing the dishes, I’m all for that,” says Dr. Thomas, founder of the Green House Project, a campaign to make nursing homes smaller and more like regular houses. But “if we wind up with nursing homes full of baby-seal robots, the robots will be trying to fulfill the relationship piece of caregiving, while the humans are running around changing the beds and cooking the food.”

This space sides with Bill Thomas. At $6,000 per robo-seal, it just seems that some less anti-bacterial real creature could be found to serve the same purpose. But Paro has made believers in several U.S. nursing homes such as one in which a dementia unit resident is quoted as whispering to it, “I know you’re not real, but somehow, I don’t know, I love you.”   The question of whether offering Paro for love and affection (and often just for calming down the agitated folks who tend to populate nursing homes) is ethical and proper is stirring debate both here and in Denmark, where more than 100 Paros have found homes.

Sherry Turkle, a professor in the Science, Technology and Society program at the Massachusetts Institute of Technology, acknowledges Paro’s potential as a communication aid, but warns against regarding it as a companion. “Why are we so willing to provide our parents, then ourselves, with faux relationships?” she asks.

Danish filmmaker Phie Ambo, who spotlighted Paro in her 2007 documentary on interactive robots, “Mechanical Love,” dismisses such concerns. “When I came into nursing homes and found people sitting in rocking chairs with dolls, no one lifted an eyebrow.”

DTI (European distributor Danish Technological Institute) requires caregivers to attend Paro seminars, where they discuss such issues as whether it’s OK to leave an elderly person alone with a Paro, and whether patients must be told it’s a robot. Don’t allow someone to “escape into a strange seal robot’s universe,” cautions Lone Gaedt, senior consultant at DTI.

Admittedly, we carry on with perfect strangers in the parallel worlds of cyberspacial social networks. But somewhere, somehow, a few lines of human interaction might be better off left un-blurred.

What do you think?

Paro the Robo-Seal Aims to Comfort Elderly, but Is It Ethical? – WSJ.com.

Baby boomers & long-term care: innovation is the key

Baby boomers well into their final careers are increasingly discovering a new one: caregiver to elderly parents. And if current studies are to be believed, boomers themselves are more than likely to need long-term care. A new report out of Canada suggests that “baby boomers will have to develop non-traditional caregiver networks, or pay for long-term care facility care” in our neighbor to the north.

Today, up to 70% of the care provided to the elderly comes from an informal network of spouses, children and close family. But the baby-boom generation is unlike previous generations in that they have relatively few children, and stable couples are a rarity, according to researchers at the Université de Montréal. Baby boomers “risk finding themselves in difficult circumstances and might have to turn to the public system or pay their way,” says professor Jacques Légaré, who authored the study of aging boomers.

Friends, siblings or cousins could make up a new, non-traditional model of caregiving for seniors who can’t afford assisted living or skilled nursing care, Légaré suggests. The paper was presented this week at the 2010 Congress of the Humanities and Social Sciences at Concordia University in Montreal.

In the U.S., most surveys put the figure of “informal caregivers” — family members or friends — closer to 80%, and estimates of the number of boomers likely to need long-term care themselves go up with virtually every new study.

Choices in long-term care also are going up, though. The National Clearinghouse for Long-Term Care Information is a government-run (Department of Health and Human Services) site that offers information and resources for long-term care planning — along with some eye-opening information about costs and coverage.

Baby boomers can take heart in the fact that innovative models are being developed in many states, and possibilities are being pursued in both public and private sectors.  Non-traditional networks may be the new best thing for this looming fact of boomer futures.

Baby boomers may need to find new, innovative care networks, report finds – McKnight’s Long Term Care News.

Dementia: stories and sources

The post about dementia sufferers and their tendency to wander (May 6) evoked a host of stories about temporarily lost parents, grandparents, friends and relations. Almost everyone, it seems, has such a story — and unfortunately, those who haven’t may collect one or two in the future.  Reader Cathy Jensen sent a poignant tale of a friend who went wandering in his pajamas during the pre-dawn hours, but was found by the garbage collectors and brought home on the back of their truck. And reader Tom McAfee, en route to see his own mom and hopefully jog memories of children and grandchildren with photos, sent a link to a podcast aired on WNYC in March.

An offbeat idea, the WNYC piece explains, turned out to be a good solution for a nursing home in Germany from which residents were wandering off. Administrators created a bus stop in front of the home, complete with bench and a painted sign for a bus that never came. It provided a place where many wanderers could sit and wait until the urge to go back home, or elsewhere, melted away. Might not work everywhere, but it worked in Dusseldorf.

And reader JTMcKay4 sent, in case you missed them in the comments section, links to the Alzheimer’s Association’s “Safe Return” program and to a source for a long list of related documents. State-specific advance directive forms can also be downloaded, free, from the “Caring Connections” site maintained by the National Hospice and Palliative Care Association site, and this space remains committed to the support of the nonprofit Compassion and Choices, from which forms can also be downloaded.

There is no guarantee against winding up in a memory unit. But a little preparation can go a long way toward helping if the time comes.

Hanging in the 'hood – a good option for boomers and beyonders and the economy

Say you’re happy in your ‘hood. The sights are familiar, the neighbors are okay, the comfort level is high. Now say you’re 70-something or 80-something and you need a little help now and then, bringing in the papers, getting to doctors’ appointments, changing light bulbs. Do you really want to pull up roots and move to a totally new environment, re-learn where everything is, make new friends among people who never knew your children (or your parents)? The latter is being chosen every day for or by seniors in America; the former is spurring a movement with an interesting variety of formats under the general heading of Aging in Place. I really want an umbrella acronym for this category, but I don’t really want to be an AIP.

On her New Old Age blog for the New York Times a few days ago Paula Span wrote about her dad’s life in a NORC.

In my father’s apartment building in South Jersey, the older tenants start drifting into the small lobby each day around 1 p.m., taking up positions on chairs and couches. The ostensible reason: The mail is about to arrive. The real reason: They relish a chance to schmooze.

“There’s a lot of discussion about the economy,” Dad reports. “And what the president said about the police and that fellow in Massachusetts.” Lesser issues arise, too. Whose daughter is coming to visit. What is on sale at the ShopRite supermarket.

Twenty-five years ago, a University of Wisconsin professor coined a great term for this kind of residence. It is a naturally occurring retirement community, or NORC. The place wasn’t built for seniors; its tenants are all ages, infants through nonagenarians. But a substantial number of residents have been there long enough to grow old together.

Since he still drives, my father heads out each morning to buy the papers, which get passed from one apartment to another. (God forbid you should squander 50 cents for your own copy and read the headlines before suppertime.) He ferries friends to doctors’ appointments. He benefits, too: his pal Manny comes by several times a day to check on him, and neighbors stock his fridge with soup and strudel.

NORCs exist all over; probably half of Miami Beach, Fla., was a NORC at one time. Watching this little community cope with shopping and banking and constant medical visits, I have wondered why services can’t be brought to these residents. Wouldn’t it be more efficient to have a nurse visit weekly, instead of each person making a laborious trip to a doctor’s office? For the senior van to schedule regular excursions to ShopRite? For the high school orchestra to give concerts in the community room, since so few older residents go out after dark?

A number of NORCs do offer this kind of help. Twenty-five states have NORC supportive service programs, according to the queen of NORCs, Fredda Vladeck, who runs the United Hospital Fund’s Aging in Place Initiative. New York leads the list with 54 NORC programs operating in high-rises, garden apartment complexes and neighborhoods of single-family homes; Indiana comes in second. The common mission of the programs, Ms. Vladeck said, is “transforming communities into good places to grow old.”

NORC’s and their cousins the Village aging-in-place concepts are multiplying, but they’re nothing new. They’ve been around for more than a quarter of a century (if you discount the automatic NORCs that small towns and Native American communities offered in ancient America afforded. And they’re proven effective. “Numerous studies have documented the benefits and potential of NORCs, including a Senate report (PDF), a foundation grant report and a graduate thesis,” Span writes.

So why, after 25 years’ experience, are there not more support programs for the millions of older Americans already living in NORCs, and the millions more to come?

Ms. Vladeck, accustomed to lobbying and testifying and organizing, sounded philosophical. “It’s incubating,” she said. “Sometimes, innovation takes a long time.”

If you want to keep your parents out of nursing homes, or want to stay out of a nursing home yourself, learning about how these alternatives work isn’t a bad way to start the plan.  There may not be a long time left, at the rate America’s getting older.

When the Neighborhood Is the Retirement Village – The New Old Age Blog – NYTimes.com.