Time for robots?

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Unsolicited e-mails are part and parcel of our modern lives. Most of us dispatch them with ruthless efficiency. Occasionally, one slips past our defences. This happened to me about a fortnight ago.

I received an e-mail from an unknown sender with the subject: ‘Aged Care Companion Robots’. They invited me to attend the 4th Annual Palliative, Aged, Dementia Care and Mental Health Forum.

While processing this information, my hand simultaneously edged the mouse cursor over the delete button. In a microsecond of indecision I was lured back to the invitation by big, bold and colourful letters in the middle of the screen that asked: ‘Do you know how Companion Robots are keeping Aged Care Residents Safe & Engaged During COVID-19?’

This question strongly resonated with me because my professional roles and interests include all these issues: the COVID-19 pandemic, patient safety, consumer engagement and aged care.  It also piqued my interest because I did not know the answer to the question. I was now firmly hooked and invested my full attention.

The e-mail had four neatly spaced paragraphs of text and an obligatory video clip. Two of the sentences were in bold to emphasize their importance: ‘Robotics offers a solution by easing the burden on care workers and reducing direct contact with residents, boosting efficiency and cutting down transmission risk. Robots have helped front-line workers reduce face-to-face time with COVID-19 patients by as much as 6x in pandemic healthcare efforts worldwide.’

The statements evoked an unexpected and strong emotional response for me. I felt unable to reconcile the conflicting feelings of pragmatic respect for the innovation and work on the one hand, and incredible sadness and concern about the relentless and progressive trend in modern society to reduce direct human contact.

When did caring for others become a ‘burden’? Why is ‘boosting efficiency’ the most important KPI? What are the longer-term, unintended consequences of reducing ‘face-to-face time by as much as 6x’?

It is easy to pontificate from the comfort of the philosopher’s armchair. The stark reality is that aged care is immensely challenging. Aged care workers do their best to deliver patient-centred, quality care despite constrained resources, lack of support and their contributions often going unrecognised by policy makers and funders.

From this perspective, robotics does indeed offer an attractive solution. It is important work that deserves investment, further research, and wider adoption. However, there is a risk that the alluring promise of greater efficiencies blind us to the inevitable, unintended consequences and trade-offs implementing any new technology requires. How will the time that is ‘saved’ be used?

While it may be appropriate to reduce face-to-face time during a pandemic to reduce the risk of transmitting infectious diseases, there is a real possibility that this will become the new normal way. Is it truly our intention to reduce ‘face-to-face time’ between carers and consumers? If the honest answer is ‘yes’, this course of action will lead to significant and avoidable harm.

Loneliness has been identified as the greatest epidemic of our times. Unfortunately, it is also a quiet epidemic, despite a prevalence that is higher than obesity. Estimates suggest one in two of us experience loneliness, and that it increases with age. There is compelling evidence that loneliness is not only a social phenomenon, but that it is associated with significant physical and mental health morbidity.

As a society we should be questioning our collective motivation for the systems we create. Would it stand up to the test of the Veil of Blindness that I explored in a previous post? Are we truly creating the best experience for consumers and carers?

Innovation and new technology undoubtedly have an important role. We should also expect that our precious resources are used efficiently and demand transparent and reliable performance metrics. However, it should not come at the expense of our greatest asset: our uniquely human capacity for compassion and connection.

The advent of Robotics should be accompanied by additional investment in our aged care workforce. Any efficiency gains should be re-invested. We should protect and preserve the most valuable aspects of aged care – our time and human connections.

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