Robot & Grandma

A couple of years ago, a "Skype-on-wheels" robot named Celia allowed adult children to remotely check on their aging parents. Now there are robots that could do the dishes, give them a bath, and hold a conversation.

Recently, a New York Times article gazed into the future of robotic caregiving to pose a "fundamental" question: "Should we entrust the care of people in their 70s and older to artificial assistants rather than doing it ourselves?"

The answer, of course, depends on who you ask. The makers of Paro (a furry baby-harp-seal-shaped therapy robot made to respond to its name, coo when petted, or cry when squeezed), would point to the technology's successes in treating Alzheimer's patients.

Similarly, Carnegie Mellon University (CMU) has designed a robot that can blink, giggle, and develop a personality when people interact with it, to assist in the therapy of people with autism. CMU roboticist Jim Osborn claims that "Those we tested it with love it and hugged it [and began] to think of it as something that is more than a machine with a computer."

But author and MIT professor Sherry Turkle is less sanguine. On seeing a 76-year-old patient share stories with the cuddly Paro, Turkle said, "I felt like this isn’t amazing; this is sad. We have been reduced to spectators of a conversation that has no meaning.... Giving old people robots to talk to is a dystopian view that is being classified as utopian."

Still others would say that personal assistant robots fill an important need at a time when the aging population is exponentially outpacing the caregiver pool.

But even robots that perform simple tasks (and don't do therapy) may come with psychological costs.

David E. Williams, in the Healthcare Collective blog calls it "spooky" that robots can give baths and do other personal tasks. Even if all the robot does is pick up, wash, and put away the dishes, Williams says, "you encounter issues of learned helplessness. If the robot can do it, why make the effort, even if effort is what provides purpose in life and staves off physical and cognitive decline?"

Finding a Caring Caregiver

If an elderly loved one needs at-home care, how do you select a professional caregiver? With careful screening of the person or agency before making your choice.

Tragically, some caregivers physically or verbally abuse their patients — or simply neglect them. And financial exploitation, which leaves no visible marks, can be just as devastating.

Unfortunately, one does not need to look far for examples:

• A Georgia homecare nurse caught on an ATM camera using her elderly patient's debit card, was indicted on charges of elder abuse and financial transaction card fraud for swiping more than $7,500 from the 86-year-old victim, $2 to $300 at a time.
• In Illinois, a hospital nursing assistant befriended her 89-year-old dementia patient, and upon his discharge became his round-the-clock caregiver. Prosecutors say she obtained a power-of-attorney, allowing her to steal over $350,000 from his estate which she used to buy a new Mercedes, remodel her home, and enrich herself and her family. The caregiver was held on $350,000 bail and faces up to 15 years in prison on charges of felony financial exploitation of a senior.

Lack of caregiver screening, training, and experience accounts for many cases of elder abuse. As the Huffington Post reports, the Journal of American Geriatrics Society published a study finding that, nationwide, many caregivers are dangerously unqualified because agencies fail to conduct background checks, drug testing, or to require experience or training of new hires. Researchers conducting the study surveyed 180 agencies, but found that only 55 percent conducted federal background checks, and one-third administered drug tests.

The article includes these tips for choosing a caregiver:

• Use a checklist to review the candidate or agency (click here and here for checklists).
• Set clear expectations before interviewing candidates, and create a daily activity timeline.
• Involve the senior in the interview.
• Assess the caregiver's degree of specialty and training.
• Check references and conduct an independent background check.