How can robots facilitate physical, cognitive, and social engagement in skilled nursing facilities?
This research helps bridge an important gap between robotics technology and real-world implementation in nursing homes. As our society grapples with caring for an aging population, these insights could help shape the development of robots that meaningfully support both residents and caregivers in nursing facilities.
The findings suggest that while robots won't replace human caregivers, they could help maintain residents' quality of life by facilitating physical activity and social interaction, particularly during times when staff are stretched thin.
College of Health researcher(s)
Highlights
Abstract
As people live longer, the population of older adults in need of support continues to expand relative to the available workforce of caregivers, necessitating new solutions to supplement caregiver availability for the physical, cognitive, and social needs of older adults. Robotics and automation present strong possible solutions. Past solutions have typically supported short-term rehabilitation and aging in place, yet many older adults live in skilled nursing facilities (SNFs), a setting reached by relatively little research to date. In this paper, we examine the unique needs of staff and residents at SNFs, after which we begin an iterative design process of robot-mediated wellness activities for the SNF space. We worked closely with domain experts in exercise science and physical therapy for older adults and a local SNF to design and test a series of robot-mediated activity prototypes with residents, visitors, and staff. We found that while both residents and staff highly value physical activity, there are nuanced challenges associated with supporting resident activity (one important element of overall wellbeing). As a result, we considered and tested a wide range of intervention options from usual approaches (e.g., mirroring movements) to creative approaches (e.g., social engagement via lewd humor). Our final design insights can inform practitioners who wish to use robots to support resident wellbeing in SNFs.
FAQ: Robots in Skilled Nursing Facilities
What are the main challenges faced by skilled nursing facilities (SNFs)?
SNFs face several challenges, primarily stemming from a growing elderly population and a shortage of qualified caregivers. This leads to:
- High workload for Certified Nursing Assistants (CNAs): CNAs are responsible for a wide range of tasks, from basic care to facilitating social activities. This heavy workload can result in burnout and high turnover rates, leading to inconsistencies in care.
- Limited resident engagement: Residents often experience a decline in physical and cognitive abilities, leading to feelings of helplessness and a lack of motivation to participate in activities.
- Barriers to physical activity: Physical activity is crucial for residents' well-being, but barriers like pain, fear of injury, cognitive decline, and a perception of exercise as boring or difficult can hinder participation.
- Social isolation and loneliness: Many residents struggle with social isolation and loneliness, which can negatively impact their overall health and well-being.
How can robots help address these challenges?
Robots offer potential solutions to various challenges in SNFs:
- Mitigating staff workload: Robots can assist with tasks such as medication reminders, exercise facilitation, and even basic care, freeing up CNAs to focus on more complex needs.
- Promoting physical activity: Robots can lead exercise sessions, offer personalized guidance, and provide encouragement, making exercise more engaging and accessible.
- Enhancing social interaction: Social robots can act as companions, facilitate conversations, and even mediate interactions between residents, combating loneliness and fostering connections.
- Empowering residents: By providing residents with a sense of control and agency over their activities and environment, robots can help improve self-efficacy and motivation.
What types of robot-mediated activities are beneficial for SNF residents?
Activities should address residents' physical, cognitive, and social needs. Examples include:
- Touch-based therapy: Robots like Paro, the robotic seal, offer comfort and emotional support through tactile interactions.
- Stretching and reaching exercises: Robots can guide residents through safe and effective stretches, improving mobility and flexibility.
- Cooperative and competitive games: Robots can facilitate engaging games that encourage physical activity and social interaction.
- Conversations and storytelling: Social robots can engage residents in conversations, share stories, and provide companionship.
- Pose matching and mirroring: Robots can demonstrate and encourage physical activity through mirroring exercises, promoting movement and cognitive engagement.
What design considerations are important for robots in SNFs?
Robots need to be specifically designed for the unique needs of older adults in SNFs:
- Visibility and Legibility: Larger robots with contrasting colors and clear movements are easier for residents to see and understand.
- Auditory Accessibility: Clear audio with lower-frequency cues, slowed speech, and longer pauses accommodate age-related hearing and processing decline.
- Social Appropriateness: Robots should be programmed with appropriate social behaviors and dialogue, considering the sensitivities of both residents and staff.
- Control and Agency: Giving residents control over the robot's actions fosters engagement and a sense of autonomy.
- Ease of Use: Robots should be intuitive to operate, minimizing the need for complex instructions or technical expertise.
What are some key movements to focus on for physical activity?
Physical activity interventions should prioritize movements that improve residents' balance and independence in daily life:
- Cross-body reaching: Maintains shoulder and elbow range of motion, crucial for tasks like dressing.
- Weight shifting and waist movements: Strengthens core muscles, essential for safe transfers between sitting and standing positions.
- Foot reaching and leg movements: Improves ankle and leg strength, supporting balance and mobility even for wheelchair users.
How can robots help residents with cognitive decline?
Robots can provide various forms of cognitive support:
- Reminders and Repetition: Robots can provide consistent reminders about activities and their benefits, reinforcing learning and promoting adherence.
- Simplified Interactions: Robots can offer clear and concise instructions, breaking down tasks into smaller, manageable steps.
- Engaging Activities: Robots can offer stimulating activities that challenge cognitive abilities in a playful and enjoyable way.
- Social Connection: Robots can facilitate social interaction, which has been shown to benefit cognitive function and emotional well-being.
What are the limitations of current research on robots in SNFs?
Current research is limited by:
- Small sample sizes and single-facility studies: Findings may not be generalizable to all SNFs and their diverse resident populations.
- Short-term interventions: The long-term impact of robot interventions on residents' well-being needs further investigation.
- Controlled environments: The effectiveness of robots in real-world SNF settings, where routines and resident preferences vary, requires more study.
What are the future directions for research on robots in SNFs?
Future research should focus on:
- Longitudinal studies: Evaluating the sustained impact of robot interventions on residents' health and quality of life.
- Multi-site studies: Conducting research across diverse SNFs to improve the generalizability of findings.
- Real-world implementations: Observing how robots integrate into daily routines and address the specific needs of different facilities.
- Ethical considerations: Exploring the ethical implications of robot use in SNFs, ensuring resident privacy, autonomy, and dignity are prioritized.