There’s care to give and money to be made, however...

Are Eldercare Robots Ineffective?

Research from Japan shows that a better understanding of the elderly, how they live, where they live, and how best to help them, may need a total rethink

“The care robots themselves required care: they had to be moved around, maintained, cleaned, booted up, operated, repeatedly explained to residents, constantly monitored during use, and stored away afterward. Indeed, a growing body of evidence from other studies is finding that robots tend to end up creating more work for caregivers.”

Don’t get old!
More and more, it’s looking like if you are elderly and in need of eldercare, then don’t look to an eldercare robot for much help. In fact, it seems that even some caregivers have grave misgivings about a robot’s ability to deliver quality care to their elderly patients.

A new book by James Wright called Robots Won’t Save Japan: An Ethnography of Eldercare Automation, based on three years of his Ph.D. research, gives twenty years of Japanese eldercare robot development a very low-performance grade. “Wright’s research addresses the Japanese government’s efforts to develop care robots in response to the challenges of an aging population, rising demand for eldercare, and a critical shortage of care workers.”

So, just exactly what are eldercare robots and what do they do? If you need a deep dive into the entire ecosystem, the National Library of Medicine’s 2023 article Robots for Elderly Care: Review, Multi-Criteria Optimization Model and Qualitative Case Study has lots to pick over. However, without naming names or finger-pointing at specific machines and their builders, here are the jobs that Wright considers to be an eldercare robot’s primary tasks: “Some [eldercare robots] are meant for physical care, including machines that can help lift older people if they’re unable to get up by themselves; assist with mobility and exercise; monitor their physical activity and detect falls; feed them; and help them take a bath or use the toilet. Others are aimed at engaging older people socially and emotionally in order to manage, reduce, and even prevent cognitive decline; they might also provide companionship and therapy for lonely older people, make those with dementia-related conditions easier for care staff to manage, and reduce the number of caregivers required for day-to-day care. These robots tend to be expensive to buy or lease, and so far most have been marketed toward residential care facilities.”

Wright’s research shows that eldercare robots in Japan are not doing what they were designed to do. And there are lots of reasons for it. But it’s not just Japan that has an eldercare robot challenge; it’s everywhere there are elderly and eldercare robots. In short, most anywhere.

Of course, Wright’s research is not a blanket condemnation of all caregiving robots; some built for physical therapy or to be of assistance in fetching or doing chores are daily mini-miracles for those who depend on them. Problems arise when robotics meets up with old people and the machines that are designed to assist them can’t perform or do so poorly, which also means that the ability to scale those eldercare robots across an aging demographic never comes to pass. Alas, there’s a vast marketplace growing ever larger that eldercare robotics is missing.

There’s care to give and money to be made, however…
The eldercare assistive robots market is anticipated to secure a CAGR of 12.4% during the forecast period 2023-2033. As of 2023, the market holds a valuation of $2.5 billion, with projections indicating a potential increase to $8 billion by 2033.

The demand for eldercare assistive robots is rising due to the increasing geriatric population in various regions. As per the UN report, 1 out of 6 people aged 65 and above is likely to face a demographic disaster shortly in the coming years. On the other hand, a survey conducted in Japan in 2012 states that the segment of the population aged 65 and above constituted around 22% in 2012, with projections foreseeing an impressive surge to about 40% by 2060. Hence, the eldercare assistive robots market share is likely to increase considerably during the forecast period.




Wright points out that the Japanese government, over twenty years beginning roughly in 2000, invested $300 million into robotics for eldercare without significant success. Actually, for a country like Japan with a population rocketing downward, an average of $15 million annually over twenty years is a pittance. Worse is that the number of eldercare robots that were produced over those twenty years has a poor rate of take-up in Japan’s elder homes and residences. Barely 10% of Japan’s 11,000-plus care facilities have and use them.

With some of those 10%, the eldercare robot was used once or twice, then, for a number of reasons, was put in storage. Principal among the shortcomings was that “eldercare robots are difficult to work with and also demand care themselves.”

See related article & podcast episode:
When the Robot Burns the Toast
Kitchen robotics for elderly & handicapped

As Wright puts it in a recent article for MIT’s Technology Review: “The care robots themselves required care: they had to be moved around, maintained, cleaned, booted up, operated, repeatedly explained to residents, constantly monitored during use, and stored away afterward. Indeed, a growing body of evidence from other studies is finding that robots tend to end up creating more work for caregivers.”

Wright’s negative conclusions about eldercare robots are something we have all probably felt in our heart of hearts while looking at eldercare robots ministering to their patients. As a caregiver for many years to my parents, one with Alzheimer’s and the other end-stage Parkinsons, I never met an eldercare robot that I’d ever have entrusted to be near my parents. But, that’s just me.

Critical observations

  • Overlooked in the real-world caregiving between eldercare robots and old people is the cultural bond that the Japanese people have with their elderly. It’s a millennia-old bond since the Yayoi brought farming and wet rice with them to the land. Simply, no one dies alone and no one lives alone. Families and extended families live together. A home specifically for the elderly was unheard of and disrespectful. Modern caregivers echoed this tradition.
  • Here’s what Wright observed from the caregivers: “They wanted to care with their own hands, which is quite a kind of an ideal in Japan, the idea that you have this kind of touch is an important aspect of providing care. And they said, you know, using robots with older people is kind of disrespectful of them, you know, these are our elders, we should be respecting them and not just moving them around, like a forklift truck moving goods or something.”
  • To Wright, there was also a disconnect between engineers developing the robots and the elderly and their care staff. Wright observed that “when some of the people who made these robots went and visited the care home they wouldn’t talk to residents. They weren’t really interested in talking to many of the care staff, and if they did, they only spoke to the male staff. “I just saw so many parallels in the way that the engineers are so disconnected from the end users. Inevitably, you have, therefore, exactly the same problems coming up, which is that the end users, it turns out, aren’t interested in using these technologies, sophisticated technologies, that are then developed without their consultation.”
  •  “Another really important thing was the constant communication between care workers and residents. So even if the care worker was brushing the teeth of the resident or lifting them. Through all of the interactions, there’s this constant communication that helps build relationships. Which becomes important when we move on to talking about robots.” Robots would do a better job if they could chat, which seems reasonable enough.

Wright titled his book Robots Won’t Save Japan. However, Japan’s population is tumbling so fast, the country has no choice but for robot-driven automation. To wit: Robots MUST Save Japan!