Adrian Malloch

The robots will see you now

A surge in New Zealand’s elderly population is on the way, yet health and home-care services are already stretched. A joint research project between New Zealand and South Korea—which is already experiencing the demographic swing that awaits us—is investigating one solution: robots.

Written by       Photographed by Adrian Malloch

Lillian Neilson loves those old songs, the waiata from her youth in Gisborne. The staff and therapists of Selwyn Village in Point Chevalier, Auckland, sometimes sing or hum along with her, turning to their phones to dig out words she’s forgotten.

“I used to be a singer,” she says. “I used to sing in our church choir. You’ve heard of Daphne Walker? I was the young Daphne Walker.”

But Neilson, 84, a mother of four and a former maternity nurse, doesn’t know any other Māori residents in the rest home, and few add their voices to hers.

“I do feel lonely, so I generally come in my room and I sing my songs. I put the telly on and sing the music that comes over.”

So when it’s her turn to have Paro, a fluffy robotic Canadian harp seal with large, fathomless eyes, she’ll sing a song to him.

In the living room of the rest home, she shows me how the robot responds.  Deceptively complex and comfortingly heavy, Paro recognises words, and adapts his behaviour to everyone who holds him. He’ll even squeal and squirm if you absent-mindedly hold him upside-down.

Neilson knows just the right spots to scratch to make him wiggle happily. People aren’t meant to kiss the seals, but the fur on his head is nevertheless streaked pink from someone else’s lipstick.

“He gives you hope,” she says. “You’re just sort of sitting here on your own, falling asleep, but if you have something like this you’re inclined to talk, and he’ll give you an answer.”

At this, Paro opens his eyes and bats his long lashes, and Neilson is delighted.

“Look at those beautiful big eyes,” she says, and he mewls back. “Aren’t you pretty? My goodness. We’ll have a hongi now.”

She brings her nose to the seal’s black-button one.

“Oh, you don’t want a hongi? Oh, you do! Come on then. Now, don’t you flirt! You’re a flirt, aren’t you? Hey, are you doing the haka or the hula?”

Paro the baby harp seal robot responds to eye contact, touch, sound, light and temperature. He remembers names and faces, and learns from people’s interactions with him. He’s has been classed as a medical device in the United States, certified as the world’s most therapeutic robot by Guinness World Records, and is used with dementia patients globally.

The seal has started to wriggle again.

“If they were to talk back we’d get the shock of our lives,” she says to me. “It’s marvellous, really. They make lonely people happy. He makes me happy.”

She looks back down to Paro.

“Would you like a cup of tea? Coffee? Milo?”

But Paro has stopped purring and lies still, heavy on her lap like a fat, sleeping puppy.

“Or would you like a beer?”

The seal opens his eyes, flaps his tail, bobs his head at her, and squeals.

“You prefer a beer! You do! Well, I can’t get you a beer, even if we had a hongi.”

He is so good, she says, for people like her, who sit here and watch the time go by.

“I talk to stuffed animals and real animals here. And I was a singer. I sing to myself. I sing a bit louder but people sit in the chair and fall asleep.

“I think of my grandmother, who just used to sit there. We’d make a hell of a lot of noise around her, but she’d enjoy it. And when we weren’t singing or anything, she’d ask if we were sick.”

Despite care facilities’ calendars of activities, outings and entertainment, those older people who live in rest homes or who need advanced care still miss out on participating in that regular bustle of family life. Paro, Neilson says, helps slow hours pass by.

“It helps the day. The day becomes shorter. Doesn’t it? Yes. Say yes.”

She’s talking to him again, lapsing into a lull for a few moments as the seal gazes at her. Then she turns back to me, and says: “I used to be a singer. I used to sing in our church choir. You’ve heard of Daphne Walker?”

[Chapter Break]

The robots are coming, and they are coming to watch over our elderly.

Around the world, lifespans are lengthening, the proportion of elderly in the population is increasing, people are developing more complex healthcare needs, and more are living alone. Meanwhile, the price of looking after our elderly is rising. The true cost of caregiving has long been concealed, as it was carried out mostly by unpaid female family members in the home or underpaid women working in aged-care institutions. Now, it’s difficult to see how the shortfall will be met.

Most people choose to stay in their own homes as they age, which is the healthcare system’s preferred option, too; people are happier, and it costs less than institutional care. But who will watch over Nana, and keep her company?

Robotics holds the answer. It’s likely that therapeutic healthbots such as Paro will become increasingly common, along with others that can offer monitoring, entertainment, connection and companionship.

Hilda Johnson-Bogaerts, general manager of the Selwyn Institute of Ageing and Spirituality, says the swiftness with which Paro dissolves a low mood is striking. He has different impacts on people with different levels of cognitive impairment, but generally Paro reduces stress and lowers blood pressure. At Selwyn, he usually visits a resident who isn’t well, has had a fall, or is feeling down.

“If they are not feeling very confident, or someone is a bit sad, Paro usually breaks it,” says Johnson-Bogaerts. “They just start smiling and interacting with him and cuddling him. It changes your focus from what you were doing or thinking about to the here-and-now interaction.”

Paro also encourages light-hearted chat, and is a catalyst for connection between staff, visitors, families, and residents. During New Zealand Geographic’s visit, the seals are stacked away when it’s time for a cup of tea and a muffin. With Paro gone, the room suddenly feels emptier. The silences are heavier. People talk, but there’s not as much happy, candid banter. It’s possible the residents were just focused on their snack, but nearly a decade of research from the University of Auckland backs up the social benefits of robots.

The results of the first randomised controlled robot trial at Selwyn Foundation rest homes showed that the group who played with Paro for an hour twice a week reported significant decreases in loneliness over the period of the trial, in comparison with the group who did usual activities. In fact, Paro was so effective that Selwyn subsequently bought its own seals to use in therapy.

Neilson, her fellow residents, their families, and Selwyn staff are at the centre of world-leading research into healthbots, run by the university’s multi-disciplinary Centre for Automation and Robotic Engineering Science, or CARES, which investigates how robots can improve society. The Selwyn Foundation runs 12 villages across the upper North Island, and researchers have been trialling different healthbots in its facilities since 2008.

CARES, which includes about 30 staff from departments including engineering, pharmacology, gerontology, healthcare, linguistics, psychology and more, was an unusual group when it first began.

“It doesn’t seem quite so crazy now,” says robotics professor Bruce MacDonald. “But 10 years ago, it was a much more crazy thing.”

MacDonald says the idea behind healthbots is that robots will help human caregivers, not replace them.

“We don’t think it means you don’t need human help, but what we think is the robot could be doing monitoring, and [carers] can look remotely and see what’s been happening with that patient during the last few days. What are they doing, what are the trends, do we need to do more? That can enable a carer to look after more people.”

CARES works in partnership with several South Korean research institutions and robot manufacturers. South Korea provides the robot-making expertise, and New Zealand the network of rest homes as testing grounds. Both countries have received funding from their governments to collaborate on healthbot projects, and both work on social robotics research and software programming.

[sidebar-1]

In 2011, the Selwyn Foundation hosted a large-scale multi-robot trial funded by the New Zealand and South Korean governments. The six studies—which involved 200 people and 31 robots in five different models, including the Japanese-made Paro—placed robots into public spaces, residential care facilities and residents’ apartments, where they measured activity, vital signs and falls.

Survey results had previously shown that one of the rest homes’ big problems was loneliness. Paro made such a difference to the residents in the study that, afterwards, Selwyn Village bought 13 of their own.

“He doesn’t work for everybody,” says Elizabeth Broadbent, a social robotics expert at the University of Auckland, “but when he does, he’s very effective.”

The rest homes also have cats, a dog, and birds, but these pets do not cooperate in the same way as Paro. The seal doesn’t bite, scratch, shed, run away, trip people, require feeding, or, as is the case with cats, disappoint you with a supercilious attitude. Paro exists purely for the pleasure of your company.

The study also suggested there’s something about a robot that’s inherently more attractive and interesting to us than animals. A dog was present during the study, but the residents talked to, talked about, and touched the robot significantly more than the pup.

It was the first time the effects of a robotic animal had been compared to a live animal. Paro, made in a lab, may be better at addressing some of the unmet needs of older people—particularly when it comes to isolation, the scourge of old age.

[Chapter Break]

Two years ago, when Kathy Peri first visited Robot World, Bruce MacDonald told her to keep an eye out for the future of healthcare.

Robot World is a four-day robot exhibition, crammed with booths displaying the latest in South Korean and global robot technology: surgical arms, robot dogs, factory selectors, delivery systems, walking exoskeletons, and fighting toys.

New to robots but not the needs of the elderly, Peri scanned the cavernous hall of Kintex, a convention centre on the outskirts of Seoul, for technology that could help New Zealanders in ways not yet imagined.

“There were all sorts of weird and wonderful things,” she says. She spotted a robotic delivery system, perfect for shuttling food and laundry down long hallways. (Later, it would be tested at Selwyn.)

Peri, a senior lecturer in nursing at the University of Auckland, was new to the Selwyn Village project. A refugee from the Christchurch earthquakes, she’d been the director of nursing at geriatic hospital Princess Margaret until the rebuilding city wore her down a little too far. She was invited north to work on the healthbots programme by her mentor Ngaire Kerse, head of the University of Auckland’s School of Population Health.

[sidebar-2]

During the robotics study at Selwyn Village, one standout for Kerse and Peri had been the residents’ reaction to the iRobis—friendly, rounded, white plastic robots with pre-programmed menus. As well as a simple face, an iRobi has a small touchscreen, which can be programmed to prompt users to take medication, test their blood pressure, play games and quizzes, listen to music, and connect with friends and family through Skype. Kerse and Peri were initally sceptical, but some of the residents grew unexpectedly attached to them. They named them, and appreciated how they turned their little white heads to say, “Good morning.”

They liked that they flashed their LEDs in welcome: blue, red, green. Peri, who has spent her career in gerontology, had never seen anything like it.

As with Paro, staff noticed the robots created more chances for the elderly to interact. Residents were talking more, discussing the robots, looking forward to their medication times. A robot hanging out in the lounge meant more talking for everyone. Kerse recalls that during an early project, a researcher noticed a group of people had gathered around one of the robots, a person-sized Cafero named Charlie. Someone had put on a music video while waiting for the lift, and the group spontaneously broke into a bout of line-dancing.

“They were all laughing, and people came along and joined them,” says Kerse. “So then they tried another song.”

When it came time for the study to end, and the iRobis to return to the university, a few of the residents became particularly upset.

“Don’t put that robot in the box! That’s my friend,” they’d say, as the researchers came to take them away. They had to carry him out and box him up in the hallway.

“That was a surprise for me, and I’ve worked with older people for most of my life,” says Peri. “One of the things that a lot of the other health professionals will say is, ‘Why are you wanting to put robots into older people’s houses? It’s not a nice thing to do, they need human people to talk to, not robots’.

“I was thinking that myself at that point. When they said, ‘Don’t put it in the box!’ I thought, ‘My God. They’ve actually got an attachment to it’.”

Surprise at the residents’ fondness for robots perhaps says more about society’s perceptions and expectations of elderly people than it does about robots. Peri remembers how, before the study began, she told her kids about it, and they were dubious.

“They were like, ‘Mum, what are you doing? Old people don’t need robots. They’re for young people’. But why should they be?”

She told her disbelieving kids: “Watch this space.”

[Chapter Break]

How do you define a robot? Is a self-checkout kiosk at New World a robot? A self-parking car? It’s easy to understand a surgical or factory robot—they’re tools. Precise, tireless, and unerring, where the human being is clumsy, mortal, and forgetful.

Bruce MacDonald—whose filing cabinet sports a very cute Japanese robot, a Bionic Man, and a forbidding T-800 from The Terminator—says though there can be a blurry line between robot and machine, a robot has a higher level of autonomy, and can make its own decisions. Thinking about what a robot is and isn’t turns out to have thorny implications for how we think about the future—and about ourselves.

There’s something about robots that both attracts and repels us. In the robotics lab at the University of Auckland, there’s a large whiteboard charting the team’s progress on various robotics applications, from vineyard management to gait analysis.

The robots that will house these ideas are flopped on the margins, like ventriloquists’ dummies. Some resemble plastic dolls, but the more human-ish they get, the creepier they become. On one desk, a robotic female head is tipped back, her eyes staring blankly at the ceiling, as Byeong Kyu Ahn works on her exposed throat. She’s part of a joint South Korean and New Zealand study aiming to create a robot that can interact socially with people, responding at an emotional level. This year, one of the attributes they’re examining is friendliness.

Being a human means unravelling a thousand lightning-fast tics, movements, expressions and variances of speech, tone, and posture—all of which create meaning. If a robot can only half-mirror that, it’s too weird for us to handle.

With the robot’s head flipped back into place, Ahn demonstrates the tiny motors that act as muscles under her South Korean-made silicone skin. But it’s hard to get past her semi-frozen expression. I am feeling the depth of the uncanny valley (see diagram on page 40), a term used to describe our aversion to robots that look almost human, but not quite.

Other robots are cute enough to elicit affection. At one point, I step back and into a robot propped against someone’s backpack. It’s a sleeping Nao, a small white figure made by Aldebaran Robotics. This one is named Puma, and I find myself instinctively apologising to him for my clumsiness. Then I catch myself, wondering: Why?

The troupe of little iRobis that were at Selwyn Village are between jobs right now, awaiting their next deployment—they are currently programmed to help in a chronic obstructive pulmonary disease patient trial.

MacDonald walks me through the menu on the iRobi’s touchscreen, showing me how it can measure my blood-oxygen level and pulse rate through an attached clip.

The Silbot3 was developed by South Korean social robotics pioneer Mun Sang Kim, who collaborates with CARES’ research partner Geon-ha Kim. This robot has been used across the Pacific by University of Auckland researchers in their programming experiments. Silbot is a play on words: it references ‘silver’, the word Koreans and Japanese use to describe elderly needs in the same way we might use ‘grey’, and ‘bot’, a play on a Korean slang word for ‘friend’.

This should be as routine as using an airport check-in kiosk, but something about the robot form turns us into play-along accomplices. We soften, engage—and pretty much do what they tell us.

It’s a phenomenon that Broadbent has shown with her research and that Johnson-Bogaerts noticed anecdotally at Selwyn, too.

“To me, it seems just an iPad on wheels, so what is the difference between an iPad reminding you to take your medication and this guy?” she says. “What they found with this guy is that people actually started having a relationship with it, because it reacts. They were obeying it. They didn’t want to disappoint the little guy so they were taking their medication. But with an iPad, you don’t care.

“I definitely believe that technology will support aged care in the future, because there’s not the workforce there to look after all the people we have. Technology can support, but it can never replace the human touch,” she says. “But I would quite like to see robots doing some lifting work.”

[Chapter Break]

That’s already happening at the Silverwing Shintomi Nursing Home in Tokyo. With more than 20 live-in robotic devices, it’s the most advanced robo-rest home in the world, offering a glimpse into the future of aged care in New Zealand.

Japan leads the world in the development of social and personal-care robotics—and it’s also ahead of New Zealand in the number of elderly. It has the world’s oldest population, and its aged-care problems loom worse than many. By 2025, those over 60 are expected to comprise 30 per cent of the population. (New Zealand is several decades behind; by 2050, people over 65 will comprise up to 27 per cent of the population.) Kodokushi, or ‘lonely death’, is particularly concerning—about 30,000 elderly Japanese die alone and unnoticed in their homes every year, sometimes lying undiscovered for weeks or months at a time.

“In Japan, there are fewer and fewer children being born, so we need to think about what we can do to help all these elderly,” says Shintomi director Yukari Sekiguchi. “Most of the staff leave the work because they get burnout, so the robots are part of a project to help that. We don’t have enough hands to help them, and so the technology is getting better and better.”

The world is not yet at the stage where robots can take the place of humans, she adds.

“But what can be done is to help the care workers avoid tiredness, and provide support for their bodies.”

At Shintomi, robots are saving the backs of staff, helping residents learn to walk again, strengthening their balance, measuring their sleep disturbances, breathing, and heartbeats, monitoring their safety, chatting with them at their bedsides, telling them the time and their schedules so they don’t spend all day sleeping, and leading them in song and movement routines. To manage all this, including repairs, software updates, and training, the centre employs a manager with an enviable job title: chief of robots.

Right now, the chief of robots, Takakai Sugimoto, is taking part in an exercise class on the sixth floor, led by the 1.2-metre humanoid robot Pepper.

“With a big voice, let’s sing and use our body together,” says Pepper, in a high, child-like voice, launching into a gentle folk tune. Sugimoto goes through the movements, too. He has an exoskeleton-like robotic device, which helps staff with heavy lifting, belted around his middle and strapped to his thighs.

Pepper, says Sekiguchi, is like a nephew to them. Sometimes, one of them will say, “Okay, we’ve done enough. He needs to rest.” And sometimes—like children responding to a hand puppet but not their parents—he’s the only one they’ll engage with at all.

The small white social robot Puma is about 60 centimetres tall, and he can walk, talk, tell jokes, even do tai chi. Craig Sutherland, left, is working on a project to place robots such as Puma in children’s hospitals. Research has found that robots can help children manage discomfort and pain, and that at times children listen better to instructions from robots than people.

In another day room, Paro the harp seal is comforting an elderly woman with dementia—just as he does in Auckland.

“She didn’t speak when she came here,” says Sekiguchi. “She had no expression. She didn’t laugh, she didn’t cry. But now she has expressions. When the family came to visit, they were so surprised to find her so changed.”

Nearby, two other Shintomi residents, 98-year-old Kisa Okubo and 86-year-old Toshiko Yoshikawa, are locked in a war to get the attention of the cuter of a pair of Sony robotic puppies, Aibo.

The dogs can develop personalities, and this one barks and plays, bows down, and sits on command. He returns again and again to Okubo, who talks to him as though he’s Taro, the name of her old dog, now long dead. She’s telling him he’s a good boy, playfully barking “Wan wan” back to him.

The women will spend about an hour with them today, in a morning and afternoon session. Okubo used to say nothing but ask for a bath—now the robodog has unlocked a little something inside her.

Otde,” she commands. The dog raises its paw, and the other residents applaud.

“It’s incredible how this dog has changed things and helped all these people with dementia,” says Sekiguchi. “We didn’t think there would be that much interaction with them—it was very surprising.”

Aibo is old technology now, launched in 1999 and discontinued in 2006, but it remains ideal for use at Shintomi. Studies of Aibo show that interacting with it has similar beneficial effects to playing with a real dog.

During the whole half hour that we spend with the women and their robots, they barely take their eyes off them, responding briefly to our attempts to talk. They are in their own world, and only the robots are there with them.

[Chapter Break]

A few years ago, at the bottom of the South Island, the town of Gore became an unlikely candidate for healthbot capital of the world.

After the Selwyn Village study was released, Gore Health chief executive Karl Metzler jumped at the chance to trial iRobis in people’s homes, not just at retirement villages.

“I got invited up to Selwyn Village to see them, and I was absolutely blown away,” he says. “They were quite mobile then, moving around the aged-care facility, and it was pretty impressive. I was all excited and I said, ‘We need to get on with trying this’.”

Robots living with people and monitoring their health? It was a bona-fide world first.

As an independent health centre, Gore Health could move quickly—much faster than a district health board. The organisation bought a Cafero robot and five iRobis, and put the Cafero into the health centre, to assess patients before they saw a human doctor or nurse, shaving time off appointments. The iRobis were deployed into homes as companions, communication and quiz portals, and to manage medication schedules. (Inspired, Metzler’s sister and brother-in-law also got into the swing of things, purchasing a robot dispenser for their pharmacy.)

Though it was just a small sample size, the home iRobis were found to be good companions, with people reporting that they didn’t feel so alone. All said they would miss them when they left. Study participant John Redman, who is 85, says his iRobi was “a terribly good thing”.

“It would tell me what the time was, and people who visited were interested. I enjoyed having it.”

Today, things have entered a lull. Like so many electronic devices, the underlying software for Gore’s iRobis is now out of date—it depended on Windows XP—rendering them lifeless. Four of them are living in Gore Health’s IT provider’s workshop. You could say they’re suffering from dementia themselves; they’re physically intact, but their operating system no longer works.

Turns out you don’t just need robots—you also need a network of industry around them, including dedicated IT support. Gore isn’t yet capable of hiring its own chief of robots, though it is now working with the University of Auckland to get them up and running again with new applications.

There is now just one woman in New Zealand—possibly the world—who has a healthcare robot in her home, and the little iRobi, Sneezy, is tucked up in 92-year-old Peggy Haar’s bedroom, forever asleep.

[Chapter Break]

In August 2016, for the first time, South Korean census figures revealed the population comprised more elderly than young people. The country is ageing faster than any other, with those over 65 making up 14 per cent of the population, or 7.26 million people. The number of young people, or those aged up to 14, totalled 6.77 million. (In New Zealand, the elderly are projected to outnumber young people at some point in the next 20 years—see sidebar).

South Koreans have a better word for aged care than we do. They call it “silver care”, and because of these figures, it’s become an area of furious government research and investment.

Ewha Womans University in Seoul collaborates with the CARES team on multiple projects in social robotics, along with the Korean Institute of Science and Technology (KIST) and robot manufacturers Yujin and Robocare. Ewha neurologist and dementia specialist Geon-ha Kim says her goal is to make elderly people with cognitive impairment happier at home. About 10 per cent of those over 60 suffer dementia, she says.

“Among the elderly, dementia is one of the most feared diseases in Korea. They think it’s a burden for their children.”

In a country that traditionally hasn’t had a strong welfare system, older people rely on their children for support. South Korean and New Zealand collaborators are in their second year of a project testing how robots can help people with dementia or mild cognitive impairment to live at home.

Success with robots, especially humanoid models, depends heavily on their social understanding and ability to learn. “Over time people learn how to use it, so the robot has to change,” says Elizabeth Broadbent. “The first time you’re quite slow, but by the time you’ve used it five times the robot can skip some instructions. So people seem to like it when the robots come up with different spontaneous things, and also when the robots used their names.”

Developments are also afoot in creating a robot that can appropriately detect and respond to human emotions—meaning early intervention in mood disorders—and can provide various cognitive training programs for those with dementia. MacDonald and his team are developing the appropriate robot behaviours for interaction with humans.

“If we can detect mood problems in the elderly, the robot can provide some programmes, such as music or talking or meditation, and if the robot also recognises the critical words such as ‘suicide’ or ‘die’, they can also connect this problem to their children or caregivers,” says Kim.

She shows me slides of her vision for the project, which will end in 2020; a cheerful robot arriving at the bedside of halmoni—grandmother—providing her information on the weather, tracking her sleep and vital signs, offering some cognitive-training games with peripheral devices, doing exercise classes with her, and connecting her with family members and others using the robot.

Kim is also discovering that robots can change elderly people’s brains. In a study that MacDonald’s team hopes to repeat with patients at home in New Zealand, Kim found that those who underwent 12 weeks of brain-training games using robots had increases in cortical thickness in the thinking and learning parts of the brain compared to the control group.

These were the types of games that might usually be performed in groups at senior citizens drop-in centres, assisted by nurses, occupational therapists or healthcare assistants. But those who did the same programmes with humans, as well as the control group, did not see the same changes. Robots were adding something extra.

“Adaptation to new technology is more challenging,” says Kim. “I think it’s a hopeful message for elderly that people can change their brains.”

At first, the older people were afraid of using the technology, she says. “They said: ‘I’m not familiar with that and I don’t want to use it. I want to use paper and pencil.’ But after three months, they were really proud of using the technology.”

Will the brain continue to show those improvements when robots are no longer novel for future generations? We don’t know.

“But robots are another tool to exercise the brain, and with humans’ willingness to open up to robots over people, that can mean other programmes can be introduced to keep the novelty,” says Kim.

Across the Han River, at the park-like grounds of KIST, the security is intense; tall fences surround every border and I have to hand over my passport to get in.

JongSuk Choi is the head of KIST’s Centre for Robotics Research, and in a project led by University of Auckland department of electrical and computer engineering lecturer Ho Seok Ahn, is developing a system that can interpret emotions and personality, gain intimacy, gather information, offer encouragement and sympathy, recognise social cues and facial expressions, obtain situational awareness—and respond appropriately.

Choi shows me the system they’ve spent the past five years working on. It’s a group of sensors and cameras that can identify humans, locate where they are in a space, and track them around, as well as detecting if they’re standing, sitting, or moving.

He says it would be useful in dementia units and rest homes to monitor moods, to detect if anyone has fallen, or isn’t where they’re supposed to be, and potentially prevent residents escaping.

Next year, in fact, the University of Auckland aims to test a system in homes to measure gait analysis. How people walk can reveal insights into cognitive decline and likelihood of falls. It can also predict depression, from the way shoulders slump or feet drag. A robot could alert friends and family if something is up, and perhaps recommend exercises known to stimulate mental health. Tactfully, of course.

Choi says the technology could also be useful in a doctor’s office, to screen patients before they see a GP, or in working with people with autism. Research at Seoul University Hospital has shown children with autism are more inclined to share information with a robot than they would with a doctor face-to-face, and are much better at following instructions when a robot friend cheers them on. Sometimes, we prefer robots to humans.

University of Auckland electrical and computer engineering research fellow Craig Sutherland has found something similar in his work with Puma, the small white robot I bumped into earlier.

Sutherland is setting up studies to use Puma in children’s hospital play areas, where the robot will have three jobs: education, entertainment, and pain management.

“He’ll tell children what’s happening and what they have to do, because they’ll listen a lot more to the robot,” says Sutherland.

With pain management, Sutherland is hoping to replicate Canadian studies that showed having robots at vaccination appointments helped children to recover faster from the jab.

“Some would hit and punch their nurses because they hated needles. But with the robot there, they just focus on that, get their needle, cry a little bit, and go back to focusing on the robot again.

“Compared to using virtual devices like iPads, or play specialists doing games or distractions, the robots have been found to be more effective.”

Sutherland says the children in the hospital sense the staff’s ulterior motives when they engage with them. “So even though the play specialists are there to help them, they still associate them with the hospital,” he says. “The robot doesn’t have the same connotations so they tend to be a lot freer.”

Children, he says, think robots are alive, in a different way to toys or stuffed animals. They know robots are powered on and off—but they still think they’re sentient. Researchers don’t yet know why this is the case.

[Chapter Break]

When the elderly residents of Selwyn Village protested at the little iRobis being powered down or put into a box, it was an impulse that most of us would recognise. Anyone who remembers a cherished toy, or who’s given their car a name, or who’s said goodbye to a pot plant before they went on holiday, would understand. Imbuing robots with human characteristics and a spirit is no different from how many cultures interact with the natural world—trees, stones, mountains, and rivers.

“I think it’s a natural human thing to do,” says MacDonald. “What we know from our studies is that people form a relationship with the little robot that’s just a plastic screen and a bit of face.”

When considering how we interact with robots, he finds it useful to use the theories of Daniel Dennett. The Boston philosopher and cognitive scientist coined the phrase ‘intentional stance’ to describe how humans are predisposed to ascribe rationality and purpose to those people or things we’re hoping to understand and predict. It’s our way of comprehending the mystery of a mind outside our own.

Some cultures are happier than others to assign sentience to creatures and objects. Both Japanese and South Korean cultures are more comfortable with animism, the idea that an inanimate object has animate characteristics. They’re more familiar with the idea that a robot could be in some sense alive—an attitude that may have been influenced by Confucianism. New Zealanders may be familiar with the concept of mauri, or life-force, which encompasses health and whakapapa, too.

University of Canterbury researcher Christoph Bartneck has studied Japanese attitudes towards robotics and points out that Japanese people aren’t as au fait with robots as Westerners might assume, though the country has a leading role in robotic development and culture. But the ‘robots will take over the world’ scenario that is so often touted in Western culture is less prevalent in Japan. With robots here to stay, we’d do well to get over it, too.

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“I think robots are a mirror of how we treat the powerless,” says Merel Keijsers, a University of Canterbury student. She has just started a PhD on robot bullying, a project she embarked on when she saw a video of people slapping, kicking, and verbally abusing a small cleaning robot at a shopping mall.

There are other cases where unsupervised robots in public places are bullied and abused. They’re not keyed or smashed, as people might a car—they’re treated as though they’re lesser humans: slapped, yelled at, and obstructed.

We don’t interact with robots the same way we do with animals or each other. It requires an entirely new paradigm of research and understanding. Cognitively, behaviourally, and physiologically, we respond to them as though they are human—up to a point. Whether it’s a robot or a person waving their hand at us, the same neurons in our brains fire, slotting it into our social order.

Robots are just human enough that we demand they follow certain social rules; research shows that if a robot doesn’t conform to unspoken social orders when playing a game, we punish them as we would a person.

And yet, as we do to other marginalised groups in society, we dehumanise robots when we want to, so we don’t feel bad about not showing empathy towards them.

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Keijsers says humans get particularly frustrated when a robot says it’s human, just like us. We need to remind them, urgently, that they’re not. She’s studying how human-robot bullying compares to human-human bullying—and what can be done to stop it, considering the robot-heavy society we’re building.

After all, robots are predicted to outnumber humans within a couple of decades. The World Economic Forum has estimated that humanity will lose seven million jobs by 2020 due to automation—particularly in administration and office roles. It does add, however, that two million jobs will be created through technological advances.

Researchers spoken to for this story have heard it all before. They’re quick to jump on any suggestion of ‘robots taking our jobs’; they prefer to use the word ‘augment’.

“What the robot can do is something people cannot do,” Sekiguchi told me. “The robot can help staff with things they weren’t able to do before now. It’s a big support to the staff.”

She thinks the best application of healthbots are the type that will help with monitoring. “It’s not possible to look after someone 24 hours a day, so having something help with that is really great.”

As robots develop, new jobs pop up—such as Shintomi’s chief of robots—and others will fade away. But that’s always been the case. Who really mourns the loss of typing pools, night soil collectors, or switchboard operators?

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Bruce MacDonald tells me about a person in the Gore study who couldn’t use the iRobi because of dementia, but didn’t want it to be taken away. “Who will I talk to?” he asked.

That’s the question at the heart of developing eldercare healthbots. We haven’t accepted that people who are disabled, or socially or physically needy, have as legitimate a place in society as the more able. There are not enough people around them—family, healthcare professionals, carers or otherwise. We don’t have the time or the resources. Their problems are too difficult, their needs not a priority. Our bodies exist for far longer than they used to; our minds do not.

There are legitimate concerns about the ethics of using robots to fill the gap left by humans. Australian philosopher and bioethicist Robert Sparrow has written widely on robots in aged care, in one paper warning of a dystopian future where the endgame is elderly left entirely to the care of robots—even though that might not be the goal of today’s robot engineers.

But is human interaction any better, when other human beings so consistently fall so far short of our needs and expectations? Why do rest-home residents open up to the likes of Paro, and why do children prefer talking to Puma?

Bruce MacDonald started the University of Auckland’s multi-disciplinary collaborative robotics programme CARES, and now leads its research project into how robots can improve society. At the lab in Newmarket, an iRobi measures his blood pressure.

At the University of Auckland, Elizabeth Broadbent, whose expertise is in how humans interact with robots, says her studies with older people have found some initial resistance to robot introduction, with a number declaring, “I want a human looking after me.”

“But the majority of people say,  ‘It’s going to help me.’ Some people saw the benefit of a robot compared to a human helping them; some things might be embarrassing if you have a person helping you. You can imagine that something like having a robot help you with toileting could be helpful in the future.

“People’s opinions can change once they see the robots and what they can do. The technology is here, but it has to get better, and that’s what we’re trying to do.

“There are some people out there who are concerned about the ethics of it, and it is quite a fast-paced, changing environment. Some people worry about robots replacing people or replacing human contact, but it’s not our aim. So far, we’ve found that robots actually increase human contact.”

It’s perfectly encapsulated in the microcosm of the sunny living room at Selwyn Village, where the chatting and laughing over the seal Paro is loose, relaxed, delighted. By the windows, two women are each cuddling a seal, and one says to the other: “You’d swear they were real when they look at you.”

Her neighbour nods, smiles. But then she looks down at Paro and whispers:

“You are real, aren’t you?”

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