Feature article
Robots to aid the disabled and the elderly
Robert Bogue
Okehampton,UK
Abstract
Purpose–This article aims to discuss the potential of robots to assist the disabled and the elderly and to highlight some of the associated ethical issues. Design/methodology/approach–Following an introduction,this considers robotic wheelchairs and exoskeletons,companion robots,assistive robots and household robots.This is followed by a short discussion of the ethical issues associated with their use.
Findings–This shows that many types of robots are available or under development which seek to aid the disabled and the elderly.Various as yet unresolved ethical issues have been raised regarding their use,most notably the potential problems arising from a reduction in human interactions. Originality/value–In an era characterised by a growing elderly population,this article provides a timely
review of robots aimed at assisting the elderly and disabled and gives some consideration of the ethical issues surrounding their use.
Keywords Disabled,Elderly,Ethics,Healthcare,Robot
Paper type Technical paper
Introduction
One of the most significant demographic events of the twentieth century was the dramatic growth in the aging population and in almost every country the proportion of people aged60or over grew faster than any other age group.During the1950s,only 4.9per cent of the world’s population was over the age of65but in the US12.9per cent of the population,39.6million people, were aged65or older in2009and by2030this will have risen to about72.1million people,or19per cent of the population. In Japan,it is predicted that26per cent of the population will be over65by2015.This phenomenon can be seen as a success for public health policies and socioeconomic development and the elderly now have far greater expectations for a more active life and more autonomy than ever before but there inevitably comes a point where they start to need personal care.The challenge is that,in parallel with this growing elderly population,there is a decline in the number of people to care for them,in part refle
cting the generally low salaries commanded by care workers.According to the US Bureau of Labor Statistics,the country will need70per cent more home aid jobs by2020but this is unlikely to occur.Accordingly,a major“care gap”is predicted in the near future and many see robots playing a vital role in dealing with this shortfall,in applications which include robotic wheelchairs and exoskeletons to aid mobility;household robots to conduct routine domestic tasks;assistive robots to conduct specific functions such as feeding and bathing;and companion or“calming”robots for patients with dementia or Alzheimer’s.This article considers these types of robot and highlights some of the ethical issues that have been raised regarding their use.
Robotic wheelchairs and exoskeletons
Many robotic wheelchairs have been developed in recent years, often by academic groups,and vary greatly in terms of functionality and capability,in part reflecting the varying abilities/disabilities of the user and also the tasks required from them.Issues such as the many potential user-interfacing technologies,navigation,the level of autonomy,safety and reliability factors,communications,functionality,control and overall system design are complex and such developments clearly pose many technological challenges.Much research has sought to resolve these issues,often individually or in combination but rarely in their entirety and the twofirst-mentioned
factors,in particular,make the design of any universally applicable robotic wheelchair extremely difficult.Nevertheless,some progress is being made in this direction and an example is a semi-autonomous robotic wheelchair developed at the Institute of Automation at the University of Bremen(Figure1).Dubbed the functional robot arm with user-friendly interface for disabled people(FRIEND),this is designed to support elderly or disabled people in their daily lives such those who are paraplegic,have muscle diseases or serious paralysis due to strokes,and aims to dispense with the need for therapists or nursing staff.It features a lightweight robotic arm with seven degrees of freedom,equipped with a prosthetic hand,the“SensorHand Speed”,produced by Ottobock,which has in-built sensors to detect any slipping of gripped object and to adapt the force accordingly.At the robot’s wrist,a force-torque sensor is mounted to perform reactive manipulative operations and to detect collisions.A dual stereo camera system is used to acquire information about the
The current issue and full text archive of this journal is available aldinsight/0143-991X.htm
Industrial Robot:An International Journal
40/6(2013)519–524
q Emerald Group Publishing Limited[ISSN0143-991X] [DOI10.1108/IR-07-2013-372]
object to
Received:2July2013
Revised:2July2013
Accepted:3July2013 519
environment and is mounted at the top of the chair on a pan-tilt head unit behind the seat and an“intelligent”tray is positioned in front of the user,onto which objects can be placed by the manipulator.This features an IR proximity sensing technique to acquire information about object locations and IR technology is also used for communication with various appliances in the robot’s environment.The unit is located beneath the pan-tilt head and can,for example,activate an automatic door opening mechanism in a refrigerator or a microwave oven.Several interface devices are available or under development and include a chin joystick,a hand joystick,speech recognition,eye movement tracking and various brain-computer interface(BCI) technologies.The robot has allowed people to conduct a variety of tasks such as preparing and eating a meal.The image processing technology used in the FRIEND illustrates well just one of the complex issues associated with the development of this type of robot.It has to operate in an unstructured environment with variable lighti
ng conditions and recognise objects within it. T o achieve this the robot uses a specially developed vision system termed robust machine vision for service robotics(ROVIS)which uses several methods for object ion-based colour segmentation and edge detection.Thefirst is used for objects with uniform colour and without texture such as bottles, glass and handles and the second for objects with textures such as books.For large objects like a refrigerator or a microwave oven,an improved scale invariant feature transform(SIFT)algorithm is used,which was developed at the university.A schematic of the ROVIS system architecture is shown in Figure2. Exoskeletons have been considered in detail in a previous issue of this journal(Vol.36No.5)and are only discussed briefly here.They are powered devices which are worn by the user and in contrast to military applications,where they are intended to impart greater strength,they can be used in the medical context to enhance mobility.Most are used to assist in walking and several are now available commercially,for example the ReWalk from Argo Medical T echnologies and the robotic exoskeleton legs produced by Rex Bionics.The ReWalk is battery-powered and uses motorised legs that power knee and hip movement.It is controlled by on-board computers and motion sensors and a forward tilt of the upper body is sensed by the system,which triggers thefirst step.ReWalk controls movement using subtle changes in the center of gravity,mimics natural gait and provides functional walking speed.Rex Bionics is working with the University of Houston to develop a system whereby the legs c
ould be operated by thought alone.The aim is to detect brain activity using EEG techniques and translate the electrical impulses into commands for the exoskeleton.
Companion robots
The concept is for robots to provide companionship to the elderly or disabled,notably those suffering from Alzheimer’s or other forms of cognitive impairment.An estimated25million people worldwide have Alzheimer’s disease and this number is expected to triple by2050.One of thefirst companion robots was the Wakamaru,a humanoid,wheeled robot which stands100cm high,made by Mitsubishi Heavy Industries and launched in2005 (Figure3).It has a limited voice recognition capability and also facial recognition and makes eye contact when“conversing”with an individual.It is equipped with ultrasonic and IR sensors and cameras which allows it to operate autonomously in an indoor environment.More widely publicised and perhaps more controversial is the Paro robot which resembles an immature harp seal(Figure4).Also developed in Japan,this is intended to have a calming effect on,and elicit emotional responses from, patients and act in a similar manner to animal-assisted therapy and is claimed to respond in a similar way to a live animal.It is equipped with a range of sensors which allow it to perceive people and its environment.With a light sensor,it can recognise light and dark and“feels”being stroked by the tactile sensor or being held by the posture se
nsor.Paro can also recognise the direction of voices and words such as its name,greetings and praise.It can learn to behave in a way that the user prefers;for example,if you stroke it every time you touch it,it will remember your action and try to repeat it to be stroked.About1,000Paros have been sold to nursing homes,hospitals and individual consumers in Japan and in Denmark,government health officials are trying to quantify its effect on blood pressure and other stress indicators.Since the robot went on sale in the USA late last year,a few elderly care facilities have purchased one and several dozen others have signed rental agreements with the manufacturer.A broadly similar product is the Genibo robotic puppy produced by Dongby Robot Co.in South Korea.This is available in several variants and the latest,the model SD,features face and voice recognition and according to the manufacturer it can express a full range of emotions as well as responding to touch. Assistive robots
The aim of these is to help a patient conduct tasks that are difficult or impossible and a good example is the Cody robot,developed at the Healthcare Robotics Laboratory at Georgia Institute of T echnology.The robot(Figure5)is equipped with compliant arms that allows it to perform the wiping motions that are involved in bed baths.The area of skin to be cleaned is selected by the patient via a camera and a laser rangefinder and the robot then cleans it with the soapy bath mitt(Figure6),using a gentle wiping motion.The robot’s two anthropomorphic arms,which
Figure1The robotic
FRIEND
Source: Credit: Wikipedia
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have seven degrees of freedom and wrists equipped with six-axis force/torque sensors,have joints with reduced stiffness to soften any accidental impacts.Wiping can be achieved using a relatively low force (,3N)and the robot is programmed never to exert a pressure capable of causing injury.The research team maintains that having a robot to carry out personal hygiene tasks such as bed baths for incapacitated patients may have advantages,such as giving the patient greater privacy and independence.Further,it
Figure 2Schematic of the ROVIS imaging system
Human-Machine Interface
Chin control Camera Pan-Tilt Head Stereo Images Acquisition
Container Detection
ROI Definition
Camera Calibration
Robust Feature-Based 2D Recognition of Objects to
be Manipulated
3D Object Reconstruction World Model
Speech recognition
BCI
User Interaction
ROVIS Hardware
ROVIS Initialization
Other Reactive Operations
ROVIS Object Recognition and Reconstruction
Source: Credit: Wikipedia
Figure 3The Wakamaru humanoid
robot
Source: Credit: Wikipedia
Figure 4The Paro thetrapeutic seal-like
robots
Source: Credit: Wikipedia Figure 5The Cody
robot
Source: Credit: Gerogia Tech
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reduces the reliance on nurses or carers.The Healthcare Robotics Lab is also involved in the“Robots for Humanity”project, a collaboration between Willow Garage,Georgia T ech and the Man and Machines Group at Oregon State University.The work is based around the PR2robot produced by Willow Garage and the long-term aim is to put robots into homes to help people with severe disabilities.Much of the present work involves Henry Evans,a patient who is mute and quadriplegic,having suffered a stroke at the age of40.Using a head tracker,Evans recently used the PR2to shave his cheek and the research group is actively investigating ways for him and others to perform such tasks on a daily basis.Further details of the human-robot interfacing technologies used in Cody and the Robots for Humanity project,together with a discussion of brain-machine interfacing, are given in a previous issue of this journal(Vol.40No.4).
The inability of disabled people to feed themselves is one of the most common causes for the need for carers and several research groups are working on self-feeding robots.This is a complex issue du
e to the varying capabilities of the users and also because the type of food involved varies according to country and culture.An example of work aimed at a particular type of food is research by the Korea National Rehabilitation Research Institute.This involves a dual-arm robotic manipulator(Figure7)that can handle Korean food such as boiled,sticky rice in an ordinary food container.Koreans typically use a spoon and steel chopsticks,sometimes simultaneously,to eat and the robot’s two arms are equipped with different end effectors to mimic this eating behaviour.In the system,the gripper of a grab-arm and the spoon of a spoon-arm take on the roles of chopsticks and a spoon,respectively. The spoon-arm has two DOF in order to transfer food on the spoon without changing its orientation and the grab-arm includes a three-DOF SCARA joint for the planar motion,a one-DOF joint for the up and down motion and a gripper. Operation is by buttons on a touchpad or by joysticks,although in trials,many users preferred the dual joystick design.
An EU-funded,collaborative project termed “CompanionAble”aims to develop a mobile robotic companion“Hector”which can work collaboratively in a smart home environment.Led by a group at the University of Reading, UK,this goes a step further than most assistive robots in that it integrates the robot with the home,allowing it to conduct functions such as closing curtains and windows,turning lights on and off or regulating the central heating,as well as monitoring potentially dangerous situatio
ns like using the stove or reporting when the individual leaves their home.In addition,it can remind a person when to take their medications or how to use the TV remote control.It will also monitor the individual and summon help from family members or medical professionals if,for example,they have a fall.Users interact with Hector directly through voice and a large touch screen and it respond to verbal commands such as“follow me”or“go to the kitchen”. CompanionAble systems have been installed in a number of demonstration homes which are being used to test and improve the wide range of functions developed by the project through long-term studies with real elderly care recipients.Final trials and demonstrations are presently underway in Belgium,Spain, France and The Netherlands.
Household robots
Household or domestic robots conduct tasks around the home and act as convenience items for able-bodied users but also have a role to play in assisting less mobile individuals.T o date,relatively few have been commercialised and the best known is the robotic vacuum cleaner.Thefirst was the Trilobite,launched by Electrolux in2001but the Roomba series(Figure8),produced by iRobot and introduced in2002is perhaps the best known,with over six million having been sold worldwide.It is powered by removable nickel/metal hydride batteries which are recharged from a wall adaptor.Newer
models have a self-charging homebase which they automatically try tofind at the end of a cleaning session via IR beacons.Four IR“cliff sensors”on the bottom of the robot prevent it from falling off ledges such as the top of stairways.Most second and third generation models have internal acoustic dirt sensors that allow them to detect particularly dirty spots and focus on those areas and fourth generation models have an optical sensor located in front of the vacuum bin to detect wider or smaller areas to clean.Many Roombas are now supplied with IR remote controls,allowing a human operator to“drive”them to specific areas.
An allied type of product is thefloor cleaning robot,for example iRobot’s Scooba range,which can clean wooden, tiled or linoleumfloors.Robotic lawn mowers are also widely available.All manner of other domestic robots are the topic or research or at the development stage,including those that can load and unload dishwashers,load washing machines,prepare food,dust and collect waste.
Figure6The soapy
mitt
Source: Credit: Georgia Tech
522
Ethical considerations
This article has only touched on the many robotic devices that are aimed at assisting the elderly and disabled but it is evident that many appear to have the potential to improve a patient’s quality of life and autonomy.A sophisticated robot wheelchair clearly offers advantages over a conventional device and a robotic vacuum cleaner or self-feeding robot must surely also be beneficial.While they certainly reduce the need for human carers and thus address one of the key problems associated with a growing elderly population,they also remove valuable opportunities for social interaction:is this beneficial?Research has shown that a reduction in human contact and social interaction has a negative effect on both the physical and psychological well-being of the elderly.Further,it has been found that decreased social engagement from mid-to late-life is associated with an increased risk of dementia.It has been suggested that social interaction reduces the risk of dementia by reducing stress and consequently by reducing the levels of hormones associated with stress.Social and physi
cal activity may also help because it increases a person’s ability to tolerate brain pathology.
The extent to which reduced or missing human contact can be compensated for by interaction with companion robots is not yet fully understood but in any event,the technology is not without its critics.Sherry Turkle,a professor of science, technology and society at MIT conducted a series of studies with Paro and was troubled when she saw a76-year old woman share stories about her life with the robot.She 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.
Figure7The assistive robot for self-feeding
Grab-arm (Arm #2)
Gripper
Gripper
Tray Spoon
Spoon-Arm (Arm #1)
Source: Credit: Song and Kim (2012)
Figure8The iRobot robotic vacuum
cleaner
Source: Credit: Wikipedia
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