Can robots replace nurses in hospitals?

Use of robots in care. Is that the future? Chances and risks!

The shortage of skilled workers in nursing is becoming increasingly dramatic. So the idea is obvious to use robots in care in the future. In Germany there are various pilot projects in which care robots are used. Care robots are still only entertaining the elderly and are being used on a trial basis in nursing homes. The experts are still divided on whether they can actually help with the delivery of food and washing. The Ethics Council welcomes innovation in care, but sets conditions for the use of robots in care.

Pepper - the care robot

According to estimates, up to 500,000 nurses could be lacking in Germany alone in 2030. Nursing staff is not only poorly paid - like most social professions - there are also shift work, illnesses such as back problems caused by lifting and positioning patients and burn-out due to the high psychological stress. According to the OECD, there are just eleven geriatric nurses for every 100 over-80s. In a European comparison with the personnel key in hospitals, Germany and Spain come off worst: there are ten patients for every nurse. What still sounds like a dream of the future today and provokes fierce ethical debates will then become reality: the use of robots in care.

Pepper is such a robot. 1.20 meters short, 40 kg in weight, has big black googly eyes and a shiny white body. It looks like it came out of a manga comic. Pepper is a robot that will be used in care in the future. She speaks different languages ​​and can, for example, remember faces. Pepper is one of the social, humanoid robots. Your area of ​​application: care facilities, but also, for example, children's wards in hospitals.

For Marc Specht, robots are the future in care

For Marc Specht, Marketing Director at BoS & S Software (BoS & S), “Pepper” is the future of care. “In the long term, we need robots, because otherwise the shortage of skilled workers in nursing cannot be covered,” says Specht.

A year ago the company bought a care robot from the Japanese manufacturer Softbank. “Pepper” is to be used in the future, for example, with residents suffering from dementia to support them with memory games. “Pepper” can also show seniors exercises or remind patients to take their medication.

Specht and the BoS & S hope that they can give the nursing staff more time by using the technical assistant. While the robot entertains a group of seniors in the common rooms, caregivers would have more space to care for individual patients.

Japan is much further in the use of robots in care

In Japan, a quarter of the population is already over 65 years of age. As there is a lack of employees in hospitals and retirement homes, the future will rely on robots for care. The entertainment robot Parlo is used in the Fuyo-En care home in Yokohama. The 40 centimeter tall robot from the Japanese company Fuji Soft can play 365 programs, e.g. rhythm games or guesswork. Parlo is one of those service robots with a bright future in the care sector.

What does the future of robots in care look like?

Pepper is still an exception. So far there have only been a few pilot studies in the German healthcare system. Politics also support individual projects. The Federal Ministry of Research believes that robots can help relieve everyday nursing work. The use of robots in nursing is still a long way off.

"You will not find the robot in normal everyday life in a care facility like this", says Peter Tackenberg from the German Nursing Council. He doubts that technology will quickly provide relief. "Robotics and AI are actually not key to solving the problems in health and care."

The use of robots in nursing has been criticized

Another research project is the Paro seal. It is being tested at around 40 care facilities in Germany. 60 cm tall, three kilos, cozy fur. Sensors ensure that Paro looks like a living baby seal. It is primarily intended to help people with dementia. The cost per seal is around 5000 euros. And you have to feed them: with data.

She also learns with the help of artificial intelligence. How do people behave? What are they telling How do they interact with each other? The robots collect data and recognize behavior patterns so that algorithms can interpret them and adapt behavior towards the patient. This not only raises questions, but at the same time also raises criticism regarding the use of robots in care. For example with Peter Tackenberg from the German Nursing Council. “Ethically this is still totally unresolved. Who is in charge of the data? What rights does the dependent person have? What rights do the employees have? Where are the protection mechanisms? And I also find it interesting what conclusions an ethics council comes to. "

Ethics Council: Pros and Cons of Robots in Nursing

Its published statement on March 10th, “Robotics for good care”, initially wanted to change people's perspective and dispel prejudices. “The suspicion that machines are used to make assistance and care for sick or elderly people even more in accordance with the stipulations of economic efficiency and non-human attention arises and destroys trust in the possibility and use of this technology,” complained the chairman of the German Ethics Councilor, Peter Dabrock, in Berlin on Tuesday.

The opinion of the Ethics Council does not want to conceal the dangers or the disadvantages for robots in care, but initially focuses on the possibilities and advantages. “Humanity and technology don't have to be in opposition,” says Dabrock. After weighing the pros and cons with regard to the future use of robots in care, the ethics council comes to the following conclusion: "Robots in care can make a valuable contribution to improving the quality of life of people in need of care and the quality of work in the care sector in the future."

However, this presupposes that the use of robot technology does not replace interpersonal relationships, that it is not carried out against the will of the cared for and caregivers or for the mere maximization of efficiency and that those affected are included in the development of the technologies.

Advantages - use of robots in care:

The German Ethics Council recognizes the potential benefits of robotics for the entire care sector, but sees this less in the elimination of staff shortages or care emergencies and more in its potential to promote good care.

This means, for example, “assistance robots” that support people in need of care with food intake or personal hygiene, and provide medication or laundry utensils. So-called exoskeletons can help the frail when walking. Service robots clean or carry people.

Robotics can support people in need of care for longer, train their physical and cognitive skills and promote rehabilitation, the Ethics Council positively states. Remote monitoring of body functions such as pulse, blood sugar level or blood pressure means that help can be provided quickly in an emergency - for example in the event of a fall.

Positive effect of the use of robots in the care of people with dementia

For the Berlin gerontologist and co-author of the report Adelheid Kuhlmey, all of this belongs to the “well-being” of those in need of care. For them, an essential task of good care is that it “enables and promotes close interpersonal relationships”. But how are so-called companion robots to be assessed here? Robots that resemble dogs, baby seals or cats and react to touch and noise with the help of sensors and, above all, are supposed to meet communicative and emotional needs?

Their positive effect on people with dementia is now undisputed: They brighten the mood, help reduce stress and overcome feelings of loneliness. The accompanying robot seal “Paro” has long been part of the supply of the Sankt Hedwig Hospital in Berlin.

Disadvantages - use of robots in care:

The Ethics Council also appreciates this positive effect and the advantage that this robot brings in care. It would be questionable, however, “if people in need of care were to meet social and emotional needs in the future mainly by using companion robots,” said Kuhlmey, who merely simulated feelings. The ethicists warn against social isolation if robots are one-sidedly relied on. At the same time, the study emphasizes that the effects of the use of robots in care have not yet been scientifically researched. Kuhlmey sums up the advantages and disadvantages of using robots in care with a quote from a nurse: “I am not against technology, but contact cannot be replaced by plastic.”

Greens want digital pact for the future use of robots in care

The Greens also see good opportunities for improving care in the use of robots in care. Kordula Schulz-Asche is, among other things, a politician from the Greens who wants to talk about the advantages of robots in care. The development is not going fast enough for the Greens. You are calling for a digital pact for care. Schulz-Asche criticizes that there is too little exchange between the projects and that innovations take far too long. In her opinion, there is also a lack of willingness to invest in expensive technology on many sides.

"I see politics as having a duty to really create framework conditions that enable the implementation of good digitization and robotics, while observing the recommendation of the Ethics Council."

Robots are already quite quick-witted when it comes to care

Until then, the robot Pepper will also continue to collect data and will certainly also learn to be quick-witted. When asked about her age, she replies: “You don't ask a lady that. But I will definitely still go through as a teenager ... "
By the time robots in care will become a matter of course in the German health system in the future, Pepper may already be a robot lady in need of care.