1 Introduction
2 Background
2.1 Care Robots in Elder Care
2.2 Acceptance of Care Robots
2.3 Attitudes and Orientation Among Potential Users
2.4 Rationale and Aim
3 Methods
3.1 Recruitment
3.2 Focus Groups
Introduction question | Brainstorm on the use and need for care robots within the field of elder care |
Transition question | Thoughts about the use/introduction of care robots in elder care. Should we have care robots in elder care? |
Key questions | Display of a video clip and pictures Reflections on the video clip and pictures; benefits and disadvantages from different perspectives Further questions: How would you feel about being cared for/assisted by a care robot when you get old and need help? Do we, in general, need to know more about care robots? What? Why? How? By whom? If you would like to learn more about care robots, how would you do this? How should the use of care robots be introduced in elder care, and what training is required? How much do you think this kind of technology costs? |
Ending question | Reflection on what was said during the discussion: Does anything need to be added? The assistant moderator is invited to reflect/ask additional questions |
All included participants | Older adults | Relatives | Professional caregiversa | Care service managers |
---|---|---|---|---|
Women/men | 16/8 | 12/4 | 11/5 | 12/3 |
Age, Md (range) | 70 (60–81) | 70 (35–85) | 41.5 (26–57) | 55 (38–66) |
Highest level of education | ||||
University | 10 | 11 | 8 | 15 |
Secondary school | 3 | 3 | 6 | 0 |
Vocational education | 10 | 2 | 2 | 0 |
Elementary school | 1 | 0 | 0 | 0 |
Country-specific demographics | Older adults | Relatives | Professional caregivers | Care service managers |
---|---|---|---|---|
Finland | ||||
Women/men | 3/1 | 2/2 | 3/1 | 6/0 |
Age, Md (range) | 74.5 (70–81) | 65 (43–70) | 42 (37–57) | 43.5 (38–56) |
Highest level of education | ||||
University | 0 | 2 | 2 | 6 |
Secondary school | 3 | 0 | 0 | 0 |
Vocational education | 1 | 2 | 2 | 0 |
Elementary school | 0 | 0 | 0 | 0 |
Germany | ||||
Women/men | 8/6 | 3/2 | 3/2 | 2/3 |
Age, Md (range) | 67.5 (60–79) | 52 (35–70) | 42 (39–57) | 56 (39–58) |
Highest level of education | ||||
University | 4 | 3 | 2 | 5 |
Secondary school | 0 | 2 | 3 | 0 |
Vocational education | 9 | 0 | 0 | 0 |
Elementary school | 1 | 0 | 0 | 0 |
Sweden | ||||
Women/men | 5/1 | 7/0 | 5/2 | 4/0 |
Age Md (range) | 72.5 (69–75) | 73 (70–85) | 41 (26–57) | 56.5 (41–66) |
Highest level of education | ||||
University | 6 | 6 | 4 | 4 |
Secondary school | 0 | 1 | 3 | 0 |
Vocational education | 0 | 0 | 0 | 0 |
Elementary school | 0 | 0 | 0 | 0 |
3.3 Analysis
Theme | Category |
---|---|
The What aspect of CRO | Basic knowledge needs Processing of care robot information Ethical issues Funding considerations |
The Who/Whom aspect of CRO | Target groups of CRO Stakeholders in CRO provision |
The How aspect of CRO | CRO activities Time aspects of CRO |
4 Results
4.1 The What Aspect of CRO
4.1.1 Basic knowledge Needs
Initially, the term welfare technology, care robots specifically, needs to be defined to reduce fears and prejudice and to overcome unjustified scepticism. This is exemplified in a changing attitude when being more informed:[…] probably when it becomes more topical and closer to myself that now you need to get one, I would probably know how to ask for the information. But since I don’t think I need it now, I don’t even know what to ask for and what kind of information I would need. (Fin: OA)
The need for basic knowledge in CRO refer to information intended to increase the knowledge, understanding and conceptualisation of care robot use in daily life. To fill the knowledge gaps, answers are required for various questions about care robots, such as what kind of care robots are available, which features do they have and what chores can they perform. These questions are related to how care robots could support professional caregivers as well as older adults and their relatives, currently, and future expectations and possible areas of use. ‘You should emphasise the benefits […] through the benefits, people will understand. If you just say we’re doing this, there will be resistance, but if you start from the benefits’ (Fin: R).So, my opinion already changed compared to the first statement about what I think about using robots [in this interview]. After seeing the film and the documents here, I don’t think I could have imagined it and suddenly now I could, yes, I could imagine it. So, it’s a question of informing people. (Ger: OA)
4.1.2 Processing Care Robot Information
To avoid such suspicions, a distinct communication is needed about reasons and intentions with the use of care robots. When these suspicions are resolved, an open-minded attitude beneficial for CRO can be experienced.We must not forget about information and explanations both to older adults and relatives, regarding the purpose […] I think that is very important, because I think that they instantly believe that the purpose of new innovations is to save staff and make cutbacks, perhaps deteriorate things. (Swe: CSM)
4.1.3 Ethical Issues
Given that the issue of compulsory use of care robots has arisen, it is worth acknowledging that this is an issue having at least two implications. On the one hand, it could be compulsory in certain situations, which might be offered from public care, referring to staff shortage and funding issues: ‘Here’s how care is done, this is a help we offer you […] if it is cameras or a timer for the stove, there are a lot of such things […] it’s nothing strange’ (Swe: OA). On the other hand, the need for sensitivity in introducing care robots is emphasised, implying that care robots shouldn’t be forced on people: ‘In the end, the user decides how far he or she wants to get involved with technology or whether he or she chooses the classic way of human care’ (Ger: OA).If a certain robot was to be introduced in one care unit and we [professional caregivers] were supposed to focus on the social part, one might think that we would get more time for that [the social part] but then the effect would be that they will remove staff, probably […] I would not want them to replace staff, but they will do that. (Swe: PC)
4.1.4 Funding Considerations
Another alternative could be care robots funded by health care insurance: ‘I could imagine that the health insurance company would be happy to make it available free of charge, because it would keep labour costs as cheap as possible. That’s probably how it’s going to happen’ (Ger: CSM). A political philosophy aspect was revealed, given voice in the quotation: ‘Of course it’s always the one who benefits the most that should be the biggest payer. In many cases, we’re talking about society […]’ (Fin: R). A suggested alternative was care robots/welfare technology ‘libraries’ for periodic needs of this kind of technology.Is this a merchandise, or is this our common right, will this mean that those who have the opportunity . . . intellectually, economically in terms of resources […] they can choose this, but all the others who do not have that, how to handle them… we are getting a very divided society. (Swe: OA)
4.2 The Who/Whom Aspect of CRO
4.2.1 Target Groups of CRO
So now we’re going to take this as our starting point. The Care-O-bot in any case, I would let it immediately into my apartment, if it would be necessary. If I could postpone a move into an assisted living for several more years.
I would definitely prefer that (care robot), before I have to go to a nursing home. (Ger: OA)
4.2.2 Stakeholders in CRO Provision
CRO provided by technical experts in collaboration with professional caregivers is suggested as an optimal strategy for CRO:Maybe it’s the peer aid, peer support, peer information on every level, so that users could tell future users, or the older adults who have been helped by care robots, could tell about their hopefully good experiences, and […] reduce distrust and fear. (Fin: R)
Seen from a general perspective, several stakeholders are mentioned in relation to provision of CRO. Official sources (governmental, regional and local authorities) are considered to have an official task for providing CRO in the national field of welfare technology information. Research and educational institutions are other stakeholders, regarded as a reliable CRO source. The manufacturers and suppliers of welfare technology and care robots also have an important role in CRO. However, the risk of bias in their trustworthiness is discussed: ‘I don’t immediately trust anything that I get from a salesperson. Of course, they just want to sell the product […]’ (Fin: CSM).So, I could even imagine that a new profession would emerge, for example medical engineering, technology and nursing. Combining these together in one occupation and perhaps initially financed by industry. With the health insurance companies, of course, because they must finance it afterwards […]. (Ger: OA)
On a more formal level, CRO can be given as community information in different places and situations. In particular, centres for older adults’ services, different care settings, theme-days arranged by seniors, centres for relatives and retirement organisations are mentioned:Make it exciting, that it is pleasurable and that I see it on different social media, I see it in stores, I see it in movies, celebrities have a small robot. I think it is difficult to just introduce it in elder care, instead we have to make sure that this technology is visible and used by others also [not just older adults]. (Swe: OA)
Field trips and information through human interaction are highlighted as important CRO arenas. In Germany, which has a different welfare system in comparison to Finland and Sweden, health care insurance companies also play an important role in providing information as a part of the general CRO.So, I always think it would be nice if there’s some kind of external person who doesn’t want to sell me this robot and just tell me how great the device could be, but that you really get honest information about advantages and disadvantages. […] (Ger: R)
4.3 How CRO Should be Conducted
4.3.1 CRO Activities
4.3.2 Time Aspect of CRO
[…] I think, later, it will be like, one care unit realises […] we don’t have staff, we have to introduce it [care robots]. Then I think the technology exists, then there are probably . . . intelligent homes that can explain to someone who might be demented . . . explain that now we will do this and that. (Swe: PC)