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Sealed with a kiss

HealthInvestor UK catches up with Professor Takanori Shibata and his robotic creation PARO, 15 years after it first entered care homes, to find out how the fluffy seal is advancing care

Jake Schreier’s 2012 film Robot & Frank imagined an android assistant able to tend to his ageing charge’s daily needs around the house. A physical helper first and foremost, the relationship between resident and robo-carer nonetheless resulted in an unlikely friendship and – for dramatic effect – a deliciously mischievous criminal collaboration too, over a series of heists.

But for PARO, a real-life robot that’s been befriending residents in select care homes around the world since 2003, a far less active future was imagined in the early 1990s when creator Professor Takanori Shibata first dreamt up the kind of robot he wanted to develop.

While visions of human-shaped robots able to cook and clean abounded, Shibata thought he should instead develop “something ‘useless’ in terms of work,” he recalls. He thought about the role played by family pets in homes all over the world.

“We don’t expect pet animals to work for us, but people love them and want to keep them, and I wondered: what is the benefit for human beings?” Shibata says.

Psychological, social and physiological enrichment, came the answer, as Shibata read up on animal therapy. And there too came his motivation: to create an animal-like robot that could provide comfort and stimulation to those receiving care, in particular dementia patients or children and adults with learning difficulties. Designed well, the robot could be deployed in situations where real-life pets might not be appropriate, he felt.

From hygiene and the risk of cuts and scratches, to the labour-intensive care required, or simply the cost of upkeep, many barriers stand in the way of pets or therapy animals reaching recipients of care, whether in hospital, residential, domiciliary or day care.

Fluffy and seal-cub shaped, PARO – now in his ninth generation – is the fruit of Shibata’s imaginings. Using artificial intelligence supported by touch, light, sound, temperature and posture sensors to perceive and react to his environment, PARO interacts with the humans that hold and stroke him.

PARO’s identity as a seal cub owes as much to Shibata’s desire to create something comfortingly elliptical, warm and fluffy, as it does to his gradual realisation that modelling a robot on more traditional pets brought with it the risk of unfavourable comparison.

Having first created three versions of his robot – a cat, a dog and a seal – Shibata asked users to evaluate the models, and then weighed up their feedback.

“In the case of a familiar animal such as the cat or dog, people had a high value at the beginning, but once they interacted with the robot they became very critical because they compared it to their image of their own cat or dog,” Shibata says.

Upon interacting with the seal, however, users were more open “because they don’t have many experiences with real seals,” he recalls. What’s more, a seal sidesteps the cultural divide between fervent dog and cat lovers, and also does not exclude those with a fear of dogs, for example. 

However, while cost of upkeep may be one of the barriers to live animals delivering therapy to recipients of care, price isn’t exactly eliminated with PARO either.

At Age UK’s Stones End Day Centre in South London where I meet Shibata and PARO, 82-year-old Iris sits at a table with her peers playing with the responsive mechanical seal. It’s an interaction only made possible by generous support from the centre’s sponsors, Pool RE and Aberdeen Asset Management, who gifted PARO to the centre back in May 2015.

Costing around £5,000 per unit in the UK today, the seal is up there with some of the more expensive pedigree dogs.

However, requiring no daily nourishment beyond an electronic charge with a kitsch dummy-shaped plug, and designed to up to last ten years, PARO can offer competitive savings over time, Shibata points out.

That argument becomes more interesting in the context of the social impact the fluffy bot can have.

For Jack Leahy, deputy day care manager at Stones End, PARO brings several obvious benefits every day. One is simply to act as an icebreaker, facilitating conversations between groups of people who might otherwise sit in silence if unattended, and conjuring up fond memories.

“They'll start stroking PARO and discussing the past, ‘oh I remember when I was young, my dad used to have a Border Collie and she'd show us around’,” Leahy says. “So it really gets them thinking, remembering happy memories from their past of having pets.”

PARO can also often calm individuals down when their dementia prevents them from clearly communicating to carers exactly what is wrong. Bringing PARO over to visit can help them “slowly calm down, readjusting to their environment, and become soothed,” Leahy says.

But, more impressive still, PARO has also been shown in some cases to reduce the need for medication. A University of Texas study published in 2016 found that group treatment with PARO for 20 minutes a day, three days a week, decreased stress and anxiety and resulted in a reduction in the use of psychoactive medications and pain medications. 61 patients aged over 65 years, who had been diagnosed with mild to moderate dementia, participated in the randomized trial over a three-month period.

In another study in Okayama city in Japan, providing PARO to dementia patients living in their own homes was found to lower depression scores over the course of a 14-month trial, suggesting that PARO could help to support elderly residents to live at home longer.

Shibata also shares an incident in which PARO helped a resident with Alzheimer’s disease at a care home in Denmark to recover her communication skills. The woman whose mother tongue was not Danish had begun to mix her languages, making it very hard for staff to understand her.

Interacting with PARO was found to enable her to speak spontaneously in understandable sentences in Danish, allowing staff to communicate with her.

 “The Danish dictionary was acquired later, and that was disconnected from her speech engine because of the Alzheimer’s disease,” Shibata reflects. “But when she interacted with PARO, because of the stimulation and activation of the remaining portions, the Danish dictionary was reconnected.”

That a bundle of sensors and machine processors dressed up to look like the latest child’s soft toy can have such an effect, shows that Shibata’s invention in reality is very far from ‘useless’.

Back in South London, at the end of my visit, PARO is being tucked away into a small animal cot, his work also complete for the day. Here, Leahy reveals, his appearances among the centre’s visitors are limited to around an hour a day (or at least an hour per group), in order to maintain something of the mystique surrounding the popular creature.  

But of course he isn’t for everyone. Leahy acknowledges that over the two years the centre has owned PARO, a handful have snubbed interacting with him as patronising, while others have eyed the seal with an element of mistrust, “in the sense that it moves around and people aren’t quite sure what to make of it”. However he adds that “I’ve never known that not to go away”.

And as well as wooing residents, the seal’s star is also rising on the regulatory circuit. After initially being certified by the US Food & Drug Administration as a neurological therapeutic device in 2009, PARO is now expected to achieve the equivalent in Europe later this year.

With its ability to reduce medication and support residents to live longer at home that could make PARO’s future in the UK an interesting one. As commissioners move towards more joined up health and care budgets, a proliferation of the doe-eyed devices could soon seem less science fiction then financial sense.

Posted on: 24/07/2017

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