Care, robots and shame: how technology is reshaping the everyday lives of older adults

Robots in care settings promise relief, safety and greater independence – but they also raise sensitive questions. Social researcher Sabina Misoch explains why shame, autonomy and loneliness play a central role, and why technology should support rather than replace human care.

Sabina Misoch is a professor and internationally active ageing researcher at the Institute on Ageing at the Bern University of Applied Sciences. She holds a PhD in sociology and conducts research on ageing, technology acceptance, ICT and social robotics, and is regarded as an expert in qualitative research methods.

Imagine living in a care facility. Would you rather be washed by a care professional – or by a robot?

There are indeed seniors who would prefer to be washed by a robot rather than by a caregiver […].

This is the question social researcher Sabina Misoch posed to older adults as part of a study. “There were indeed older people who said they would prefer to be washed by a robot rather than by a care worker, because a robot does not judge,” says Misoch. One factor plays a central role here: shame. Some fear that care professionals might have demeaning thoughts.

The use of technology also plays an important role outside institutional care settings. “Being able to stay at home for longer is the most important reason for using technology,” says Misoch. It feels freer and more independent not to rely on other people. With a purely functional system, there is no need to feel grateful. Many losses associated with ageing are linked to shame and embarrassment. “No one enjoys it when their memory deteriorates and they no longer know what day it is.” A technology that is “just a thing” and works reliably can be a major source of support in such situations.

However, the use of technology to support older people is not only relevant in terms of maintaining autonomy for longer. It can also be a relief for relatives. A key concept here is safety. For example, sensors have been tested in refrigerators that contact an emergency person if the fridge has not been opened all day and something may be wrong. “Interestingly, the safety aspect is something older people themselves pay less attention to than their relatives,” says Misoch.

Robots as conversation partners

AI-driven robots could enable more targeted support – both at home and in institutional settings.

Other technologies include smartwatches that measure vital signs, or more complex systems such as robotics that can accompany people throughout the day. These systems can detect when someone gets up, remind them to take medication and attend appointments, or offer music and games for cognitive training. “The spectrum of companionship is incredibly broad – for example, I can have a communicative counterpart in the form of a robotic system,” says Misoch.

At the same time, the robots developed and tested so far face limitations when it comes to communication. Many systems have been restricted to pre-programmed interactions. In a comparative study, Misoch used a small robot called “NAO” to promote physical activity among older adults at home. The aim was to find out whether exercises guided by a robot were more motivating than those delivered via video or email. However, the robot’s repertoire was limited. “If it fell over, for example, there were five different sentences it could use to respond,” Misoch explains. Initially, participants found NAO entertaining, but over time it became boring.

This could change with the integration of artificial intelligence (AI), which would allow systems to develop through self-learning. However, this would require an immense amount of data about users and raise questions about data protection. At the same time, it could improve the quality of interactions, as the system would gradually learn to provide more individualized support. “‘Ah, Mrs Müller likes this, but she always performs this exercise inaccurately – I need to pay closer attention,’” Misoch gives as an example. Such AI-driven robots could enable more targeted support, both at home and in institutions.

Will robots replace human contact?

For people who suffer greatly from loneliness, a robot can be a good option.

Asked whether there is a risk that such robots could eventually replace interpersonal interaction, Misoch responds with a laugh: “Hasn’t someone already married their robot?” In Western societies, the idea that technical systems could fulfil social functions is still viewed rather negatively – unlike in Japan, for example. There, a conversation with a robot is not considered less valuable than a conversation with a human being. While robots are often perceived in Western contexts as soulless machines, they are more likely to be seen in Japan as animated entities. A conversation with a robot may be amusing to us, but it does not have the same quality as communication with another person. “My assumption is that this could change over time. Societies do not remain static, and different generations are shaped by different influences,” says Misoch.

In one study, participants were asked whether they could imagine a robot as a social companion. “Most found the idea rather off-putting. But there were also some who said they could imagine it if they were otherwise lonely.” Misoch does not believe that robots will one day replace human contact. Humans are social beings and not meant to live in complete isolation, but in community with others. For people who suffer greatly from loneliness, however, a robot could be a viable option.

Technology as a response to the shortage of care staff

The goal is not to replace human care, but to relieve it […] and to gain more time for what truly matters.

If care institutions fail to keep pace with technological change, there could be long-term consequences. “In ten to twenty years, they will probably no longer be able to find enough staff,” says Misoch. Technological progress is also a response to the growing shortage of care professionals. The goal is not to replace human care, but to relieve it.

One of Misoch’s studies showed that care professionals spend a large portion of their time on administration, organisation and walking distances – tasks that involve little direct contact with residents. Many of these activities, such as medication management, could be supported technologically and would be less prone to error. This would allow care staff to devote more time to what truly matters: relationships and personal attention. “A care home staffed only by robots would not be a solution,” Misoch emphasizes. Human care remains indispensable.

Digital participation instead of social isolation

Seniors are realizing that not being online increasingly also leads to exclusion. Interest in being (safely) active online is growing.

But what about social networks? “It has already become clear that digitalisation offers older people an opportunity to maintain and nurture contacts,” says Misoch. The concern that digital media might displace face-to-face interactions – often discussed in relation to young people – is less relevant for older adults. Due to physical limitations, they are more likely to stay at home anyway. Media use can therefore be a way out of social restriction. There are now even dating platforms for older adults. “The industry has long recognised that this is an attractive market – and it is being targeted not only with products, but also with dating platforms and all sorts of other offerings.”

However, older people often have a certain reluctance when it comes to “just trying something out.” While young people tend to be curious about new tools and experiment with them, older adults are often more cautious and quickly fear breaking something when an error message appears. Support is therefore crucial. According to Misoch, care institutions in particular have an educational responsibility here. Continual learning is especially important in later life. Unlike the baby boomer generation, today’s older adults were not already digitalised during their working lives. Care homes could, for example, designate a contact person for digital questions whom residents can turn to. The baby boomers now entering retirement, by contrast, are largely already familiar with digital technologies.

Regardless of generation, dealing with risks in the digital world is also essential. “You simply have to stay on top of it, because new loopholes keep emerging,” says Misoch. There are already organisations offering courses on digital security for older people. With AI, however, new risks are emerging: just a few audio recordings may be enough to imitate a person’s voice. Scammers could use AI to mimic the voice of a grandchild and stage an emergency requiring urgent financial help. Being safe online is an issue that many older adults find highly relevant. “They realise that not being online increasingly leads to exclusion. That’s why I think it’s important to teach digital skills in care homes as well,” says Misoch.