When Illinois dementia therapist Corey Tague saw one of her elderly patients speak for the first time in a year, she knew she'd discovered a significant new form of treatment. The fact that the patient was speaking to a robotic stuffed animal made it all the more remarkable.
“I knew we were on to something,” says Tague, a long-time therapist and educator specializing in late-stage dementia. “Many of these patients are terminally ill, in the throes of depression, and this robotic seal can have an immediate effect. You see it in their outward behavior, their facial expressions, and how they interact with the seal. Sometimes family members are moved to tears.”
Animals are not a new concept for a nursing home setting -- pet mascots, animal visitation programs, and animal-assisted therapy have become widespread in residential homes around the world, for the affection, companionship and improved quality of life that they offer the people living there. Even the most docile dog or cat, however, can lash out, especially when an older person with dementia may hug too tight, or hold on too long.
Concerns about allergies, and bites or scratches from pets have also kept some homes – particularly in Japan, where the idea originated – from employing live animals. The solution? A high-tech, antibacterial fur-covered, robotic stand-in.
Early prototypes included robotic dogs and cats, but these were less popular in practice, with people complaining that the reactions of the artificial pets seemed, not surprisingly, artificial. Enter Paro, a robotic seal pup with soft fur and hand-sewn eyelashes. Paro’s benefits are chalked up to its generic and somewhat unfamiliar form, so patients have fewer expectations of how it should behave.
In a review published in Gerontology, Paro has been credited with reducing loneliness and depression, and prompting more interaction in dementia patients in several different countries beyond Japan, including Denmark, Sweden, Italy, and the U.S. An estimated 24.4 million people suffer from dementia around the world, with that number expected to increase to 82 million by the year 2040, according to the researchers. About half of the cases are Alzheimer’s disease. Quality of life is an area of great concern to therapists and family members, because of the withdrawal, anxiety, and depression that so often accompany dementia.
Tague, whose patients are primarily in end-of-life hospice care in Illinois, credits Paro with offering a positive, tactile experience that evokes memories of nurturing former pets or young children.
“It doesn’t work 100% of the time,” she says. “Women seem to be more receptive, and it seems to work best if someone has had pets in the past that they were very attached to. They’ll start to talk to me about their life growing up on a farm, or what pets they used to own. Paro also appears to bring up memories of babies, and I see my patients try to brush or feed him, sing to him, and rock him.”
Ethically, Tague is careful to introduce Paro as a robot, rather than pretend it’s a live animal. Typically, she says, the residents ask, “Is it real?,” and she replies that it is a real robot. Beyond that explanation, she allows the patient to interact with the seal however they choose, and they’ll often later call him a rabbit, a cat, or a dog.
About 1,500 robotic Paros – 1,300 of them in Japan – have been employed around the world since their development in the early 2000s.
Tague is convinced that number will increase, despite the robot's $6,000 price tag.
"People with dementia are tired of being corrected when their memory fails, and sometimes they just withdraw into depression as their disease progresses," she observes. “This robotic seal offers a non-judgmental, cuddly companion that can help bring them out of their isolation.”
Corey Tague, Dementia Therapist and Educator. Passages Hospice. Phone interview conducted Feb.23, 2012.
Takanori Shibata and Kazuyoshi Wada. "Robot Therapy: A New Approach for Mental Healthcare of the Elderly - A Mini-Review." Gerontology 2011;57:378-386.