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Introduction: The aging of the population and the high incidence of those over 80 lead to an inevitable increase in chronic degenerative diseases, such as dementia, resulting in increased morbidity and disability. Treatment of people with dementia involves both pharmacological and non-pharmacological interventions. In particular, robot-assisted therapy is a potentially useful treatment for dementia as it has the advantage of improving mood, encouraging social interaction and communication. The overall objective of the study is to evaluate the improvement in patient-perceived quality of life following the use of the Paro robot integrated with usual care in the older people with dementia., Methods and Analysis: For this study, 20 patients with dementia are recruited and divided into Experimental Group (EG) and Control Group (CG). Twenty-four session of intervention are conducted, divided into 2 sessions per week, for 12 weeks. The therapy sessions last 20 min. The Experimental Group will receive a social robotic intervention with Paro combined with usual care; the Control Group will receive only the traditional therapy, consisting of cognitive stimulation (reality orientation therapy, cognitive training) and occupational activities (painting workshops, cooking workshops, garden therapy, music therapy, etc.). Paro is a seal-shaped robot designed to have a calming effect and elicit emotional responses in patients in hospitals, nursing homes, and retirement homes. Assessment will be performed at the baseline, at the end of intervention and 3 months after the end of intervention. During these phases, several scales will be administered to the patients, such as Quality of Life-Alzheimer's Disease, Addenbrooke's Cognitive Examination, the Rating Anxiety In Dementia scale and the Cornell Scale for Depression in Dementia, Quebec User Evaluation of Satisfaction, Neuropsychiatric Inventory, the Technology Acceptance Model., Discussions: The final goals of the present study are to evaluate the improvement in patient-perceived quality of life following the use of the Paro robot integrated with usual care in the older people with dementia., Ethics and Dissemination: The study was approved by the Ethic Committee of the Istituto Nazionale Ricovero e Cura Anziani, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS INRCA) during the session of 12 April 2022. It was recorded in ClinicalTrials.gov on 23 November 2022 on the number NCT05626205. The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bevilacqua, Maranesi, Felici, Margaritini, Amabili, Barbarossa, Bonfigli, Pelliccioni and Paciaroni.)

The aim of this paper is to describe the results collected with the Italian study conducted within eWare project, aimed at supporting the autonomy and health of the older people affected by dementia and their informal caregivers, through the use of an innovative system based on a social robot and a sensorized environmental infrastructure. Nine dyads of older participants with their caregivers were enrolled in testing the system for 6 months. The results show a positive impact of the system in supporting the achievement of personal goals of the participants, as well as in supporting the quality of life of the informal caregivers. Nevertheless, the impact of the system in reducing the caregivers' burden needs to be deeply investigated. This research highlights the potential of the eWare system but modifications will have to be made, especially on the interactivity capabilities, in order to meet the peculiar needs and wishes of older people with dementia and to favor the long-term use of the system.

Earlier studies show frail seniors often experience loneliness and depression. Moreover, frailty can lead problems with medication and nutrition patterns. The availability of family care and/or nursing care at home is limited. Digital companions, such as social robots, could complement homecare nurses, thereby improving the quality of care to frail seniors. The Guardian project has co- designed with end-users, a social robot providing social company and health support. To assess the digital and co-created solution, usability evaluations have been conducted with 43 participants distributed as fairly as possible between frail seniors, family carers and professional nurses; in three different European areas: The Netherlands, Italy and Switzerland. The goal of this study is to evaluate if the GUARDIAN solution is accepted by the target users and also gather data on how to improve the system for ensuring added-value in home care. The iterative method based on user-centered approach put the end-users at the centre of the usability evaluation. Through thematic analysis of the qualitative datasets, we conclude that a high number of users accept the solution and describe it as useful. End-user needs have been mainly addressed but some new improvements have been pointed out by the participants and some other needs have been uncovered.

The aim of this paper was to explore the psychosocial determinants that lead to acceptability and willingness to interact with a service robot, starting with an analysis of older users' behaviors toward the Robot-Era platform, in order to provide strategies for the promotion of social assistive robotics. A mixed-method approach was used to collect information on acceptability, usability, and human-robot interaction, by analyzing nonverbal behaviors, emotional expressions, and verbal communication. The study involved 35 older adults. Twenty-two were women and thirteen were men, aged 73.8 (±6) years old. Video interaction analysis was conducted to capture the users' gestures, statements, and expressions. A coded scheme was designed on the basis of the literature in the field. Percentages of time and frequency of the selected events are reported. The statements of the users were collected and analyzed. The results of the behavioral analysis reveal a largely positive attitude, inferred from nonverbal clues and nonverbal emotional expressions. The results highlight the need to provide robotic solutions that respect the tasks they offer to the users It is necessary to give older consumers dedicated training in technological literacy to guarantee proper, long-lasting, and successful use.

Purpose GUARDIAN is a new technology-enabled ecosystem to support older adults and their carers in an indoor living environment. The GUARDIAN ecosystem is designed to address the different needs in different countries, creating an ecosystem accepted by the end user through a socially assistive robot (SAR) and two web applications (one for caregivers and one for frail older adults) that appropriately consider cultural differences. The project aim is to support older adults, formal carers and informal carers so that older adults can live safely at home for longer with enough comfort. Amongst others, the GUARDIAN Socially Assistive Robot (SAR) will be able to provide older adults with input and stimulation for activities (see also, Nap et al., 2018). This paper describes the iterative co-design and evaluation of GUARDIAN in three countries (Italy, Switzerland & The Netherlands) up to a first alpha working prototype of the SAR connected to the web interfaces that can be operated via a tablet. Method To gain insight into the perceptions, accessibility, acceptability and satisfaction with GUARDIAN, usability evaluations were performed using the IBM usability questionnaire (Lewis, 1995) and interviews were performed in the three different countries involving a total of 13 older adults, 14 informal carers and 15 formal carers. User requirements were translated into additional technical requirements for the further development of the SAR and supporting eco-system. Through a mixed-methods approach involving both project partners and end-users, it was explored how societal needs and concerns about the social and ethical impact (Lukkien et al., 2021) of using the SAR can be addressed in the design and use of GUARDIAN. Results and Discussion Based on the user-centered, value-sensitive and responsible innovation co-design results, three core functionalities have been identified for GUARDIAN: 1) monitoring the behavior, emotions, health and well-being of the older adult; 2) day structure support for e.g., medication and appointments; 3) social companionship. The results from the usability evaluations show that the proposed ecosystem is of high usability for both older adults and their carers, with positive mean scores above the scale mid- point of the usability questionnaire items. Only error handling and error messages scored slightly lower than the scale mid-point for the carers. From the interviews it appeared that GUARDIAN satisfies the user requirements, highlighting the feasibility of the application of the ecosystem as a supportive technology for monitoring, day structure and social companionship for older adults. Based on the interview results with the informal carers, it was found that they feel reassured through GUARDIAN about the well-being of the older adult. They reported positive attitude to the ability to monitor the relative at a distance; without being too intrusive to the older adult's privacy. Formal carers reported that GUARDIAN supports them to (re)activate their clients from a distance and GUARDIAN provides additional insights into the behavior and well-being of the client. From a responsible innovation perspective, some high-level opportunities were identified for shaping a more meaningful and ethically acceptable SAR, for instance in relation to personalization, safeguarding older adults' autonomy and promoting human connectedness in care practices supported by SARs. GUARDIAN has large potential to support independent living for older adults and (in)formal care at a distance. [ABSTRACT FROM AUTHOR]