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As one of the most rapidly ageing economies, Japan currently faces a shortage of care workers and a relatively low intake of migrant workers. Faced with increasing demand, rising expectations for better care, and a declining number of care workers, there is the opportunity to rethink and analyze how care can and should be provided in residential care homes, including through the support of technology, such as robots. This chapter explores a nursing home in western Tokyo where robotics-aided care has been introduced and has previously been shown to improve standards of care. Although evaluations of socially assistive robots (SARs) and safety monitoring system suggest a positive impact, the mechanism through which the technology-driven system improves care and residents’ quality of life remains unclear. Using a systems approach, the authors sought to uncover this mechanism. They found that key factors for the successful implementation of robotics-aided care stem from within the organization, with a particular focus on the concepts drawn from resilience engineering, key attributes of which are anticipating, responding, monitoring, and learning. The chapter details some of the tools that pre-dated the introduction of these technologies in the care home and use a resilience framework to analyze interview data with care staff. Using a systems approach, the researchers unearth considerations (i.e., opportunities and challenges) for the future of care delivery in an institutional setting and highlight the characteristics of a context in which technologies can be effectively introduced and successfully implemented in nursing homes.

It has been reported that robotics-aided care can contribute to enhancing older people’s social participation and quality of life in nursing homes, while simultaneously reducing the burden on care professionals at nighttime. Due to increasing demand for social care and the relative workforce shortage, it is likely that a greater number and variety of robots will be introduced and implemented in the future. While the benefits of applying robots and assistive technologies are recognized, the current limitations and weaknesses have also been identified. One of these is the difficulty associated with a user-centered design, involving older adults with impaired cognitive and sensory abilities in nursing homes. In order to overcome this challenge, a project was carried out to develop a soft and compact bedside communication robot with an input/output device, connected to existing technologies (e.g. monitoring camera, biological sensor). Drawing on the principle of gemba (deference to frontline professionals’ experience, expertise and skills), users’ feedback was reflected in the iterative steps of robot development. The original soft and communicative robot was introduced and its effectiveness was tested by measuring older people’s reactions and changes in their behaviors and engagement levels. The article reports the development process and results of a small-scale evaluation study, comparing the impact of this original soft-type robot with and without its communicative functions. The human–robot interactions were captured on video, and the analysis revealed that while communicative robots reduced the psychosocial burden on older adults, positive emotional, verbal, visual and behavioral engagement was generated with the help of the non-verbal plush toy.

AIM The primary aim of this study was to examine the impact of age, gender and the stage of dementia on the results of an assistive technology intervention that make use of communication robots (com-robots). The intervention was designed to improve the social participation and interactions of nursing home residents. While our previous study showed that the overall effects of com-robot intervention were positive, it was unknown what impact age, gender and the stage of dementia of participants had on such an intervention. METHODS This was a non-randomized, multicenter quasi-experimental intervention study conducted in residential care homes in Japan. Two types of com-robots were introduced for 8 weeks after baseline evaluation. The World Health Organization's ICF was used for evaluating any changes present after the 8-week intervention. In total, 78 residents (68 women, 10 men, 86.5 ± 7.7 years old) participated in the study. The Degree of Daily Life Independence Score for People with Dementia (DDLIS-PD) was employed for measuring the stage of dementia. RESULTS The results showed that the older participants aged ≥80 benefited more from the intervention than the younger cohort did (P

Background With the arrival of a super-ageing society, the use of technologies in social care is not only necessary but inevitable. However, there is a dearth of evidence to demonstrate how assistive technologies (AT) can improve standards of care while improving the working conditions of care professionals and care givers. Furthermore, little is known about users’ perceptions of such technologies. The objectives of this paper are: first, to test the effects of an integrated AT system on users (both care recipients and staff) in a residential care home; and second, to understand their perceptions of such technologies. Methods We combined an infrared monitoring camera with communicative robots and a sheet-shaped body vibrometer. A 4-week pre/post intervention study was conducted, during which the evaluation was carried out before, during and after the intervention. Twenty care recipients (average age of 89.5) and 15 care professionals participated in the study. In order to measure the effectiveness of the integrated system, the care recipients’ quality of life was examining using the interRAI method. Regarding the impact on professionals, stress levels were examined during night shifts. Perceptions towards use of the system were also explored by the system usability scale (SUS) and semi-structured interviews. Results After the system was introduced, the number of unnecessary visits by care professionals during the night was dramatically reduced (by 8.2 times per person on average), and staff’s stress levels were also reduced. The SUS and interview data show mixed results in terms of the perceptions of care recipients and staff towards using the technologies. Conclusion Overall, the use of integrated assistive technologies yielded positive results. However, some issues were identified with regard to future implementation of such technologies in a residential care home. This study was financially supported in part by the Japanese Council of Senior Citizens Welfare Services.

Socially assistive robots (SARs) are seen as part of a pragmatic solution to addressing the increasing demands, shortage of care workers and to realizing the potential of optimum integrated care. Yet their effectiveness and impact on older people’s care, activities and participation are still unknown. A total of 67 people aged 65 and over participated in a 24-week-long, quasi-experimental study in five residential nursing homes in Japan. The personalized care plan and targets were created based on the framework of the WHO’s International Classification of Function, Disability and Health (ICF). Three types of socially assistive robots were used. The participants in the robot intervention groups showed greater improvements in their scores for targeted activities and participation than the control group. Statistically significant improvements were observed in communication, self care, and social life. SARs have great potential for improving older people’s quality of life. With further research, the use of these robots by older people could be considered as a serious option in the future. In addition, the ICF framework can be utilized further for measuring the effects of introducing SARs on older people’s quality of life. Universal Accessibility Evaluation Organization Japan AMED

A sheet-shaped body vibrometer (SBV) is a type of assistive technology which offers a constant and noninvasive method of recording and monitoring the physical condition and sleep patterns of care recipients. With the aim of creating a safer environment for both care recipients and caregivers, we connected the SBV to a communicative robot (com-robot), to function as an integrated system. The robot has a sensor which activates when a care recipient tries to stand up, whereupon it sends an alert to care staff and speaks to the care recipient. The combined technologies offer an enhanced sense of security, as they watch over older people during the night, visualise sleep patterns and alert care staff. As proof of concept, this study examines the usefulness of this connected system by testing its effectiveness among two types of users (care recipients and professionals) in a residential care home in Japan. For the former, sleep parameters were investigated to see if there was any change over time in and impact on an older person's quality of life. As a measurement of quality of life, the interRAI method was used as a comprehensive assessment tool, based on which a care plan was also created for each care recipient. The interRAI is a nursing care evaluation and nursing care plan creation guideline package that provides unbroken care that can be used at home, in facilities or in the community For the latter, the study tests the level of fatigue among care professionals during night shifts before and after the intervention. For triangulation of data, semi-structured interviews and usability tests were carried out. Despite a few points for improvement, the results highlight multiple benefits for care recipients and professionals of using the SBV and com-robot integrated system in a residential care home. Tokyo Metropolitan Government