Can Robots Solve the Staff Shortage Problem in Health Care for Seniors?

Longevity may be the most important trend we’ve ever experienced. It’s driven by — and in turn, it affects — everything from health to housing, money to technology, lifestyle to social policy. There’s so much to be aware of — and it’s just getting started! Now you can keep up with all the latest developments in this weekly column.

 

Two forces are converging to produce a crisis in health care. (Some of you may be saying, “Only two?” Fair enough — but that’s a bigger topic for another day.)

1. The aging of the population, driven by longevity, will create significantly increased demand for both in-home and institutional health care for seniors;
2. At the same time, there is a critical shortage of health-care workers. This has certainly been by aggravated by the COVID-19 pandemic. Every sector of health care, from hospitals to retirement homes/nursing homes to in-home services, is struggling with a shortage of qualified workers. Every sector anticipate the problems will only get worse.

Could robots be — if not the answer — an answer?

It’s not a new idea. Robots have been around for a while, and they are steadily getting better. And we’ve all seen those cute photos of robots singing and dancing with groups of smiling (usually female) seniors. But is this just a cute outlier? Or does it have real potential? And how would we know? What is the evidence?

I only came across this article, on the Stanford University website, this past week. It’s a little over a year old, but I think it’s very relevant. It reports on a research project in Japan that examined the impact of robots on nursing homes in the country. A more detailed report on the research can be viewed here.

The researchers wanted to look at the impact of robots on service industries in general, probing what they called a “dueling narrative” — on the one hand, robots as the symbol of a “looming dystopian future” with more automation replacing human workers and depressing wages; on the other hand, robots “spurring productivity and freeing workers from repetitive, strenuous, monotonous work while helping to relieve labor shortages arising from aging populations.” So it wasn’t driven only by health care, but it also did zero in on Japan and nursing homes because “Japan has been an early adopter of robots to address the shortage of care workers relative to growing demand for long-term care services.”

As I’ve commented here many times, Japan has the oldest population in the world, with about 30 per cent of people being over the age of 65. At the same time, as this report points out, “Official projections indicate a shortfall of 380,000 care workers by 2025, in part because care workers often experience physical repercussions such as lower back pain, while receiving wages barely exceeding the minimum wage.”

As a consequence, Japan has actively embraced the use of robots. The government even has an official “Robot Plan” that “aims to increase the share of people who want to use robots for providing care, from 60 per cent to 80 per cent.” (I’m astonished that it’s already as high as 60 per cent.) Local governments even provide subsidies for the adoption of robots in nursing homes; typically 50 per cent of the cost up to approximately US$1,000 per robot.

How are the robots used? What is the impact on human staff? What is the impact on the seniors? Here are some of the highlights:

• The average nursing home studied employed 42 care workers and 8 nurses, out of 80 total staff. About one-third of the homes reported that staff retention was a problem. (The U.S. average is about 65 staff per home)
• The percentage of Japanese nursing homes who report using any type of robot jumped sharply from 17.6 per cent in 2016 to 26 per cent in 2017 (the latest year for which for I could find any figures)
• The most common type of robots in use are monitoring robots, which help monitor whether residents have gotten out of bed, fallen or need assistance. These are used by about 15 per cent of nursing homes
• Other functions performed by robots include transfer aid (helping care workers move individuals), reported by about eight per cent of homes; mobility robots, assisting residents with movement, toileting and bathing, reported by just over five per cent of homes; and communications (interaction) robots, reported by about three per cent of homes
• This is perhaps counterintuitive, but robot-adopting homes had between three per cent and eight per cent more staff than non-adopting homes. “Nursing homes with robots also appeared to have higher management quality; they were 10 per cent more likely to have a human resource manager and were more likely to report that they make an effort to improve wages for retention of employees”
• Where staff increases occurred, it was entirely among the non-regular employees. “Robot adoption doubled the number of non-regular care workers and significantly increased the number of non-regular nurses. The estimates on regular employees were negative but statistically insignificant”
• Robot adoption did reduce the monthly wages of regular nurses “by a modest but non-trivial amount.” The researchers identified a possible cause: “The reduction in nurse monthly wages could reflect reduction in caregiver burden during night shifts, since monitoring robots are designed to substitute for tasks such as frequent night-time rounds to monitor residents’ well-being. It may also be due to more nurses shifting to part-time work, which has been encouraged by the Japanese government and the Ministry of Health, Labor and Welfare as a strategy to increase worker flexibility”
• Robot adoption did reduce the likelihood that a nursing home would be worrying about staff retention, “which suggests that robots may indeed help reduce the burden on care workers are nurses”

In sum, beneficial outcomes.

Let’s see how fast this happens here.

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