Potential and risks of social robots in care to alleviate loneliness

Social robots are mobile computers that can enter into a communicative exchange with humans, creating the illusion of social interaction. Due to the communicative functions in this interaction, human characteristics such as empathy, values, goals or emotions are attributed to the robot. Social robots must be distinguished from other technical devices whose primary purpose is to provide support on levels other than communication. In the household, for example, these are robotic hoovers or self-propelled robotic lawnmowers. In a professional setting, transport robots are an example without communicative functions.

Social robots are also often referred to as companions. A distinction is made between social robots that primarily look after humans by assisting them or encouraging them to communicate, and those that humans look after, e.g. in the form of cuddly robots or robotic pets^{[1], [2]}.

The aims of social robots are to reduce loneliness for humans through communicative acts, to promote communication between humans and the social robot and to create a feeling of security and connectedness. Loneliness is the subjective feeling of being disconnected from other people, which is experienced as negative. It is to be distinguished from loneliness, which is characterised by the physical absence of people. People can also feel lonely in the presence of others. At the same time, people can feel connected, i.e. not lonely, when they are alone. Similar to other medical robots, social robots connect the nodes “robot” and “digital health”. The psyche as an essential dimension of health is thus addressed and strengthened by a digital and embodied artefact of the sensor-supported robot.

The design of social robots is diverse and most social robots exist in the prototype stage as of April 2024^[3]. A few robots have already reached market maturity, making them freely available for purchase by private individuals or care institutions.

The best-known and most widespread social robots are the humanoid Pepper and the cuddly seal Paro, which are examples of the two categories of social robots mentioned above. Pepper is 120 cm tall, completely encased in a plastic shell, moves on wheels and is able to respond adequately to conversational impulses. In addition to the humanoid face, Pepper has a tablet screen on which further interaction is possible. Pepper also has arms for gripping and grasping, which makes further interaction possible. Paro, on the other hand, is a 60 cm long plush seal surrounded by fur. Paro follows the sounds from its surroundings with its gaze and can interact by blinking its eyelashes and making its own noises. It is possible to address Paro, but interaction is limited to eye contact and sounds; Paro is also unable to interact with the environment using its arms or other functions.

Other examples of companions along the lines of Pepper are the Fraunhofer Care-O-Bot, Betty or Matild^[4]. Other examples of cuddly robots in the sense of Paro are the dog Aibo or the dinosaur Pleo^[5]. So far, cuddly robots have mostly been used in inpatient care facilities with a focus on dementia^{[4], [6], [7]}. Companions in the sense of Pepper are also used in hospitals in addition to inpatient care facilities for the purpose of navigation or for initial contact with the general public. Social robots have not yet been used much in the home environment of private individuals or in outpatient care^[8].

Comparability with analogue phenomena

Social robots imitate social interactions between people and are analogous to interpersonal dialogue or interaction with pets. Thus, social robots are directly linked to interpersonal behaviour. The social robots used in studies are often ascribed human characteristics (anthromorphism). Such attributions can also be observed in animals or other non-human actors. In this respect, social robots are not a novelty, but are based on the habits of humans. In studies on the effectiveness of cuddly robots, for example, interaction with therapy dogs or other animals is used as an active control group^[7]. This assumes comparability in the mode of interaction between cuddly robots as social robots and pets. However, especially the more complex social robots with roles, arms and speech understanding are a novelty that enables human-machine interactions on a new level. As companions, such companions could make the most of the potential of digitalisation and alleviate loneliness even beyond the inpatient care context.

Social relevance

The topic of loneliness is gaining social relevance. In the UK, the first Ministry for Loneliness was established in 2018 under Theresa May, with Diana Barran as the Minister for Loneliness as of April 2024. In Germany, the first initiatives are sprouting up, but they have emerged from local and regional impetus and work separately from one another. In Dortmund, for example, the Loneliness Coordination Centre was established in November 2023, and in the Berlin district of Reinickendorf, a full-time position for the Loneliness Officer was created in February 2024.

These initiatives are responses to the increased prevalence of loneliness, which was fuelled in particular by the COVID pandemic with the isolation of people from different households ordered by the authorities. However, for decades there has been a trend towards social atomisation, i.e. the dissolution of intergenerational extended families and firmly rooted neighbourhoods in favour of nuclear families and more anonymous coexistence^[9].

Loneliness is often discussed against the backdrop of demographic change, which is particularly focussed on older members of society. Due to the death of relatives and friends in old age, they are more often alone than their younger counterparts – and being alone is a risk factor for feelings of loneliness. Accordingly, research is also focussing on loneliness in old age and in care facilities for the elderly, which are under double pressure due to the shortage of skilled workers – fewer staff due to fewer (well-trained) young people and, at the same time, higher demand due to more older people. Technology seems to be an obvious solution here, as it has generated efficiency gains in other sectors, i.e. higher output with less input^[10]. However, the extent to which new technical possibilities can also support the withdrawal of people from social interaction must be critically analysed^[11]. The goal – and the stakeholders involved agree on this – should not be to replace humans with robots^[8]. Rather, social robots should complement and – if possible – make life easier for carers and those being cared for. It is also important to emphasise that loneliness is not an issue of old age, but can affect all social groups – even those who appear to be socially well integrated. There are still blind spots in the debates about social robots when it comes to equipping private households, in which young lonely people also live, with companions.

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