Fighting loneliness with empathic robots might well be the way to cure the epidemy of isolation that is currently taking place in Japan. Let’s discover why! Have you heard of Tracey Crouch? In 2017 and for just one year, she was in the United Kingdom, the world’s first minister in charge of loneliness. For the elderly, loneliness is not just a fleeting feeling. It kills. A meta-analysis (Holt-Lunstad et al., 2010) showed that the consequences of loneliness and isolation carry the same mortality risk as smoking 15 cigarettes a day. In Japan, 35 million people are 65+ years old. Among this population, 15 % of older men have less than one conversation every two weeks.

By 2050, at the global level, we expect to see more people over the age of 65 years than under 15 years, reaching a total population of 1.5 billion. According to the latest forecast by the National Institute of Population and Social Security Research, in 2040, nearly 9 million people above 65 years old will be living alone. In Tokyo, only 46% of the elderly will be the only member of their household. This planned epidemy of solitude already leads to a more and more common phenomenon known as “solitary death” or “kodokushi.” Every week, 4,000 people die alone, unnoticed for days, weeks sometimes months. A new industry recently appeared to clean the flats of the people who died in complete isolation. In Japan, as in many other countries, the traditional nuclear family has gradually dissolved. The children take less care of their parents, and households with several generations living together are now seldom found. Being alone is different from being lonely. People living alone can still have a social life and not experience loneliness. Nevertheless, in a society where, as argued by MIT Professor Sherry Turkle in her brilliant book “Alone Together,” we have sacrificed our social life to technology, we can expect more and more people to experience loneliness.

Robots for the elderly can be divided into two broad categories: Service robots that will help in the daily life tasks and Companion robots whose primary goal is to improve the psychological status and overall well-being of their users. Even though the frontier between these robots can be blurry sometimes, in this article, we will concentrate exclusively on the Companion robots and how they can be used as a means to break the vicious loneliness circle and to bring a sense of presence to the elderly. The beneficial effects of pets in reducing Blood Pressure are still controversial (Elien et al., 2018). Somehow, the use of pet robots, such as the famous baby seal Paro has been shown to decrease stress and anxiety in elderly patients who have dementia (Petersen et al., 2017). Even though the Animal-Assisted Therapy benefits are still unclear and depend on the level of interaction, the use of pet robots by the elderly has been shown to significantly reduce the level of loneliness after 20 sessions over a 7-weel period (Tamura et al., 2004).

EMPATHY AND ROBOTS

According to a survey conducted by the Japan Cabinet Office in 2013 on the use of robots for long-term care, 65% of the respondents were in favor of using a robot. In a country such as Japan, where technology is even found in toilet seats, the use of Robots is a natural path to follow. The question is to know what is the level of technology and anthropomorphism needed. Are robots accepted because they will mimic animal or human appearance or because of deeper cognitive functions such as empathy?

Empathy, the ability to share the feelings and emotions of others, is the critical component for robots to be socially and psychologically accepted and for a bond to be established between humans and machines. MIT’s Professor Kate Darling studies the numerous ethical issues linked to the introduction of robots in our human environment. She notably found that humans can express empathy for robots and will be reluctant to destroy them after spending a playful experience with them. Recently, the team of Suzuki et al., 2015 found the first neurophysiological evidence of humans’ ability to empathize with robots in a perceived pain experiment. Empathy is a bilateral process, and caring for others is a hardwired component of human evolution. It could explain why relatively simple robots appear to be therapeutically beneficial when used with the elderly. Fighting loneliness with empathic robots is the ultimate link between society and technology.

Using AI and deep learning algorithms to detect facial cues to detect emotions is now a multi-billion dollar market, and companies like Amazon, Microsoft, or IBM are investing a lot of resources to find the ultimate emotion algorithm. Reliable emotion detection is at the core of accurate empathic robot responses. Somehow emotional cues are more profound than simple boolean signals. A multidisciplinary meta-analysis of facial cues revealed that reliably detecting emotions was much more complex and finely expressed than initially envisaged. Without robust emotional recognition, the path to empathy will be filled with hurdles. Do robots need an active empathic component to be therapeutically relevant? It is what we will try to analyze in this article and look at the past, present, and future of robots used for fighting loneliness.

To be used effectively as a cure to loneliness in super-aging societies and potentially as part of the therapeutic arsenal against dementia, companion robots will have to integrate multiple characteristics, both physical and psychologic.

KABOCHAN: THE TALKING DOLL

Fighting loneliness with empathic robots does not mean that there is a need for Sci-Fi Technology. Kabochan is just a talking doll built to mimic a 3-years old boy. Relatively simple technically, Kabochan is equipped with five sensors to detect sound, light, and motion. The latest version can say 450 sentences and sing eight songs. It also reacts when patted on the head. Kabochan is the brainchild of a startup company based in Osaka, equally funded by the Healthcare Group Fujimoto Holding Co. and toymaker Wiz Co. and specifically designed for nursing care facilities and lonely elderly. When compared to other robots, Kabochan, with a price tag of around $300, is very affordable. Carers and families have seen very positive results when using Kabochan with patients who have dementia. The elderly will cuddle and take care of him and will be more prone to discussing with their carers and family. Kabochan is the perfect example that hyper-technology might not be the only way to go and that the elderly might only need some minimal stimuli to break the circle of loneliness.

PARO: THE FIRST THERAPEUTIC ROBOT BESTSELLER

The Paro’s project was initiated more than 25 years ago by Takanori Shibata of the Intelligent System Research Institute in Tokyo. Paro was designed as an alternative to pets to be used in environments where animals were not allowed, such as nursing homes. More than 3,500 units of Paro have been sold in more than 30 countries since 2005. At a price tag of around US$ 4,000, Paro is a niche product but has been instrumental in proving the many therapeutical benefits of robots. Despite its relative simplicity, Paro moves his tail, opens/closes its eyes, and emits small sounds when being pet. Paro has been approved as a Class II medical device by the FDA in 2009 and has calming effects on patients who have dementia.

LOVOT: THE ROBOT WHO WANTS TO BE LOVED

LOVOT stands for LOVE and ROBOT. The cute little furry robot won the “best robot award” at the CES 2018 show. The ultimate goal of Lovot is to bring happiness. Lovot has expressive lovely big eyes that will create a sense of depth. With more than 50 sensors, ten processors units, 180-degree camera, and being warm to the touch, Lovot can navigate in its environment, recognize its environment, express behavioral patterns and establish an emotional attachment with humans. Like Parrot, Lot doesn’t talk but emit some sounds to communicate and express its feelings. When gently rocked, Lovot will fall asleep. Fighting loneliness with empathic robots is a complex challenge, and “Loving” robots like Lovot is an interesting and disruptive approach.

ERICA: THE HUMAN LIKE ROBOT ANDROID

In less than ten years, famous roboticist Hiroshi Ishiguro of Osaka University went from the minimal human design teleoperated Telenoid R1 to Erica regarded as the most beautiful and advanced autonomous android. Erica analyses its environment; she seeks eye contact and can hold a conversation in a very realistic way. Erica is still a costly research project but is probably paving the way for what will be Androids in the future.

ELLIQ: THE HYBRID ROBOT

ElliQ doesn’t look like a human, doesn’t look like an animal, Beta testers referred to ElliQ as “…a new entity,…, a presence.” ElliQ, with its glowy sci-fi lightning, looks more like Eve in the Wall-E movie. ElliQ is a Hybrid device that responds to voice commands and allows the elderly to stay connected with their family and carers and make voice or video calls. ElliQ reacts proactively to the need of the elderly and acts as a multimedia gateway. ElliQ is not Japanese but American and is an excellent example of what new smart hybrid devices to help the elderly can be. The only drawback of ElliQ is that by acting as an intergenerational gateway, there is a need for a real human willing to respond and interact at the other end of the line.

AVOIDING THE UNCANNY VALLEY

In 1970, robotics professor Masahiro Mori wrote a now-famous article about “The Uncanny Valley.” He described how a person would shift from empathy to revulsion when responding to a human-like robot failing to reach a lifelike appearance and then fall into the so-called “zombie” territory where humans have lost their humanity. Nowadays, this “uncanny valley” hypothesis has been considered as probably too simplistic by researchers such as Hiroshi Ishiguro. Still, this hypothesis has numerous implications in movies CGI – The movie Polar Express is the classic example of CGI characters that fell in the valley- and especially in Virtual Reality Games.

The critical question is to understand how to avoid the “uncanny valley” and what is the level of human likeness to instill in the robots for users to feel confident and empathic with them.

According to the Japanese New Energy and Industrial Technology Development organization, by the year 2025, the Healthcare robot market, in Japan only, will be a $US 5 billion market. Companionship robots will undoubtedly account for a significant portion of this new industry, and the next decade will see a global expansion of what will then be regarded as a must-have standard aging easing device. Will it change the way we perceive human relationships? Probably! Sherry Turtle arguments that naming and anthropomorphizing machines could lead to the weakening of human social bonds. As we bury our dead pets in the back garden, some robots in Japan, such as Aibo, are already given a sepulture. Kids often give names to their toy dolls. Naming and cuddling a robot in the late stages of life might be the next step in the evolution of human societies. Real empathic robots are still science-fiction, but dogs and cats with their limited empathic abilities are already proven to provide comfort. Fighting loneliness with empathic robots can be regarded as the ultimate innovation. Robots will certainly not enhance the social links between generations, but they might at least enlighten the dusk of life.