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Picture the scene: You move into a nursing home in the final years of your life, when you are no longer able to manage on your own. And there you discover the future.
The place teems with humanoid robots. They help feed you. They offer you a steadying arm when you walk and even catch you if you fall. They help you get out of bed, rise from a chair and get up off the lavatory. They help lift you out of the bathtub. Thanks to artificial intelligence, the robots can respond to your needs and even anticipate them. They also have distinct personalities: You can talk to them, and they talk back. They recognize you and learn to understand your personality over time.
Many residents also have robot pets, such as robot dogs. Thanks to AI, these also have their own personalities. You find yourself interacting with a robotic pet much as you did with a live one.
Through your smart wristband, a specialist off-site health company monitors all your vital signs, 24/7. It too uses AI and smart computers to track and even anticipate medical needs. It alerts on-site nursing staff at the first sign of distress. Security cameras in every room, also monitored remotely using AI, protect you from neglect or abuse.
The nursing home is remarkably clean, and there's a simple reason: Robots also perform much of the cleaning and maintenance. The lavatories are self-cleaning, automatically disinfecting the room after every use.
There are still human staff members, of course, including nurses and nurse's aides. But they are fewer in number than before, and their time is used much more efficiently. They go where they are needed. As a result, they are paid much better than in the past.
This picture is futuristic, but it is not fantasy. This is what nursing homes will look like, maybe in as little as 10 years (unless human incompetence or malice prevents it). Most of this technology either exists already or is in development. And it's needed. As I've been writing about nursing homes and elder affairs in recent years, I've been seeing the various pieces of the puzzle start to fall into place.
Another one recently dropped at the Massachusetts Institute of Technology, where researchers have developed their first prototype of an eldercare robot. "EBAR," or Elderly Bodily Assistance Robot, can help elderly and infirm individuals walk. It can help them get up from a chair or step out of a bath. It can even catch them if they fall, deploying air bags where needed.
EBAR is only a prototype, a proof of concept. But Harry Asada, the engineering professor overseeing the project, says it is possible that working EBARs could be in nursing homes in as little as five years.
Everyone, he adds, wants them "tomorrow."
Graduate student Roberto Bolli, who designed EBAR, says the current prototype cost a mere $7,000 to build. Those built for the real world will presumably cost a lot more, but it's a sign that this technology is within practical reach.
Currently, EBAR is a remote-controlled model, but AI will soon make them autonomous. Future EBARs will respond to instructions and anticipate needs. What they will be able to do in five years, let alone 10, can only be imagined.
The Japanese (of course) are also developing eldercare robots.
Robotic cleaners, meanwhile, have been available on the market for years. They will get much better.
Robot pets also already exist. I wrote about Sony's Aibo nearly five years ago. Since then I have seen firsthand how it can have a profound emotional impact on an elderly person living alone. (Robot pets are not like windup toys. They are more like R2-D2 from Star Wars. I've learned that it's impossible to describe adequately what they are really like. You have to experience them.) I suspect other companies will take Aibo as a proof of concept and make their own versions a commonplace product. If Apple (AAPL) had bought the division from Sony (SONY) and launched, say, the "i-Bo" (Apple Dog?) with its characteristic panache, they would probably already be everywhere.
The technology for smart wristbands and remote monitoring of nursing-home residents' health already exists as well. When Apple CEO Tim Cook unveiled the first Apple Watch in 2014, it seemed obvious the company had an eye on aging Western societies and the future of eldercare. Smartwatches and wristbands can now monitor an array of health signs. They can also identify a fall. A rural building contractor recently explained to me why he had an Apple Watch. "I usually work alone," he said. "This thing will call an ambulance if I fall off a ladder."
As for self-cleaning toilets - Paris, France, has had self-cleaning public lavatories since the 1980s. (There used to be an urban myth about someone getting trapped inside.) Japanese-style lavatories, as satirized by South Park, will presumably soon be coming to a nursing home near you.
Some people, such as sentimental traditionalists, may be dismayed at the picture of a nursing home that is mostly automated and full of robots. They shouldn't be. Or, to be more precise, they shouldn't be when they consider the alternative.
America's nursing homes are in crisis. Possibly, they always have been. They are understaffed. The staff they do have are underpaid and overstretched. This can easily lead to abuse as well as neglect and, arguably, worse. Eldercare lawyers have told me about cases where residents who should never have been left alone drowning in the bath and not being discovered for an hour. One told me about a client's mother who died of neglect and was "partially eaten by ants." Yes, really. A few years ago, the National Academies of Science issued a devastating report on the state of America's nursing homes.
It is easy to point fingers, but the problem is systemic. The Biden administration tried to mandate that the industry increase staffing, but the industry successfully blocked the move in the court, arguing that it couldn't afford to pay the extra staff to satisfy the mandate, even if it could find them. But the industry is also berating the Trump administration and the GOP for cracking down on illegal immigration. It argues that without illegal immigration, the staffing crisis will be even worse. The reason? The wages for nurse's aides are so low. You will earn more per hour walking Americans' dogs than you will as a nurse's aide looking after Americans' parents and grandparents in the final years of their lives. (You'll probably also get in less trouble if you are caught abusing your charge.)
Few Americans will do this work for so little money.
But if you think the industry should raise wages, you have to answer the follow-up question: Who will pay? The lazy answer, "somebody else," is no answer at all. Will you pay? The average nursing home already costs about $120,000 a year. The main payer for nursing homes is Medicaid - not Medicare, but Medicaid. Congress just voted to cut Medicaid.
(At this point, people who watch too much cable TV will write to tell me that Congress only cut the part of Medicaid that provides free solid-gold, brand-new Cadillacs every year for all the 50 million Mexican drug dealers living in America.)
The problem is pretty clear. The need for nursing homes and other forms of eldercare in America is rising and rising sharply, as the number of older people goes up. But currently eldercare and nursing homes are expensive. We can't (or won't) pay the costs even to provide enough high-quality care at the moment. There is certainly no reason to think we will suddenly start doing so.
The futuristic nursing home with its robots, automation, artificial intelligence and computerized health monitoring will be much cheaper to operate because it will require fewer staff. But it will almost certainly be safer and healthier for residents than most nursing homes today. There will be fewer humans working there, but it's plausible to hope they will be paid better and treated better than staff today, and will be able to devote their time and energy to the things that most improve residents' lives.
But questions remain. How soon will we get there? And will this future be available to all?
And perhaps most important: Just how much damage will our country's completely broken political system, with its endemic corruption, selfish special interests and moronic tribalism, cause along the way?
Picture the scene: You move into a nursing home in the final years of your life, when you are no longer able to manage on your own. And there you discover the future.
The place teems with humanoid robots. They help feed you. They offer you a steadying arm when you walk and even catch you if you fall. They help you get out of bed, rise from a chair and get up off the lavatory. They help lift you out of the bathtub. Thanks to artificial intelligence, the robots can respond to your needs and even anticipate them. They also have distinct personalities: You can talk to them, and they talk back. They recognize you and learn to understand your personality over time.
Many residents also have robot pets, such as robot dogs. Thanks to AI, these also have their own personalities. You find yourself interacting with a robotic pet much as you did with a live one.
Through your smart wristband, a specialist off-site health company monitors all your vital signs, 24/7. It too uses AI and smart computers to track and even anticipate medical needs. It alerts on-site nursing staff at the first sign of distress. Security cameras in every room, also monitored remotely using AI, protect you from neglect or abuse.
The nursing home is remarkably clean, and there's a simple reason: Robots also perform much of the cleaning and maintenance. The lavatories are self-cleaning, automatically disinfecting the room after every use.
There are still human staff members, of course, including nurses and nurse's aides. But they are fewer in number than before, and their time is used much more efficiently. They go where they are needed. As a result, they are paid much better than in the past.
This picture is futuristic, but it is not fantasy. This is what nursing homes will look like, maybe in as little as 10 years (unless human incompetence or malice prevents it). Most of this technology either exists already or is in development. And it's needed. As I've been writing about nursing homes and elder affairs in recent years, I've been seeing the various pieces of the puzzle start to fall into place.
Another one recently dropped at the Massachusetts Institute of Technology, where researchers have developed their first prototype of an eldercare robot. "EBAR," or Elderly Bodily Assistance Robot, can help elderly and infirm individuals walk. It can help them get up from a chair or step out of a bath. It can even catch them if they fall, deploying air bags where needed.
EBAR is only a prototype, a proof of concept. But Harry Asada, the engineering professor overseeing the project, says it is possible that working EBARs could be in nursing homes in as little as five years.
Everyone, he adds, wants them "tomorrow."
Graduate student Roberto Bolli, who designed EBAR, says the current prototype cost a mere $7,000 to build. Those built for the real world will presumably cost a lot more, but it's a sign that this technology is within practical reach.
Currently, EBAR is a remote-controlled model, but AI will soon make them autonomous. Future EBARs will respond to instructions and anticipate needs. What they will be able to do in five years, let alone 10, can only be imagined.
The Japanese (of course) are also developing eldercare robots.
Robotic cleaners, meanwhile, have been available on the market for years. They will get much better.
Robot pets also already exist. I wrote about Sony's Aibo nearly five years ago. Since then I have seen firsthand how it can have a profound emotional impact on an elderly person living alone. (Robot pets are not like windup toys. They are more like R2-D2 from Star Wars. I've learned that it's impossible to describe adequately what they are really like. You have to experience them.) I suspect other companies will take Aibo as a proof of concept and make their own versions a commonplace product. If Apple (AAPL) had bought the division from Sony (SONY) and launched, say, the "i-Bo" (Apple Dog?) with its characteristic panache, they would probably already be everywhere.
The technology for smart wristbands and remote monitoring of nursing-home residents' health already exists as well. When Apple CEO Tim Cook unveiled the first Apple Watch in 2014, it seemed obvious the company had an eye on aging Western societies and the future of eldercare. Smartwatches and wristbands can now monitor an array of health signs. They can also identify a fall. A rural building contractor recently explained to me why he had an Apple Watch. "I usually work alone," he said. "This thing will call an ambulance if I fall off a ladder."
As for self-cleaning toilets - Paris, France, has had self-cleaning public lavatories since the 1980s. (There used to be an urban myth about someone getting trapped inside.) Japanese-style lavatories, as satirized by South Park, will presumably soon be coming to a nursing home near you.
Some people, such as sentimental traditionalists, may be dismayed at the picture of a nursing home that is mostly automated and full of robots. They shouldn't be. Or, to be more precise, they shouldn't be when they consider the alternative.
America's nursing homes are in crisis. Possibly, they always have been. They are understaffed. The staff they do have are underpaid and overstretched. This can easily lead to abuse as well as neglect and, arguably, worse. Eldercare lawyers have told me about cases where residents who should never have been left alone drowning in the bath and not being discovered for an hour. One told me about a client's mother who died of neglect and was "partially eaten by ants." Yes, really. A few years ago, the National Academies of Science issued a devastating report on the state of America's nursing homes.
It is easy to point fingers, but the problem is systemic. The Biden administration tried to mandate that the industry increase staffing, but the industry successfully blocked the move in the court, arguing that it couldn't afford to pay the extra staff to satisfy the mandate, even if it could find them. But the industry is also berating the Trump administration and the GOP for cracking down on illegal immigration. It argues that without illegal immigration, the staffing crisis will be even worse. The reason? The wages for nurse's aides are so low. You will earn more per hour walking Americans' dogs than you will as a nurse's aide looking after Americans' parents and grandparents in the final years of their lives. (You'll probably also get in less trouble if you are caught abusing your charge.)
Few Americans will do this work for so little money.
But if you think the industry should raise wages, you have to answer the follow-up question: Who will pay? The lazy answer, "somebody else," is no answer at all. Will you pay? The average nursing home already costs about $120,000 a year. The main payer for nursing homes is Medicaid - not Medicare, but Medicaid. Congress just voted to cut Medicaid.
(At this point, people who watch too much cable TV will write to tell me that Congress only cut the part of Medicaid that provides free solid-gold, brand-new Cadillacs every year for all the 50 million Mexican drug dealers living in America.)
The problem is pretty clear. The need for nursing homes and other forms of eldercare in America is rising and rising sharply, as the number of older people goes up. But currently eldercare and nursing homes are expensive. We can't (or won't) pay the costs even to provide enough high-quality care at the moment. There is certainly no reason to think we will suddenly start doing so.
The futuristic nursing home with its robots, automation, artificial intelligence and computerized health monitoring will be much cheaper to operate because it will require fewer staff. But it will almost certainly be safer and healthier for residents than most nursing homes today. There will be fewer humans working there, but it's plausible to hope they will be paid better and treated better than staff today, and will be able to devote their time and energy to the things that most improve residents' lives.
But questions remain. How soon will we get there? And will this future be available to all?
And perhaps most important: Just how much damage will our country's completely broken political system, with its endemic corruption, selfish special interests and moronic tribalism, cause along the way?
