technology
Dr Shibata with PARO.
Source: Australian
Healthcare Week
is decreasing. That means we have more and more elderly people,
and less and less young people. So, we have to expect that we will
have more elderly people who need care at home or at facilities.
However, we are going to have a shortage of manpower to take care
of them, so we need to improve certain conditions. To do that, the
Japanese government has emphasised developing technologies to
do so – especially artificial intelligence and robotics.
Apart from PARO, what other projects are coming out?
Seal of approval
The furry therapeutic robot
helping to improve the
lives of older people.
Takanori Shibata interviewed
by Conor Burke
J
apan has a rapidly ageing population. Currently, 25 per cent of its
127 million people are aged 65 or older, and by 2040 projections
say that number will be at 35 per cent.
This has many knock-on effects, including a lack of healthcare
workers. While five decades ago there were 12 workers for every
retiree, in 50 years there will be an equal 1:1 ratio. This is where
artificial intelligence and Dr Takanori Shibata comes in.
Shibata is the inventor of PARO, a therapeutic robot ‘seal’ that is
helping to fill the workforce gap and improve the lives of the elderly.
It’s already in use around the world and was introduced here in
2014. As Shibata told the aged care conference, his ninth-generation
robot seal has all the therapeutic benefits of a real animal with none
of the negatives. PARO also has the ability to learn: if you call it by
another name, it eventually responds to the new name.
Studies have shown that therapy using PARO in aged care
settings can reduce the use of psychotropics. Shibata cited a study
that carried out treatment with two groups, one with PARO and
one without. The group treated using PARO reduced their use of
depression and anxiety medication by 30 per cent, and the after-
effects of PARO lasted two hours longer than the medication.
PARO has also been shown to reduce stress, pain, aggression,
wandering, sleeplessness, drug-related falls and tremors in people
with Parkinson’s disease.
Other trials have shown rehabilitation of swallowing when using
PARO as treatment – the patient can strengthen throat muscles by
communicating with PARO. Also, CALD people with dementia who
have lost language have been shown to recover it – again, through
communication with the robotic seal.
Shibata believes that even healthy older people can use PARO for
company as part of a healthy ageing plan.
Aged Care Insite spoke with Shibata at Australian Healthcare Week.
ACI: Why is Japan experiencing hyper-ageing?
TS: Japan has a high ratio of elderly people, but the population itself
36 agedcareinsite.com.au
People know about animal therapy, but we cannot have animals in
some places, like hospitals, nursing homes and so on. Also, some
people have allergies, and there are bites and scratches.
For such places and such people, animal-type robots would be
have a therapeutic effect, like real animals. I’ve been working on the
development of PARO since 1993 – more than 25 years now.
In the US, PARO is certified as a medical device by the FDA. Their
public health insurance accepts reimbursement when PARO is
prescribed for patients diagnosed with pain, anxiety, depression and
behaviour issues. Soon we will register PARO as medical device in
Europe, and after that in Australia.
As the clinical evidence increases, PARO is gradually being
accepted in the dementia care field and for cancer patients, people
with PTSD, Parkinson’s disease, brain injury and so on.
In Australia, you have home care packages and government
support for elderly people. If they want to use PARO at home to
improve their medical conditions or quality of life, they can use the
home care package to purchase PARO. That is a very good system,
because if they improve their conditions at home, they can stay at
home longer.
Is that the same in Japan? Does the government encourage
people to stay at home for longer?
In Japan we have long-term care insurance as well as medical
insurance. The long-term care insurance is public insurance for
elderly people, and if the people are living at home, they can use the
fund for bedside service, rental equipment and so on.
If they move to elderly facilities, the government pays the monthly
cost to the facilities. In the case of home care, the average cost is
about $1400 per month for one person. But if the same person
moved to the elderly facility, it costs about $5600. There’s a big
difference in the cost for government, long-term care insurance.
So the Japanese government encourages elderly people to stay at
home for as long as possible.
In the case of physically healthy people with dementia who are
living at home, especially people with Alzheimer’s disease, if they
have negative behaviours like aggression or wandering, the carers
or family may feel like they cannot take care of their parent or
grandparent, and they may send them to a facility. But if they reduce
or improve the negative behaviours, they feel like they can take care
of that family member for longer.
In Osaka, they apply the long-term care insurance to renting
PARO. People rent PARO for $200 per month, and the insurance
covers 90 per cent of the cost, so people pay only $20 per month.
We’ve had more than 70 cases, and when people rented PARO,
they improved their negative behaviours, and that reduced the
burden of care for family members. A lot of people continued to use
PARO by paying the monthly cost and they stayed at home longer.
Of course, some people needed to move to a facility or a hospital
because of medical reasons, so they returned PARO. But some
people have bought PARO because they think they need it in
their life. ■