What are the effects of 'robopets' on the health and wellbeing of residents in care homes? A systematic review of qualitative and quantitative evidence

This review was led by the Evidence Synthesis Team.

Background

The use of animals in a therapy context is known as animal-assisted interventions (AAI). Research has found AAIs to be beneficial in reducing stress and behavioural problems in the general public, and AAIs have been shown to reduce depression and behavioural problems, while also providing companionship, among older people in residential care, including persons with dementia. However, AAIs can pose risks including bites, infections and accidents such as falls, and care homes may not be able to meet the needs of living animals. These issues, along with the limited availability of appropriate animals, mean that AAIs may not be offered as therapy or as an option for meaningful activities.

Robotic animals, or ‘robopets’, are “small domestic robots which have the appearance and behavioural characteristics of companion pets” and may provide an alternative to AAIs. Examples of robopets that have been used in a care home setting include a baby harp seal (PARO), a robotic cat (NeCoRo), and a robotic dog (AIBO). The advantages of robopets include imitative lifelike behaviour, programmed responsiveness, and their ability to provide alternative models of communication and interaction (tactile-kinesthetic, visual, sensory-emotional, and social).

In this review we provide a state-of-knowledge synthesis on the impact of robopet-human interaction on care home residents and care home staff.

Objectives

The main objective of this review is to assess the effectiveness of robotic animals for improving the psychological wellbeing and quality of life of residents in long-term care.

Secondary objectives of this review are:

• to assess whether the effectiveness of robotic animals differs on residents’ social interactions, functional activity, physical health and medication;
• to assess whether there are adverse effects (for residents or care home staff) of robotic animals in long-term care;
• to extend the review of the evidence to explore the qualitative experience of robotic animals from the perspective of residents, carers and care home staff.

Research Questions

What are the impacts (short-term and long-term) of robopets on the health and wellbeing, medication use, and quality of life of older people living in residential/nursing care?

• Are robopets effective in improving resident health and wellbeing? (evidence from randomised controlled trials)
• What are residents’ (including those with dementia) experiences of interacting with robopets? (evidence from the qualitative studies)
• What are the views of residential care staff on the use of robopets on residents and on life in the care home in general? (evidence from qualitative studies)
• What challenges of involving robopets in care homes are faced by residents, families/carers and care home staff? (evidence from quantitative and qualitative studies)
• Are any adverse events associated with the use of robopets in care homes? (evidence from quantitative and qualitative studies)

Project outputs and impact

The systematic review, published in the International Journal of Older People Nursing, brought together evidence from 19 studies involving 900 care home residents and staff and family members. We have also prepared a Briefing Paper that summarises the findings in an easy-to-read format.

Lead author Dr Rebecca Abbott, from the University of Exeter Medical School, said:

“Although not every care home resident may choose to interact with robopets, for those who do, they appear to offer many benefits. Some of these are around stimulating conversations or triggering memories of their own pets or past experiences, and there is also the comfort of touching or interacting with the robopet itself. The joy of having something to care for was a strong finding across many of the studies.”

Five different robopets were used in the studies – Necoro and Justocat (cats), Aibo (a dog), Cuddler (a bear) and Paro (a baby seal). Some of the studies were on older people’s experiences of interacting with the robopets, while others sought to measure impact on factors such as agitation, loneliness and social interaction.

However, the research showed that not everyone liked robopets, and suggested that specific staff training around best use may help residents get the most out of their robopet. Knowing whether someone likes animals, or previously had a pet of their own, is also likely to impact on how much they might engage with a robopet.

Co-author Dr Noreen Orr said:

“It is not always possible to have a cat or a dog come into a care home, so robopets can offer a good alternative. Of course robopets are no substitute for human interaction, but our research shows that for those who choose to engage with them, they can have a range of benefits. A new wave of more affordable robopets may make them more accessible to care homes.”

Future work should examine whether the benefits are short-term or sustained over time.

In the news

The publication of the review lead to much interest from the media including from The Times,
The Daily Mail,  INews,  BBC Radio Devon and Scotland and Care Home UK

Acknowledgements

Re-use of related publications is permitted “under the Creative Commons Attribution-ShareAlike License (CC-BY-SA), version 3.0