Care bots are on the rise and replacing human caregivers
If you Google “care bots”, you’ll see an army of robot butlers and nurses, taking vital signs in hospitals, handing red roses to patients, serving juice to the elderly. For the most part these are just sci-fi fantasies. The care bots that already exist come in a different guise.
The Elder care assistive robots market is anticipated to secure a CAGR (Compound Annual Growth Rate) of 12.2% during the forecast period. The market is valued at USD 2.2 Billion in 2022 and is likely to be valued at USD 7.1 Billion by 2032. - Future Market Insights
These care bots look less like robots and more like invisible pieces of code, webcams and algorithms. They can control who gets what test at the doctor’s office or how many care hours are received by a person on Medicaid. And they’re everywhere. Increasingly, human caregivers work through and alongside automated systems that set forth recommendations, manage and surveil their labor, and allocate resources.
They are emerging because the US has chronically underinvested in care infrastructure, relying heavily on informal family support and an industry sustained by poorly paid workers – largely immigrants and women of color. These workers have a median annual salary of $25,000, and nearly a quarter of the workforce lives below the federal poverty line. Yet, demand for their labor is set to soar. In the United States, more than 50 million people are over the age of 65, and this number is expected to nearly double by 2060. The question looms: who will care for them?
There is a growing faith that tech can fill this gap by rapidly building care systems at scale, with the help of artificial intelligence and remote monitoring. Exhausted and understaffed nursing home workers could have sensors and webcams to help them keep tabs on residents’ health and wellbeing. The growing “AgeTech” industry could help seniors age in place in the comfort of their homes.
As the Guardian reports, for example, a company called CarePredict has produced a watch-like device that alerts carers if repetitive eating motions are not detected as expected, and one of its patents notes it can infer whether someone is “using the toilet”. Another firm has created technology that observes when someone fell asleep and whether they bathed.
Some of the uses of care tech are valid and valuable. But these tools may also conceal human costs.
Automated decision-making and AI can undermine the autonomy of the very people these systems are intended to help. In-home cameras, facial recognition systems, wearable movement trackers and risk prediction models can lead to elderly and disabled people feeling forced to turn their houses into nursing homes. This undercuts the focus on dignity and self-determination central to independent living and community-based care.
Automated decision systems can also reinforce policies that treat the poor, the elderly, disabled, the immuno-compromised and communities of color as disposable. Within healthcare, technology is increasingly used to screen patients, direct nurses’ attention and support clinical judgments. But these systems often reproduce – and even worsen – bias, because the data they use reflect inequities already embedded in healthcare. For example, Zaid Obermeyer and his colleagues reported in Science in 2019 that a system used to allocate healthcare to 200 million people a year in hospitals across America dramatically underestimated the medical needs of African Americans.
In some states, governments have adopted automated decision-making tools to assess eligibility for Medicaid services, often without much public debate and little transparency over how decisions are made. For example, an algorithm in Arkansas was intended to more fairly distribute hours of care allocated to people receiving home- and community-based services. But it faced a wave of scrutiny for drastically cutting hours for people who rely on personal care assistants for basic activities of daily living such as bathing, eating and going to the bathroom.
Surveillance in the name of care brings up uneasy questions about the privacy and autonomy of those who need support. Technologies like Electronic Visit Verification (EVV) were introduced to monitor provision of care inside homes using features like GPS location tracking, but they have left disabled and elderly service recipients and their workers feeling like they’re shackled to an ankle monitor.
Many efforts to build care bots are motivated by a genuine desire to mend fissures in a strained and fragmented system. The devastation wrought by the Covid pandemic made our need for better care clear, not just in hospitals and clinics, but in our homes, schools and streets. As National Domestic Workers Alliance director, Ai-jen Poo, has urged us to acknowledge, the care industry was a “house of cards on the point of collapse” long before the pandemic.
The pandemic and decades of grassroots organizing have encouraged the Biden administration to focus on investing in care jobs, provoking a new public conversation about care as critical public infrastructure. The Biden plan proposes investing $400bn to provide seniors healthcare and personal care services at home. While the plan usefully puts significant public investment at the heart of a revitalized care system, it does not reconcile the thornier issues – surveillance, eroding autonomy and bias – that accompany the government’s inevitable reliance on technologies of care management.
The care bots are already here. But their incursions don’t have to lead to techno-dystopia. Our future visions for a caring society must be built on a foundation of justice and equity, dignity and autonomy, not just efficiency and scale. The most essential aspects of caring for one another – presence, compassion, connection – are not always easy, or even possible, to measure. The rise of the care bots risks creating a system where we only value the parts of care that can be turned into data.
These care bots look less like robots and more like invisible pieces of code, webcams and algorithms. They can control who gets what test at the doctor’s office or how many care hours are received by a person on Medicaid. And they’re everywhere. Increasingly, human caregivers work through and alongside automated systems that set forth recommendations, manage and surveil their labor, and allocate resources.
They are emerging because the US has chronically underinvested in care infrastructure, relying heavily on informal family support and an industry sustained by poorly paid workers – largely immigrants and women of color. These workers have a median annual salary of $25,000, and nearly a quarter of the workforce lives below the federal poverty line. Yet, demand for their labor is set to soar. In the United States, more than 50 million people are over the age of 65, and this number is expected to nearly double by 2060. The question looms: who will care for them?
There is a growing faith that tech can fill this gap by rapidly building care systems at scale, with the help of artificial intelligence and remote monitoring. Exhausted and understaffed nursing home workers could have sensors and webcams to help them keep tabs on residents’ health and wellbeing. The growing “AgeTech” industry could help seniors age in place in the comfort of their homes.
As the Guardian reports, for example, a company called CarePredict has produced a watch-like device that alerts carers if repetitive eating motions are not detected as expected, and one of its patents notes it can infer whether someone is “using the toilet”. Another firm has created technology that observes when someone fell asleep and whether they bathed.
Some of the uses of care tech are valid and valuable. But these tools may also conceal human costs.
Automated decision-making and AI can undermine the autonomy of the very people these systems are intended to help. In-home cameras, facial recognition systems, wearable movement trackers and risk prediction models can lead to elderly and disabled people feeling forced to turn their houses into nursing homes. This undercuts the focus on dignity and self-determination central to independent living and community-based care.
Automated decision systems can also reinforce policies that treat the poor, the elderly, disabled, the immuno-compromised and communities of color as disposable. Within healthcare, technology is increasingly used to screen patients, direct nurses’ attention and support clinical judgments. But these systems often reproduce – and even worsen – bias, because the data they use reflect inequities already embedded in healthcare. For example, Zaid Obermeyer and his colleagues reported in Science in 2019 that a system used to allocate healthcare to 200 million people a year in hospitals across America dramatically underestimated the medical needs of African Americans.
In some states, governments have adopted automated decision-making tools to assess eligibility for Medicaid services, often without much public debate and little transparency over how decisions are made. For example, an algorithm in Arkansas was intended to more fairly distribute hours of care allocated to people receiving home- and community-based services. But it faced a wave of scrutiny for drastically cutting hours for people who rely on personal care assistants for basic activities of daily living such as bathing, eating and going to the bathroom.
Surveillance in the name of care brings up uneasy questions about the privacy and autonomy of those who need support. Technologies like Electronic Visit Verification (EVV) were introduced to monitor provision of care inside homes using features like GPS location tracking, but they have left disabled and elderly service recipients and their workers feeling like they’re shackled to an ankle monitor.
Many efforts to build care bots are motivated by a genuine desire to mend fissures in a strained and fragmented system. The devastation wrought by the Covid pandemic made our need for better care clear, not just in hospitals and clinics, but in our homes, schools and streets. As National Domestic Workers Alliance director, Ai-jen Poo, has urged us to acknowledge, the care industry was a “house of cards on the point of collapse” long before the pandemic.
The pandemic and decades of grassroots organizing have encouraged the Biden administration to focus on investing in care jobs, provoking a new public conversation about care as critical public infrastructure. The Biden plan proposes investing $400bn to provide seniors healthcare and personal care services at home. While the plan usefully puts significant public investment at the heart of a revitalized care system, it does not reconcile the thornier issues – surveillance, eroding autonomy and bias – that accompany the government’s inevitable reliance on technologies of care management.
The care bots are already here. But their incursions don’t have to lead to techno-dystopia. Our future visions for a caring society must be built on a foundation of justice and equity, dignity and autonomy, not just efficiency and scale. The most essential aspects of caring for one another – presence, compassion, connection – are not always easy, or even possible, to measure. The rise of the care bots risks creating a system where we only value the parts of care that can be turned into data.
Read more articles related to Elder Care: Elder Care Series
.png)
Comments
Post a Comment