Let healthcare workers have a say in robot-application in healthcare
Technology is one of the answers to the challenge in healthcare, but despite many pilots, the introduction of technology seems to be continuously stranded. Even video care, which took off during the pandemic, has subsided again. Nevertheless, there is a good chance of success, says Teatske van der Zijpp, lecturer in 'Person-centeredness in an aging society', provided we use technology in a way that suits the needs of the end users and does not get in the way of personal control.
Relational image of people vs. self-reliance
The government has a challenge to fill the shortage in care. Policy documents emphasize self-reliance alongside self-management and replacing care with technology, but van der Zijpp doubts that this is the way forward: "There is a lot of talk about self-reliance, but this is not feasible for everyone. I believe in a relational view of people, in which we are aware of our interdependence with each other. This fits in with a holistic view of care. For example, you can use an electronic medication dispenser to save care hours, but if the patient subsequently becomes lonely because of the loss of that contact and develops new health problems, the effect is not positive. Healthcare professionals therefore look at that demand for care holistically, not task-oriented. Whatever you deploy in terms of technology, it must be an extension of that. Also, as far as I'm concerned, technology is only a solution if it supports 'caring together' whereby (in)formal networks are also involved in care."
This is exactly where it often goes wrong, says van der Zijpp. Technology is used, but does not always fits the job or everyone's needs: "For the care provider, technology is often something on top of the existing workload which, initially, creates more work. So we try to approach that reality and examine where things are not going well. How is the primary process where care supply meets care demand affected? Is the utility of the technology being seen? Is the care worker being 'unburdened' when it comes to the technical aspects of the tools being used? There is often a lack of support, for example if such a medication dispenser gets stuck. That's what we're trying to get clear in our research." Moreover, technology has a limited application, van der Zijpp emphasizes: "If you deploy a robot to help a person with dementia with a daily structure, then there comes a point when that robot no longer helps. Care staff must then not only be flexible with the technology, but also agile and able to act when adjustment is needed. So there are no one-size-fits-all solutions."
The use of technology must therefore be person-oriented; it must allow the user to maintain autonomy and control, not feel like it has been imposed on them. That is why it is important to not only view the use from a financial, strategic or technological perspective. The users are necessary for a successful development and implementation. Not just the care users, but also the care givers: "The care worker knows the practice and can see where the added value lies. Moreover, you can find out in conversation whether technology is profitable in certain cases. Robots are good at repetitive tasks and heavy work, let's use them for that. Suppose you could make a robot that does all the registration, so that a care employee's hands would be free. The use of technology can offer a lot, but as far as I'm concerned it should not get in the way of the autonomy of the patient and caregiver."
Social robots as connectors
Former student and care innovator Teun Toebes recently voiced criticism of the use of a robotic cat for patients with dementia. This could lead to a deterioration in care and possibly even contribute to stigmatization of the patient. And wouldn't a real dog or cat be better? Van der Zijpp is optimistic about care robots such as these: "In my view, this is a care innovation that makes something possible that was not possible before, and that provides real added value. You can't take a real cat or dog in at any time, but these you can." Van der Zijpp understands the criticism that a robot cat has a certain stigma: "We certainly have to weigh up that, and that is also a nursing task. Care robots in private spheres are already accepted, such as sleep robots, so perhaps this use will also normalize. We can also explore where a robotic cat might support personal contact between patient and family. The robot then becomes a connector, where otherwise the grandchildren might stay away.
How to proceed?
So there is a lot of potential, but there are also many steps that still need to be taken. Van der Zijpp suggests that we pay a lot of attention to proven technology and its implementation, so that we can get it right: "If it doesn't do the job currently, we should first look at how we can fix it. We have to look at the actual needs for care and the available supply of care to find the opportunities where robots can actually contribute and improve the process. Technicians know what is possible and care personnel know the practice, so in dialogue we should be able to make things happen."
'Robots in Healthcare' is one of the central themes within ICT in Practice, the annual showcase event for applied research within Fontys ICT. Within this theme there is frequent collaboration with the field and other lectorates and researchers.
Teatske van der Zijpp is connected to Fontys University of Applied Sciences People and Health as Lector technology in the lectorate 'Person-centeredness in an aging society'. On September 8, she will give her lecture together with Pieterbas Lalleman. There are still places available, register here.