On episode 737 of the popular podcast This American Life from WBZ in Chicago, Cecilia Brown chronicled the poignant but sad story of her grandmother, Dee Brown, who lived in assisted living when the coronavirus pandemic hit.
She says at the beginning of the podcast, which is a collection of recorded phone calls with her grandmother, “Dee had dementia, but it was pretty mild. She’d forget small things like where I lived, tell me stories she told me before. But she was still pretty with it.”
The first phone calls are playful and a substitution — a substitution for in-person interaction as visitors were not allowed in the facility that Dee and so many of America’s seniors lived in.
The Brown family had devised a schedule of who would call Dee each day to give her some semblance of companionship. It helped keep her mind occupied because isolation is particularly difficult for people with dementia. The brain is a muscle that must be used to maintain it.
Brown’s phone calls with her grandmother grew sadder and harder. Dee started to lose track of whom she was talking to. She forgot what she was doing and lost the ability to make sense of her life. By the time national policymakers realized how burdensome isolation had become on seniors with dementia or Alzheimers, it was too late for Dee.
“By a few months into the pandemic, the toll of isolation on people with dementia was clear. Medical examiners started listing social isolation related to COVID-19 restrictions as a cause of death for people in long-term care centers,” Cecilia wrote. “Someone from the Alzheimer’s Association told me people with dementia have been wandering more, that maybe they’re looking for the people who no longer visit. Dee started doing this, too, opening people’s doors in the middle of the night.”
By September of 2020, five months into the pandemic, the Centers for Medicare and Medicaid Services realized they had made a mistake. They started allowing visitors for patients that really needed them to survive, for people in emotional distress.
Cecilia Brown’s podcast about her grandmother ends this way: ”But that change in guidelines came too late for her. Dee died just a few weeks before it, on August 18. She died alone. I ended up deciding to record one last call with Dee in late July, a couple of weeks before she died. It was the last time we ever spoke.”
Cecilia Brown saw first-hand how difficult isolation can be on seniors — all seniors, much less the ones with a crippling diagnosis like dementia. The Centers for Disease Control, in fact, reports that isolated seniors are at a 50 percent greater risk of suffering from dementia, and added that isolation increases the likelihood of suffering a premature death from all causes.
Good news abounds, though, for those whose fight continues. It comes in the form of animatronic pets — i.e., machine companions.
As noted in a recent issue of the New Yorker, 20,000 robotic pets have been given to seniors in 21 states who long for companionship — and anything to keep their brain sharp, to keep that muscle working.
Loneliness is itself an epidemic, and the seminal question around the use of robots is how well they fill the void of what they are replacing — priceless human interaction.
As Sigal Samuel wrote for Vox in December 2020:
“Some particularly well-designed robots, like Paro, have also been shown to increase human-to-human interaction among nursing home residents and between seniors and their kids. It gives them something positive to focus on and talk about together.”
Researchers have realized just how significantly this research can pay for itself. Social isolation and loneliness adds $7 billion each year to the cost of Medicare because isolated individuals show up to hospitals more frequently for longer stays.
The New Yorker chronicled the success of these animatronic pets and offered this example of how one senior interacts with their pet named ElliQ.
“Shortly after we began speaking, ElliQ asked if it could tell us an “interesting fact.” A lemon, it said, contains more grams of sugar than a strawberry does. Then Deanna asked for a poem. ElliQ paused for a moment, before reciting a short verse by Emily Dickinson, on the theme of hope. Deanna said the robot was good at making her smile. Maybe that wasn’t intimacy, but it didn’t feel like solitude, either.”
In most cases, seniors cannot trick their minds into believing these robots are a total replacement for human interaction, but that might not be the goal. Rather, the goal is to help what ails them by bridging a gap.
The key for successful “gap-filling” between human interactions is to have the artificial intelligence equipped to carry on open-ended conversations or communication. Even those short bursts of conversation are enough to keep the mind stimulated and working.
As Irene Papadopoulos, a professor at Middlesex University posits:
“No-one is talking about replacing humans – the evaluation demonstrates that we are a long way from doing that – but it also reveals that robots could support existing care systems.”
Use of these robots for between 5-10 hours per week saw a discernible improvement in their mental health.
Development of these robots is costly, but their spread over the last few years suggests their prevalence will continue to grow. Dee Brown could have used one. Countless others can as well.
Joel Landau is founder and chairman of The Allure Group, a network of six New York City-based nursing homes.
Joel Landau, is founder and chairman of The Allure Group, a network of six New York City-based nursing homes.