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 Largest Efficacy Experiment On Robotic Animal For Patients With Dementia Underway

Cyberfriends may not be too far off in the distant future for patients with dementia. But research and ethical questions around their use remain.
 
Enter PARO, a robotic seven-pound baby harp seal that is a $6,000 medical device currently being tested with patients. The largest efficacy study to date on this robot is underway in Australia, with its protocol published this month in BMJ Open.
 
People with dementia make up half of all nursing care center residents and more than 40 percent of assisted living residents, according to the American Health Care Association.
 
Robotic pets’ lifelike behavior and presence enable patients to use their other senses (sight, touch) and may have a calming effect, just like real pets, researchers said. PARO, created in 2004, was intentionally designed as a seal to remove any negative associations patients may have had with cats or dogs—or even robots, according to lead author Wendy Moyle, RN, DipAppSci, BN, MHSc, PhD, director of health practice innovation at Griffith University, Brisbane, Queensland, Australia. She added that the robot was given enough girth and weight to mimic an infant, which may illicit positive associations for those who are parents.
 
These simulated seals sense touch, light, sound, temperature, and posture. Made of antibacterial fur, they shake when stroked, are warm to the touch, and suck on a charger shaped like a pacifier. They show emotion (happiness, anger, surprise) and adapt to the user, performing actions that result in petting.
Critics of this device cite ethical concerns, such as tricking the patients into believing that the robot is real. They also worry that the pet infantilizes people and demeans their dignity.
 
A 2013 pilot study published in the Journal of Gerontological Nursing and conducted by the same authors and German researchers found “a positive, clinically meaningful influence on quality of life and increased levels of pleasure and also reduced displays of anxiety.”
 
Yet this study and a handful of other previous studies have been criticized for using too small a sample size to stand scientific rigor. The latest study, which started in June 2014, will ultimately enroll 380 adults with dementia and involve 35 Australian accredited long term care facilities having 60 or more beds.
 
The patients will be randomized into three treatment groups: PARO (robotic animal), plush toy (non-robotic PARO), or usual care (control). For 10 weeks, patients in the first two groups will interact with PARO or the plush animal for three individual 15-minute sessions. The research team will videotape these interactions and monitor for improvement in agitation, mood states, and engagement. The researchers will also measure other factors such as sleep duration, step count, change in psychotropic drug use, change in treatment costs, and staff and family feelings toward PARO or the plush toy.
 
Jackie Oberst is Provider’s managing editor. Email her at joberst@providermagazine.com. Follow the magazine on Twitter @ProviderMag and @ProviderMyers.
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