Tech Won't Save Us - Robots Aren’t the Solution to Elder Care w/ James Wright

Episode Date: March 16, 2023

Paris Marx is joined by James Wright to discuss Japan’s efforts to develop robots to care for its growing elderly population, what the government hoped to achieve with that plan, and why it hasn’t worked out as planned.James Wright is a research associate with Turning Institute and a visiting lecturer at Queen Mary University of London. He’s also the author of Robots Won’t Save Japan. You can follow James on Twitter at @jms_wright.Tech Won’t Save Us offers a critical perspective on tech, its worldview, and wider society with the goal of inspiring people to demand better tech and a better world. Follow the podcast (@techwontsaveus) and host Paris Marx (@parismarx) on Twitter, and support the show on Patreon.The podcast is produced by Eric Wickham and part of the Harbinger Media Network.Also mentioned in this episode:Paris is visiting New Zealand and doing a number of events through the latter half of March. Find all the dates and details here.James wrote about Japan’s efforts to automate elder care for MIT Tech Review.Jennifer Robertson spoke about the gendering of robots to cement conservative gender norms.Support the show

There is this danger that if you just see care as a series of individual tasks, you just have this really flattened vision or view of what care is, where all of the meanings, motivations, you know, values attached to care are just erased. And you end up with just a series of physical actions or speech actions. And care workers and care recipients are just reduced to kind of two-dimensional characters. Hello and welcome to Tech Won't Save Us. I'm your host, Paris Marks, and this week my guest is James Wright. James is the author of Robots Won't Save Japan and a research associate at the Turing Institute. He's also a visiting lecturer at Queen Mary University of London. Before we get into this week's episode, just a quick update. If you are in New Zealand, I will be there starting this week as you listen to this. I'll be doing some events around the country.

So on March 17th, I will be in Auckland. March 21st, I'll be doing an event in Dunedin. March 22nd in Christchurch. March 28th in Wellington. And then once again, I'll be back in Auckland on March 30th for another event, which will be in the evening because the earlier one will be in the afternoon. So if you are in New Zealand, feel free to come out and see me while I'm in the country. You can find more information on the events in the show notes. Now, I really wanted to have James on the show because when I saw that he had written a book about robots in Japan, and in particular robots in elder care in Japan, you know, my mind immediately flashed back to the mid 2010s, when we were having all of these discussions about how automation was going to

eliminate all these jobs, and it was going to hit so many sectors of the economy, and all of these drivers were going to lose their jobs to self driving cars. And one of the other kind of major industries that were being talked about at that point was how, you know, care workers were going to lose jobs to all these robots in care homes and other kind of care professions, things like the pepper robot or Robear, which was going to kind of lift up elderly people and all these other robots that were proposed for, you know, various sectors of the economy, basically. And what we all know is that that never really came to pass. And so I was really interested in digging into this further with James to understand, you know, how these narratives came about, how roboticization has actually worked in the elder care industry in Japan, where, of course, their kind of demographic crisis is further along than ours here in Europe or North America. And also to see how that kind of gives us a reality check for these broader narratives that we still have around robots being used in care and elder care. And, you know, what that tells us about how we really need to respond to these problems

if robots are not going to be our silver bullet quick fix that some people imagine they will be. There are just a bunch of fascinating details in this conversation. So I hope that you enjoy it. I certainly did, you know, getting to explore these topics that have been of interest to me for quite a long time. Maybe you were following that as well.

You know, even if not, I still think that you will find this conversation really fascinating. And so with that said, if you do enjoy my conversation with James, make sure to leave a five-star review on Apple Podcasts or spotify you can also share it on social media or with any friends or colleagues who you think would learn from it and if you do want to support the work that goes into making these shows every week so i can keep having critical discussions with people

like james you can join supporters like if eddie in the united states sam in golden colorado and michael from newcastle in the uk by going to patreon.com slash techwon'tsaveus and becoming a supporter. Thanks so much and enjoy this week's conversation. James, welcome to Tech Won't Save Us. Thanks so much for having me on and I'm a huge fan of the podcast. Thank you. You know, the listeners will be like, oh my god, another person who's a fan of the show coming on as a guest. Paris does this all the time. Paris just wants to get praise from people. But, you know, I'm having you on the show, not because you told me you're a big fan of the show, but because you have this new book called Robots Won't Save Japan, which I think is really insightful, especially when we think about some

of the narratives that we've had around elder care and narratives that still, you know, reemerge because this is kind of a live issue that is certainly becoming something that is more in the public discourse in the West in recent years, you know, as we're looking at trends in demographics and things like that and concerns around having enough labor to take care of old people and all these sorts of questions that are kind of constantly being discussed. And so I thought it would be great to have you on to talk about what you learned in looking at Japan, which is this country that is kind of ahead of everyone else on that kind of demographic curve, to see, you know, what we can look forward to and what we can learn, of course, as we seek to respond to

these issues and not be blinded by kind of techno-solutionism as we're trying to think of how we're going to approach that. And so, you know, as I'm saying there, I want to start by getting an idea of why this is an issue in the first place. So why, when we look at Japan, but also, you know, beyond that over here as well, do we see elder care as such a big issue? Yeah, no, I think that really gets to the heart of a lot of the framing of the techno-solutionism, like you said, in Japan, but also in the EU, or in other countries in the UK. And I mean, in the case of Japan, specifically, the kind of demographic situation and the care crisis, always used to introduce pretty much any media article or academic work about care robots or other care technologies. So I think it's really

great to kind of dig into it and to try and understand, you know, where that framing comes from and, you know, how accurate is it and what work is it trying to do? It's pretty well known, like you said, that Japan has like one of the oldest national populations. Currently, it's about 30% of the population are aged over 65. And that's expected to reach 40% by 2050. At the same time, you know, the total fertility rate is well below the population replacement level. And it has been for many years now. So Japan's overall population has started to shrink with a smaller proportion of children and young people. And at the same time, you know, alongside the demographic picture, there's already a shortage of thousands of care workers.

So the most recent estimate that I've seen is that the shortfall is expected to reach almost quarter of a million people by 2025. I mean, that's just like two years away. So we have this sort of narrative that Japan's population is old, it's getting older, the care demands are already heavy, they'll continue to rise, and that there just aren't enough young people to provide, you know, the required amount of care. And so that becomes a logical argument. Okay, so if that's the case, we need some kind of solution that doesn't involve people and that technology and in the case of Japan specifically, robots could be, you know, the best solution to this kind of care crisis. But when we look at it in a bit more detail and start to unpick some of that sometimes,

you know, simplistic narrative that the, you know, the aging population just equals too many old people and not enough young people to provide care. Actually, you know, there are specific reasons why there is this, you know, shortfall of care workers. So one is that Japan introduced a new care system, the long-term care insurance system in 2000, which is a universal care insurance system. So everybody over the age of 40 pays a premium. And then once they reach 65, if they require some kind of care service, they would pay a copay of, you know, means adjusted between 10 and 30%. And the rest of the costs would be covered by the insurance system. So in some ways, that was great, because it kind of socialized the cost of elder care. But at the same time, it was like

the government saying we're now responsible for elder care. And what that meant is that a lot of informal carers provided less care, more people were using formal care services, more women, especially who would have been informal carers, went into work. The really interesting thing is that since the year 2000, Japan's population has fallen. The number of people of working age has fallen, but the number of people in work has risen. And part of the reason is because more women have entered the workforce, partly as a result of the care insurance system. That's fascinating, right? Because I guess what you're saying is that, you know, before this system came in, the way that most elderly people would be taken care of is it was kind of informally, you might have like the daughter or, you know, the husband's wife kind of

taking care of the parents sort of a deal. It was not something that was kind of in the formal economy, but was something that was just kind of happening as kind of social relationships, familial relationships. And then this new policy comes in from the Japanese government that, you know, kind of creates more of a public system for elder care, which then, you know, requires workers to go into the system, requires the construction of more of these care homes, but also allows women to go into the workforce. So you have more of like, you know, getting them into the formal economy more so. But then that also has implications for, you know, how this all works, the need for labor in order to make this work. And I believe you say a number of women who then kind of go into the workforce also then go into the care workforce. So, you know, they're kind of

just moving formally in that way. Exactly. But not enough. So I think part of the expectation was when the long-term care insurance system was implemented, that all of these women who are providing informal care would become paid care workers. But that's not really what happened because although the number of paid care workers has been increasing year one year, every year, it hasn't made up, I think, for that shortfall in the loss, perhaps, of some informal care. And, you know, the reasons for that are that care work in Japan, like many other places, is really badly paid. I mean, it's often paid at minimum wage level. It can be extremely

physically and emotionally demanding. It's not particularly valued in society, seen as kind of unskilled. And so it's not really been a particularly attractive, necessarily, industry for people to go into. No, and I think that's really important to understand. And I'm sure won't be a surprise to any listeners in North America or the EU to hear about how care workers are treated and the expectations in that kind of an industry, right? One of the things that we often see is, especially in industries that are more feminized, that the labor standards and the expectations of pay and stuff are lower because that's how it's kind of been treated in our societies. I'm wondering, before we move on to talking about how you saw these robots kind of implemented in these care

homes and, you know, how they were developed and things like that, why is the Japanese government in particular looking at kind of a policy framework and a policy approach that encourages roboticization of elder care rather than, you know know any number of other approaches to it i guess it helps to give like a very general kind of framing of the current political situation in japan where it's come from so the liberal democratic party is in power and it has been for most of the post world war ii period it's conservative in recent, there's been a kind of general aversion to immigration. So there have been migrant workers coming to Japan, but in relatively small numbers compared to countries in Europe or North America. And so part of this political motivation for focusing on robots has been an aversion to having migrant care workers come in to do care work, which has happened in Europe, for instance. by adopting robotic solutions for care, you could boost Japan's robotics industry,

create this massive, potentially massive export market to have Japanese care robots sent around the world to all of these other aging populations. And at the same time, potentially solving the problem of care in Japan itself. There's this anthropologist of Japan, Jennifer Robertson, who just summed it up really well. She talked about part of the policy around kind of humanoid robots being about retro tech, so advanced technology in the service of traditionalism. So, you know, she was looking specifically at humanoid robots in Japan, but how these apparently very technologically sophisticated devices actually end up reinforcing very gendered, ableist, and racialized stereotypes and traditional views of the family, harking back nostalgically to this golden era of

Japanese post-war economic growth driven by industrial technologies. That's fascinating. It almost makes you think of like the Jetsons, you know, the robots are in there, but everything's still very, you know, traditional, patriarchal, stuff like that. Absolutely. So in 2007, under Shinzo Abe during his first term as prime minister, the Japanese government published a document called Innovation 25, which imagined what Japan would look like in the year 2025 with all of these like high-tech devices, including robots. And it definitely kind of evokes that kind of Jetsons 1950s futurism.

And actually it was later published as a kind of manga comic book in Japan so that people could see the future. Although I do have to admit, you know, with COVID and with a lot of remote learning and like telehealth and everything, it's not actually that far from what has actually happened. But yeah, so there's this idea of the government looking to the future, what the future should look like, often in, you know, in quite a socially conservative way, but imagining really sophisticated technologies. The idea that you could develop care robots grew, I think, in the 2010s. And actually in 2009, there was a major kind of government funded research project, a four year research project to develop an international standard ISO 13482 for personal care robots. And that was really kind of laying the foundation and saying, okay, if we're going to have care robots, so first,

we're going to start by establishing a standard for safety. That was followed in 2013 by another four-year project, which was aimed at funding actually the research if we have any knowledge of Japan from the West, it's knowing that it has these big kind of electronics companies like Sony or SoftBank or, you know, whoever, who are making these products, you know, we're familiar with that kind of history for Japan. So the idea that, you know, it's going to make these robots for us, and this is going to be part of the future of their kind of economy, just kind of makes sense, right? right kind of theoretically that they would be working on these things and that these are the types of products that they're going to deploy for us because they've had these robots for so long and you know whatever i think another piece that's really interesting there is you talk about the standards right and one thing that you mention in the book is that there's kind of

a debate or a fight around standards because this is going to be really important to define what the future of these kind of elder care robots might be, where Japan and Germany are kind of on one side of this and want one type of standard because they are really advanced in robotics and whatnot and want to keep control of that market. And then on the other hand, you have China and South Korea that are more trying to get into this market, that are more trying to sell more of these things, and they want a completely different standard. And so there's this kind of fight over what this is going to look like and thus who is going to win out, right? Will the Germans and Japanese kind of protect their market share and their control over this market? Or will the Chinese and South Koreans be able to work their way in by pushing a different type of standard? Yeah, absolutely. That was very much a kind of mindset when I was starting out my fieldwork research. I spent three months with the National Institute of Advanced Industrial Science and Technology. They were kind of

administering this big robot care development project but yeah they saw standards as really important strategically actually i mean my book is called robots won't save japan and part of the inspiration for that title is the fact that there are not one but two previous books in japanese with the title robots will save japan I mean, that kind of like speaks to the huge amount of confidence and this idea that robots would solve all of Japan's problems. its market share in producing electronics to China and Southeast Asian and other East Asian countries, in part because they've been played by the global standards kind of framework, the way it's worked, the organizations, and that they hadn't managed to use this system, this global system of standards in order to protect their market share. And so it had all been lost. And so, you know, that book had highlighted why it was really important for Japan to engage proactively in standards diplomacy

to ensure, you know, things like, you know, robots specifically, which Japan had a big head start in, could be protected into the future as their most important future industry. So, I mean, it sounds kind of very technical, but it's really important to my interlocutors and the people that I was doing my research with. No, definitely. Like, it's certainly an aspect of this that you wouldn't expect to be something that is important. But, you know, setting these standards is actually incredibly important. And, you know, the Chinese in particular have been working hard in recent years in order to set and control some more of the standards that are being set internationally, because that will

help their market share and, you know, what they expect their companies and what have you in the way that the West and the United States have kind of set a lot of those standards in the past for their own benefit, right? So I want to move on to talking about these robots in particular. And I think the best place to start, and it's where you look in the book, is actually where these robots are developed, right? Because you went and spoke to some of these developers who were working on creating these types of robots. What were the things you found that were driving them? And what did you find surprising about going to these places where these robots are actually being kind of created

that maybe you didn't expect to see with their development? Yeah, sure. So like I said, I spent a few months with robotics engineers and programmers at this National Institute. They weren't actually developing robots themselves directly. They were administering this big funding project and they were helping private companies that were actually doing the development work. So these engineers were helping these private companies in a variety of different ways. So producing tools to help them, doing kind of project management, managing kind of stage gates in the production process or the development process, and also helping them to test their robots, a large robot safety testing center that had been

built as part of this earlier project to certify robots to the ISO standard. But seeing their work, I kind of got a sense of how they were approaching care as a kind of engineering problem. I kind of talk about how they have this kind of algorithmic view of care. So they see care as this kind of series of individual tasks, which could be logistical actions like moving somebody, you know, you move, you push somebody in a wheelchair from point A to point B, or cleaning somebody, or feeding somebody, moving bodies through space, speech actions, you know, communicating with somebody is an action. And then trying to figure out how all of these individual tasks could be done by robots. During the time that I was there, over three months, there was only one time where I was aware of that the engineers actually visited a care home and interacted with the presumed end users of these robotic devices. And there was very little interaction between the engineers on the one hand and, you know, older adult residents

of a care home on the other. So there is this danger that if you just see care as a series of individual tasks, you just have this really flattened vision or view of what care is, where all of the meanings, motivations, you know, values attached to care are just erased, and you end up with just a series of physical actions or speech actions. And care workers and care recipients are just reduced to kind of two-dimensional characters. I think it's such an important observation about how this all worked, right? Because one of the other things that you mentioned as well, like beyond, you know, being at the offices of this institute, it was how when, you know, some of the people who made these robots went and visited the care home, You know, they wouldn't talk to residents.

They weren't really interested in talking to many of the kind of care staff. I think you said they only spoke to like the male staff as well or like had a meeting with only them, which shows like a particular kind of approach to this. Right. And a particular way that they're imagining or or people who they see as important, who they need to speak to, and others who they don't, right? Which is a particular problem that, you know, comes up again and again when we see engineering and how engineering tends to approach some of these problems, right? And kind of the biases in that larger profession. Yeah, absolutely. And it really reminded me of an earlier work, actually, by an anthropologist, Diana Forsyth, who was researching expert systems in the US in the 1980s, 1990s. I just saw so many parallels, you know, in the way that the engineers are so

disconnected from the end users. Inevitably, you have therefore like exactly the same problems coming up, which is that the end users, it turns out, aren't interested in using these technologies, sophisticated technologies that are then developed without their consultation. Yeah, no, it makes perfect sense, right? And so I want to shift to looking at what actually happens in the care homes and how these robots are actually implemented and the real impacts that they have, right? And so I think before we talk about the robots themselves, maybe you can give us an idea of what it's actually like to work in one of these care homes or what these care homes are actually like in Japan. You know, you said that these workers are often underpaid, often women, things like that. But what else did you notice about these

care homes in particular and what it's like to be at one of them? That's a difficult question. It's like a lot. So the care home, which I call Sakura, it's what I translate as a publicly funded care home. So it was residential with, I think it was about 60 residents and about 25 staff. So it had a kind of a daycare center where people could drop their elderly relative on the ground floor for the day to do activities and have meals. And then there was a residential care home on the second and third floor of the building. And in recent years, the long term care insurance system has kind of become more and more expensive. And so the government has started to try and reduce costs and so they've started to tighten the criteria for things like entering a care home so the people who are entering care homes like sakura which is the most common type of care home

in japan have typically like some degree of dementia and quite often have a disability or they're not able to walk they use a wheelchair and so typically it's mainly female residents because for a number of reasons women tend to live longer in japan quite often it's the wife would look after their husband typically typically when they're older. The husband would die and then the wife would go to the care home. Typically, I think the average age was around 88 in this care home in Saqqara. And so, you know, what you have is mainly older women, mainly with fairly severe dementia, with a certain level of disability. And then you have care workers, who most of them were born in Japan, and generally women, although there were

more male care workers, quite often who'd been laid off from manufacturing jobs. And, you know, a couple of younger care workers who'd gone through a vocational school, but that was quite rare. It was mainly older women was probably the main, the main group of care workers. And I kind of describe in the book, a kind of average day, and the days were quite similar, because it's quite regimented in terms of what happens when, you know, meals are served at certain times, everybody eats together. And, you know, I also described in the afternoons, there's a kind of recreation session. There were also volunteer groups coming in and out of obviously, this was before COVID. Yeah, it's very difficult. But I hope that gives a sense.

Absolutely. I think that gives us a good overview of how it actually works, especially for anyone who hasn't, you know, been to a care home themselves and wouldn't actually know how it works. Yeah, just to add, sorry, another really important thing was this constant communications between care workers and residents. So even, you know, if the care worker was brushing, you know, brushing the teeth of the resident or lifting them, because a lot of what all of the lifting was still manual. In Japan, it's quite common still for care workers to manually lift residents rather than using a sling or kind of device. But you know, through all of the care actions, there's this constant kind of building of relationships and through communication. Yeah. Which becomes important when we move on to talking about the robots. Absolutely. Because one of the things that you describe in the book as well is how, you know, a lot of these workers have back issues, right? Because they're doing

a lot of that lifting. They're lifting a lot of these elderly people who can't get up on their own or, you know, have mobility issues, as you're saying, right? And so this becomes one of the many reasons that robots are proposed as a way to kind of help, you know, these workers or relieve some of these labor issues. So when we look at the proposals for robots themselves, you know, you look at three in particular that were tried in this care home. Do you want to explain what those robots were and how they are supposed to work and how they are, you know, theoretically supposed to kind of fit into the day-to-day of the care home? So under the kind of big care robot device development project that I was researching, they had several different kind of categories of care robots.

So lifting devices, mobility aids, monitoring systems, communication robots, and then also toilet and bathing aids to try and cover like the breadth of different care actions, care tasks. So the three robots that I looked at were Hug, which was a lifting robot, a kind of quite boxy looking, very heavy device with a robot arm. So you would kind of maneuver the resident over this robot arm and press a button and the arm would raise and lift the person up and you could then wheel this hug robot around press another button and the person would go down and be lowered onto a chair or wheelchair bed toilet and so the idea was that you know using this this device you wouldn't have to manually lift the resident.

The second robot was Paro, which is a seal-type robot. It looks cute. I mean, it's like a kind of, it's meant to be a seal pup. It has some kind of AI software that enables it to be taught its name. So if you call it by a certain name, after a while, it will respond by crying and barking like a seal and wiggling its tail. And it also has haptic senses, so it responds to touch and it has a temperature control system. So it's a kind of body temperature. And then also the third robot was Pepper, which was this kind of humanoid robot that was used to do recreational exercise sessions

so it would kind of stand at the front of the room and talk to the residents and say you know we're going to have this exercise session and play some music and then model different upper arm exercises upper body exercises that residents would follow along to yeah because pepper doesn't have a lower body either you know the residents do have lower bodies but often they're not kind of in use right because they'd be sitting down and it's more difficult for them to do so especially for the type of people who would be in one of these homes pepper obviously does not have legs you know just a kind of base i should should have mentioned that. Yeah. Yeah. But I feel like if anyone has looked into these robots before or encountered any of them, it's probably Pepper,

right? Because Pepper has been promoted a lot, not just in Japan, but in North America and Europe as well, as, you know, one of these robots that is going to like have this communicative function or do a whole range of things, right? You know, one of the robots that I mentioned to like have this communicative function or do a whole range of things, right? You know, one of the robots that I mentioned to you before we started recording, and that's mentioned in your book, of course, is BroBear, which is another one that was kind of proposed back in the 2010s that was also supposed to be a lifting robot. I remember there was like, this was one of the kind of examples of potential automation that was used frequently in a lot of these discussions in the mid-2010s.

But as you write in the book, this really never went anywhere despite all of the talk that there was around this being one of the potential robots that were going to automate elder care or help to automate elder care. And so what did you find when these robots were trialed in the care home? Because you've discussed to us, you know, what these robots are theoretically to do or what they're kind of set up to do. But in practice, what were they actually doing when they were implemented into the care home? Well, yeah. So if I just go through them, so HUG, which is this lifting robot, you know, you would think that with care workers who suffer from back

pain, and at this care home where I did my research, it was like 80% of the care workers said that they had some kind of back pain. The idea was that, you know, this was like the lowest hanging fruit in terms of care robots. You know, you have a proven technology, you can prove it's safe to use, it's going to reduce injuries and care staff, it's going to improve their working conditions, you know, what could go wrong. But when they actually used this robot, almost immediately, there was such a negative reaction from members of the staff. So they said, you know, this looks scary, the residents aren't going to like it. When they tested it out with some of the residents and started to lift them up,

you know, a couple of people said it was uncomfortable. Other people said it's fine. But the care workers said, you know, they said it's uncomfortable. So, you know, it's not safe to use it. We don't want to use it. And they also talked about how they wanted to care with their own hands, which is quite a kind of an ideal in Japan. The idea that you have this kind of touch is an important aspect of providing care. And they said, you know, using robots with older people is kind of disrespectful of them. You know, these are our elders. We should be respecting them and not just moving them around like a forklift truck, you know, moving goods or something. Yeah. And, you know, I feel like that makes perfect sense, right? Because especially, you know, you have this elderly person, you're taking care of them. You know, I guess that touch

is particularly important, especially when you're in this kind of more institutionalized environment, where you might not get so much of that, you know, because you're not kind of in a home setting or anything. So I think that makes perfect sense. And then you say as well, like, you know, it's not just that this hug robot that can be uncomfortable or people have negative reactions to it. And those negative reactions are not just among the residents, but among some of the staff as well, even just on perceptions of how people might respond to it. You know, they don't really like the idea of using this. But, you know, as you say, like they already have kind of non-robotic solutions that they could be using if they wanted to, things like slings and things like that, that would help with the lifting. But many of them

don't use those either. And so it just seems like ill-prepared to actually suit the realities of what's going on in the home. Yeah, absolutely. And that was a major issue. I mean, once you kind of dig below just the initial kind of reactions to how it looks, it was also the fact that, you know, the spatial arrangement of the care home, the fact that you couldn't just leave Hug out. I mean, you couldn't leave it in the corridor or in somebody's room because somebody could trip over it, they could hurt themselves, like bump into the edges, press the button by mistake. So it always had to be wheeled to the specific person who needed to be lifted. It took some time to put them onto the machine to move them, and then you have to move the robot back to where it's being stored. And this was a common theme with the other robots as well. It wasn't just the case that, you know, they do their action and then they kind of magically go back work, the care workers, which I think sometimes the engineers who

develop the devices didn't really view that as work. I mean, it was an invisible tasks that took additional time for care workers to do. Yeah. And the engineers obviously weren't going into the homes very much to see how these robots were used in practice, as you describe, they were quite detached from the realities of working in or living in a care home. And I think that's quite important as well, right? We know that, especially in these homes where they have to take care of, you said, about 60 residents, you know, there is a certain amount of time that they have for particular tasks. And the question is, do you dedicate that time to wheeling around a robot and setting up a robot? Or, you know, are you using that

to actually spend time the bit of quality time you have with that resident that they are going to appreciate right yeah exactly so one of the other robots paddle was seen as being the most hands-off like easy to use robot so this is the seal cub shaped robot, which, you know, care workers responded really positively to initially. They thought it was really cute. A lot of the residents also found it cute. And they're quite happy to have it there in front of them to touch it, to stroke it. It's very tactile. It has kind of like fake fur, you know, but soft, warm. So, you know, the first few days there was a very positive reaction and actually i mean pador has been developed it was first developed in like 1999 it's been around

for a really long time and the inventor of pador has created like successive versions of pador that have tried to improve you know the design the issue came after a few days when a couple of the residents started to kind of develop an attachment to paddle so one older man would you know pick up paddle and it was put in front of him and figured out that there is a zip underneath and would try and unzip Pador and remove the skin. And, you know, there's a kind of robotic body underneath. Obviously, the care workers felt that that was dangerous. So they had to stop him from interacting with Pador, which was fairly straightforward

because he was in a wheelchair, he was in the corner of the room, so they could just relocate Pador to a different table where he couldn't get to it but another woman she would talk to pador with the other people on her table and then she'd put it onto her lap and wheel herself back to her room and put pador to bed and start talking to it and quite often crying having a really emotional reaction to that, eventually refused to eat meals or to sleep unless Palo was there, you know, beside her. And I mean, other studies of Palo have, although many have been very positive, some of them have found similar kinds of very emotive reactions, which have been, you know, interpreted positively or negatively. But also, you know interpreted positively or negatively but also you know attachment emotional attachment as with other social robots and in the case of the care home Sakura that was

seen by care staff as being quite a negative thing you know their conclusion was that you know we have to carefully monitor Paro and make sure that you know people have like a fixed amount of time playing with paddock basically so again it seemed like it would be an easy thing to just give residents but in reality care staff had to spend quite a lot of time and effort kind of monitoring its use and quite often they just put it out of reach somewhere. Yeah, I'm sure it disrupts kind of the flow of the care home. You know, you said the time is quite regimented. And then, of course, in some of the cases where people have these particular attachments to them or don't react to it in the way that it is kind of programmed or designed to be reacted to,

then all of a sudden that creates kind of work to have to monitor it, to have to make sure that it's being used properly, to have to make sure that residents are responding to it in a way that, you know, you would expect. And then having to deal with the consequences if that's not the case. Yeah, exactly. There were similar issues again with Pepper, which was this kind of humanoid robot from SoftBank Robotics. Pepper, for anyone who's not familiar with it, is a kind of white plastic and metal kind of humanoid. I think it's about four foot tall and it has a touchscreen on its chest and a kind of podium dome kind of base that it can be wheeled around on.

That one was seen by the care staff as being kind of the most robot-y robot. I mean, it was like people's perceptions of what a robot would look like, you know, kind of humanoid, high-tech looking, having, you know, different technologies, a touchscreen, and apparently being able to have a conversation because Pepper can talk. But again, you know, there were problems and perhaps because it was so sophisticated, there were even more problems in terms of Pepper sometimes not working correctly, always needing a Wi-Fi connection, which the care home didn't really have.

And, you know, sometimes breaking down or not working as expected. The great kind of marketing line for Pepper was that it would be the world's first kind of emotionally engaged robot. You know, it could tell your emotions by reading your facial expressions. That was one of the big selling points. Although actually, in reality, it was almost never used. It took a lot of work for Pepper to learn how to read emotions. I think you had to feed it many images. So in most commercial applications, that functionality was never used. But what the care staff used it for, they would wheel it to the front of the room, a big room where all of the residents would gather. And it would kind of do its spiel of, you know, running a recreation session. What the care workers found was that actually, if they just wheeled Pepper to the front, explain what Pepper was to the residents, which they had to do on a daily basis, the residents wouldn't really do what Pepper was telling them to do. So they wouldn't really do their exercise. You had to have a human staff member stand next to pepper and copy pepper's actions and echo what pepper

was saying because pepper is really short so people at the back couldn't really see what pepper was doing properly and pepper also has a very high-pitched voice in japanese so they couldn't really hear what pepper was saying properly so um you know there was a kind of interesting reaction i mean i think residents were interested the was a kind of interesting reaction. I mean, I think residents were interested. The care staff kind of enjoyed having this like robot there. But when you look not just at Pepper, but all of the robots, you see this kind of trend of, you know, as we've discussed, like these invisible tasks, extra labor that the care workers have to do and also kind of cutting into like you said the kind of interaction time the time to communicate with the residents so instead of having a conversation with the residents they're instead trying to figure out like how what's wrong with pepper how do i reboot it or moving hug around the the corridors and these work care workers who are really hard pressed at times. I mean,

they're running around corridors with, you know, responding to nursing calls and doing other things. So, I mean, you know, even if it only cut into their time to do care by a few minutes per hour, that was really felt in how they would interact with the residents. Yeah. You know, and I think one of the things that stands out with what you're describing is that these robots are creating more work than expected, you know, taking more time in order to operate. And at the same time, they're performing fewer functions than, you know, people were probably led to believe, or at least not doing them as well as was maybe promoted or expected through the marketing materials, right? And this is particularly important because, you know,

the idea is that these robots are going to replace some of the need for human labor in the elder care system. And of course, what you're seeing in your work is that that's probably not the case, right? One of the things that stood out to me was that, you know, the workers in Japan were not so worried about the robots kind of replacing our jobs as we often hear the narrative being in Europe and North America. You know, I guess in part because as you're saying, there is such a shortage of elder care workers who are around there who are, you know, able to do this work. But then the other piece of that that you described is that, you know, while they might not be taking away jobs, they are still acting in a way to kind of de-skill and de-value some of these labor if these robots are used and implemented in the way that they are imagined.

Can you expand on that a bit and explain why that is a concern? Yeah, sure. I mean, I think it was perhaps best typified by a care worker standing next to Pepper and literally just copying what Pepper was doing, the physical actions of Pepper, repeating what Pepper was saying. I mean, it was a skilled task, you know, interacting with residents, talking to them, communicating with them. It was a skilled task before they started using Pepper. And after they started using Pepper, they just copied what Pepper was doing. It became a manual task. And, you know, with Hug, similarly, there was a skill to communicating with the resident. There was an element of touch and contact, which was seen as very important and valuable in care that was replaced by operating the hug

machine and moving it around and storing it and cleaning it maintaining it and with paddle again it kind of could stand in for a communicative task like communicating with the resident talking to the resident having a conversation now you could just give the resident power and just leave them to it. So, I mean, in each case, there's definitely a case to be made that, you know, is de-skilling those tasks. The devaluation comes in with the fact that these robots are really expensive. So if we're saying that the robots can't really replace care labor, but they can de-skill it, it implies that if you have a limited pot of money for your care system and you're going to scale up the use of these robots, you have to, you know, in this kind of zero sum game of care economy, as it is in the long-term care insurance system unless you want to spend like a massive amount of money you're going to have to reduce the amount that you're paying to human care workers and so i kind of hypothesize that like the only way that you could really make these robots work at scale if you're going to scale this up across japanese care, you'd have to have much bigger care homes with more

residents and perhaps less skilled and definitely less well-paid care workers. And the kind of ironic thing is that these robots were originally kind of, I think, intended in part to replace the need for migrant care work. But in reality, I mean, what it points to is a kind of synergy of migrant care workers that perhaps don't speak so much Japanese with robots or other devices where they can get around the need to speak Japanese. And, you know, if you can reduce care work to manual tasks that can be done by, you know, a migrant care worker that doesn't speak Japanese, that could be paid less money. You know, that it seems like that may be one direction that Japan is heading. And actually, despite the kind of anti-migrant rhetoric and

kind of policies for a long time from the LDP party in Japan, actually in recent years, they've started to deregulate a lot of migration routes to Japan. And they've started setting targets to bring hundreds of thousands of migrant workers from China and Southeast Asia to Japan. So it seems like the kind of tide is turning in that particular debate. So this is one possible future that I kind of suggest could play out in Japan, a kind of technology-enabled migrant care system, which I suggest is not really a great solution because there's a strong sense that migrant care workers could be exploited in Japan. Absolutely. No, and I think you lay that out really well, right? The concerns that come with it and what it would potentially mean.

And one of the things that you noted in the book was that the workers were seeing these robots being trialed. We're seeing them not really working out so well and then finding out how much they cost. And we're saying, like, why would we spend all this money on these robots when we could just be paid better, you know, which just seems natural. But of course, you know, people don seems natural. But of course, you know, people don't want to pay workers well, as we well know, as we're still seeing, you know, fights play out right now around that. I guess I would want to shift more toward the narratives

then around this, right? Because there are a lot of narratives around, you know, robots being central to how we address this demographic crisis that range all the way from corporate visions reflecting their desire for profit to more progressive visions of highly automated societies where human labor is far less necessary. We have no more leisure time and all this sort of stuff, right? What does your research tell us about those narratives and what responding to, you know, demographic aging and an increased need for elder care will actually require? I think it's very difficult. I mean, I wouldn't want to give a kind of blanket answer, I think, because doing ethnographic research, I think it's really important to just focus on what the technology is in a particular context, how it's actually used. I mean, I think those narratives

are really important and they help shape technological development and how it's actually used. I mean, I think those narratives are really important and they help shape technological development and how it's received. You know, I think it's really important to focus on the specific context. To be perfectly honest, when I started my PhD, I was quite naively optimistic about robots. I thought, you know, I did think that probably they would provide a really, you know, helpful solution for many issues around care work. And it was through the process of doing the actual field work and seeing them in use that kind of changed my mind about these specific robots. I think you can point to these wider issues around de-skilling for sure. But, you know, I've also seen other technologies that have been helpful, potentially helpful. Things like, you know, using machine learning to predict when older people are likely to fall,

with falls being a major cause of injury and death for older people. So, I mean, it really depends on what is the specific technology and how they're being used. I think when I see this, right, my concern is often that we have these narratives around how robots are going to be so useful to addressing elder care, right, and how it's going to require far less labor. And we get distracted by that, and not really recognizing the realities of what happens when these technologies get implemented, and how they don't tend to work out as expected. And then that leads us to not really be investing in or looking at the real solutions to the problem, because we just falsely believe that

we can just let the technology sort this out. You know, we don't need to be worried about, you know, the labor aspects of this or how we're actually going to have enough workers to do this or what creating a good kind of working environment would be in order to get people to do this work that is going to be really necessary. And thinking about these bigger questions because, oh, you know, the robots and the technology will address it for us. And I feel like one piece where this really came through in the book to me was you write that in 2018, 85% of Japanese businesses didn't renew their Pepper leases. And, you know, Pepper was supposed to be not just a robot that was going to be useful in elder care,

but many different kind of commercial applications. And then once these businesses actually used it, they were like, yeah, not so much. But at that same time, as that was happening, Pepper was still kind of being treated as this kind of revolutionary development in Europe and North America, as these narratives were essentially being rolled out, right. And so I guess that's kind of where my concern is with these things. Yeah, I'd absolutely agree. And I think that is the main danger of especially a government buying into the hype and actively funding it to the tune of hundreds of millions or even over a billion dollars. idea that it would distract from actually investing that money in more effective and more equitable approaches to care. And also in making very difficult, perhaps, you know, political and economic decisions about the future of care by always, you know, imagining that robots are going to save us. But yeah, I think the framing in general of technology as a solution and as a kind of salvation is not helpful for many reasons. I mean, not just distracting from the important political decisions that need to be made, but, you know, raising expectations and hype without addressing really the substantive challenges. Yeah, so I agree with you. Absolutely.

Thank you. Absolutely. Thank you. James, this has been a really fascinating conversation to dig into, you know, what has been going on in Japan, what these elder care robots have actually meant for the way that people are working and what they are likely to mean, you know, into the future, right? As we face these demographic aging, you know, issues, crises, as some would define it, these are going to be important conversations. I'm sure that the discussion of robots and electronics is going to come up again and again as one of the there as we continue to discuss these things in Europe and North America, which is a bit further behind on that kind of graph or curve, as we were saying earlier. Before we close off our conversation, anything else that we should know about this that we maybe didn't get to in my questions? One thing that I would point to, and it's interesting for me, you know, kind of observing what's's happening in Japan is despite the fact

that care robots haven't really been widely adopted by care homes, I think the current figure is probably around 10% of care homes are using some kind of robotic device, which is well below the expectations for these development projects. But the government is really doubling down on tech solutionism. And one of the major kind of flagship R&D projects at the moment is Japan's Moonshot Research and Development Program, which they've invested about a billion dollars and has so many project objectives that just read like science fiction so for instance making cybernetic avatar robots to overcome limitations of body brain space and time by the year 2050 regrowing lost limbs developing cryo sleep for interstellar travel even brain to

brain communication so even going beyond like elon musk's like wildest dreams i don't know it's fascinating for me beyond looking at care robots specifically is also to look at these other you know sci-fi imaginings of the future and in the case of japan the really fascinating thing is the growing disconnect between the rhetoric, which is just going way out, and the reality of what is actually possible and the actual technologies that are currently available. So I don't know what that says about what lesson can be learned from that, But it's really fascinating. Yeah, no, definitely. And I think it's a widespread problem that is not just occurring in Japan, unfortunately, as these kind of sci-fi visions distract us from reality in many cases. And I believe you spoke to an engineer in the book who kind of said that these ideas of like elder care automation and robots

taking over are pretty much sci-fi as well, not something that is really happening in reality. So James, it was fascinating to speak to you about all this, to get your insight on all of it. Really insightful conversation. Thank you so much. Thank you, Paris. James Wright is the author of Robots Won't Save Japan, a research associate at the Turing Institute

and a visiting lecturer at Queen Mary University of London. You can follow James on Twitter at at JMS underscore right. You can follow me at Paris Marks and you can follow the show at at Tech Won't Save Us. Tech Won't Save Us is produced by Eric Wickham and is part of the Harbinger Media Network. And if you want to support the work that goes into making the show every week, you can go to patreon.com slash tech won't save us and become a supporter. Thanks for listening. Thank you.