Healthcare for older adults with dementia is an important healthcare problem in Japan and in other developed countries. Importantly, healthcare workers in Japan are also getting older. In order to address solutions to this problem, using robots is being realized and is starting to assist healthcare and welfare practice needs. The aim of this study was to identify the characteristics of a transactive phenomenon in relationships among older adults with dementia, with nurses as intermediaries and with a cognitive skill-aid robot. Subjects were two institutionalized older adults who were diagnosed with dementia using Hasegawa’s Dementia Scale-Revised; a Kabochan (Nodding Kabochan) fixed with a remote-controlled speaker, Pechat (Kabochan with Pechat). Measurements of autonomic nervous activity were done using wearable electrocardiography attached to the subjects for four hours. Heart Rate Variability data were assessed at various frequency bands using a HRV software tool. In a continuously recorded data, interbeat (R-R) intervals were obtained for a 1-min segment using the maximum entropy method. In this study, the two major spectral components of HRV, the variances of the low-frequency (LF: 0.04 - 0.15 Hz) band and high-frequency (HF: 0.15 - 0.4 Hz) band, were calculated. Activities and behaviors of subjects transacting with Kabochan were observed by the expert nurses and video-recorded. Throughout the transaction period, observations were recorded of patients’ behavior, words uttered and over-all contents of the transactive conversation with the Kabochan or Kabochan with Pechat. Identified characteristics were transactive relationship phenomenon; changes in autonomic nervous system activity of persons with dementia are expressed as per one minute, linguistic response of elderly people, transactive relations among Kabochan, Kabochan with Pechat, and nurses as intermediaries. These were exhibited as Figures: Situation 1, A Sense of Fear, Situation 2, A Pleasant Sensation, and Situation 3, Misunderstanding and Confusion. It also showed that autonomic nervous system activity of persons with communication skills is actively changing in older adults with dementia. Conversation of adding Pechat to the Kabochan illustrated that nurses as intermediaries showed emotional conversations as established by effectively manipulating the Pechat. Also, it was revealed that if Kabochan with Pechat uttered words about patient’s personal information in a conversation, the patient felt a sense of fear. The researchers suggest that when developing future
References
[1]
Statistics Bureau Portal Site of Official Statistics of Japan. (In Japanese)
http://www.stat.go.jp/data/jinsui/
www.stat.go.jp/data/nenkan/65nenkan/zuhyou/y650202000.xls
[2]
Siegel, C. and Dorner, T.E. (2017) Information Technologies for Active and Assisted Living—Influences to the Quality of Life of an Ageing Society. International Journal of Medical Informatics, 100, 32-45.
https://doi.org/10.1016/j.ijmedinf.2017.01.012
[3]
Ministry of Health, Labour and Welfare in Japan (2016) Long-Term Care Insurance System of Japan.
http://www.mhlw.go.jp/english/policy/care-welfare/care-welfare-elderly/dl/ltcisj_e.pdf
[4]
New Energy and Industrial Technology Development Organization: Robotic Solutions; Building a Smart Society with State-of-the-Art Technology.
http://www.nedo.go.jp/content/100582006.pdf
[5]
Taketomi, T. and Sankai, Y. (2012) Walking Assistance for Cerebral Palsy with Robot Suit HAL. Japanese Society for Medical and Biological Engineering, 50, 105-110.
[6]
Ohnuma, T., Lee, G. and Chong, N.Y. (2017) Development of JARoW-II Active Robotic Walker Reflecting Pelvic Movements While Walking. Intelligent Service Robotics, 10, 95-107. https://doi.org/10.1007/s11370-016-0212-7
[7]
Takei, M., Chikami, S., Iida, T., Saita, R., Kubomura, C. and Kamada, H. (2008) Design and Implementation of a Prototype of Dialogue Robot with a Personal Character. IEICE Technical Report, 108, 13-18.
[8]
Shiba, H., Kanoh, M., Kato, S., Kunitachi, T. and Itoh, H. (2005) A Facial Control Method Using Emotional Parameters in Sensibility Robot. IEEJ Transactions on Electronics, Information and Systems, 125, 1852-1860.
https://doi.org/10.1541/ieejeiss.125.1852
[9]
Schwiegelshohn, F., Wehner, P., Rettkowski, J., Göhringer, D., Hübner, M., Keramidas, G., Antonopoulos, C. and Voros, N.S. (2015) A Holistic Approach for Advancing Robots in Ambient Assisted Living Environments. 2015 IEEE 13th International Conference on Embedded and Ubiquitous Computing, Porto, 21-23 October 2015, 140-147. https://doi.org/10.1109/EUC.2015.37
[10]
Bernabei, V., De Ronchi, D., La Ferla, T., Moretti, F., Tonelli, L., Ferrari, B., Forlani, M. and Atti, A.R. (2013) Animal-Assisted Interventions for Elderly Patients Affected by Dementia or Psychiatric Disorders: A Review. Journal of Psychiatric Research, 47, 762-773. https://doi.org/10.1016/j.jpsychires.2012.12.014
[11]
Van Wynsberghe, A. (2013) Designing Robots for Care: Care Centered Value-Sensitive Design. Science and Engineering Ethics, 19, 407-433.
https://doi.org/10.1007/s11948-011-9343-6
[12]
Tanaka, M., Ishii, A., Yamano, E., et al. (2012) Effect of a Human-Type Communication Robot on Cognitive Function in Elderly Women Living Alone. Medical Science Monitor, 18, CR550-CR557.
[13]
Kuwamura, K., Nishio, S. and Sato, S. (2016) Can We Talk through a Robot as If Face-to-Face? Long-Term Fieldwork Using Teleoperated Robot for Seniors with Alzheimer’s Disease. Frontiers in Psychology, 7, 1066.
https://doi.org/10.3389/fpsyg.2016.01066
[14]
Pino, M., Boulay, M., Jouen, F. and Rigaud, A.-S. (2015) Are We Ready for Robots That Care for Us? Attitudes and Opinions of Older Adults toward Socially Assistive Robots. Frontiers in Aging Neuroscience, 7, 141.
https://doi.org/10.3389/fnagi.2015.00141
[15]
Mordoch, E., Osterreicher, A., Guse, L., Roger, K. and Thompson, G. (2012) Use of Social Commitment Robots in the Care of Elderly People with Dementia: A Literature Review. Maturitas, 74, 14-20. https://doi.org/10.1016/j.maturitas.2012.10.015
[16]
Tanioka, T. (2017) The Development of the Transactive Relationship Theory of Nursing (TRETON): A Nursing Engagement Model for Persons and Humanoid Nursing Robots. Int J Nurs Clin Pract, 4, 223.
https://doi.org/10.15344/2394-4978/2017/223
[17]
Tanioka, T. (2017) The Transactive Relationship Theory of Nursing. In: Tanioka, T., Yasuhara, Y., Osaka, K., Ito, H. and Locsin, R., Eds., Nursing Robots: Robotic Technology and Human Caring for the Elderly, Fukuro Shuppan Publishing, Okayama, Japan.
[18]
Tanioka, T., Osaka, K., Locsin, R., Yasuhara, Y. and Ito, H. (2017) Recommended Design and Direction of Development for Humanoid Nurse Robots Perspective from Nursing Researchers. Intelligent Control and Automation.
Imai, Y. and Hasegawa, K. (1994) The Revised Hasegawa’s Dementia Scale (HDS-R)-Evaluation of Its Usefulness as a Screening Test for Dementia. Hong Kong Journal of Psychiatry, 4, 20-24.
[22]
Huang, Q. and Tang, J. (2010) Age-Related Hearing Loss or Presbycusis. European Archives of Oto-Rhino-Laryngology, 267, 1179-1191.
https://doi.org/10.1007/s00405-010-1270-7
[23]
Shaffer, F., McCraty, R. and Zerr, C.L. (2014) A Healthy Heart Is Not a Metronome: An Integrative Review of the Heart’s Anatomy and Heart Rate Variability. Frontiers in Psychology, 5, 1040. https://doi.org/10.3389/fpsyg.2014.01040
[24]
McCraty, R., Atkinson, M., Tomasino, D. and Bradley, R.T. (2009) The Coherent Heart: Heart-Brain Interactions, Psychophysiological Coherence, and the Emergence of System-Wide Order. Integral Review, 5, 10-115.
[25]
McCraty, R. and Shaffer, F. (2015) Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health Risk. Global Advances in Health and Medicine, 4, 46-61.
[26]
Sakamoto, M., Ando, H. and Tsutou, A. (2003) Comparing the Effects of Different Individualized Music Interventions for Elderly Individuals with Severe Dementia. International Psychogeriatrics, 25, 775-784.
[27]
Yamasoba, T., Lin, F.R., Someya, S., Kashio, A., Sakamoto, T. and Kondo, K. (2013) Current Concepts in Age-Related Hearing Loss: Epidemiology and Mechanistic Pathways. Hearing Research, 303, 30-38.
[28]
Kanoh, M., Oida, Y., Nomura, Y., Araki, A., Konagaya, Y., Ihara, K., Shimizu, T. and Kimura, K. (2011) Examination of Practicability of Communication Robot-Assisted Activity Program for Elderly People. JRM, 23, 3-12.
https://doi.org/10.20965/jrm.2011.p0003
[29]
Inoue, K., Sasaki, C. and Nakamura, M. (2015) Communication Robots for Elderly People and Their Families to Support Their Daily Lives—Case Study of Two Families Living with the Communication Robot. Studies in Health Technology and Informatics, 217, 980-983.
[30]
Li, S. and Zhang, X. (2017) Implicit Intention Communication in Human-Robot Interaction through Visual Behavior Studies. IEEE Transactions on Human-Machine Systems, 1-12. https://doi.org/10.1109/thms.2017.2647882
