As the number of hospice and palliative care programs grow across the country, so does the competitive nature of hospices to offer unique services that enhance the quality of life of their patients and families they care for to gain an edge in the market. One new and unique addition to a few hospice care programs is now the use of personalized assistance robots to bring comfort to the dying.
I have been a board-certified music therapist working in hospice and palliative care for over a decade. As part of an interdisciplinary care team I use music to provide pain and symptom management, be it physical, psychological, social, emotional or spiritual. My days are filled with bringing personalized music tailored to patient preferences and needs. It is not usual for me to reach for my guitar, keyboard, a variety of rhythmic instruments or even my smartphone to create, play or record music during sessions. Occasionally I will seek out additional sensory tools to enhance or compliment the therapeutic process of music therapy for my hospice patients.
One tool I have been reaching for often this year that I would have never imagined possible is my hospice’s therapeutic robot; we call him “Sammy”. Sammy, otherwise known as PARO is an advanced interactive therapeutic robot designed to stimulate patients with dementia, Alzheimer’s and other cognition disorders. PARO was developed by Japanese industrial automation company AIST for hospitals and extended care facilities where live animal interactions present logistical difficulties. PARO is currently in the 8th generation of design that has been in use in Japan and throughout Europe since 2003.
I was first introduced to Sammy during my hospice new employee orientation rounds at our inpatient hospice unit. It was explained to me that Sammy is a robotic pet that responds to voice, visual and tactile stimulation. Like many on the hospice team, I was curious and a bit skeptical on how patients would respond to this. Within seconds of being handed what looks like a fluffy white baby seal pup, I was told to talk to it. I held Sammy in my arms and said hello. Two big beautiful dark eyes opened, met mine and blinked. Sammy began making coo like noises and nuzzling me while I petted and spoke to him. The encounter was completely surreal, like meeting an exotic sweet baby alien for the first time. In the moment I was so enamored by the interaction that I could not believe he was not real.
Since then, I have found using Sammy as an excellent addition to my hospice music therapy practice. Our hospice has since purchased a travel bassinet so I can bring Sammy out into the community when I run music therapy memory care groups, or even when visiting individuals in their homes. We will pass Sammy around for petting and cuddles and I will play and sing the iconic Doris Day’s “How Much Is That Doggie in the Window” as Sammy turns his head towards the music, moves his head, and even wags his tail on occasion. In between groups, I can wipe him down with an antibacterial wipe (hello infection control) and he doesn’t require any feeding, walking, watering or toileting!
I can count many occasions when some of my hospice patients have been in a nursing home or hospital where they miss and are not able to have interactions with their favorite pets. Some may have sensory impairments, dementia, or advances illness that hinders them from interacting in the world as they were once able to. I have now seen first hand how Sammy has brought peace and comfort when I provide live music while placing Sammy on a patient’s bed as they stroke his soft fur and interact with him via his very real animal like responsive movements to their touch. I have seen patient’s with Alzheimer’s disease who are nonverbal and withdrawn light up when they hold him and even begin to sing during our sessions.
This innovation is bringing another layer of support in the hospice and palliative care continuum. I believe that the PARO seal has enhanced my practice, and I hope more medical communities will embrace this technology to improve their patient care experience.
Reality Changing Observations:
Q1. What additional ways do you foresee hospice and palliative care programs using robots in the future?
Q2. What do you think are the strengths and weaknesses of using therapeutic robots in the care of persons with dementia?
Q3. What are some other institutions that may benefit from the use of PARO robot technology?