Who will take care of Italy’s older people? Robots, maybe

Italy, which has one of Europe’s lowest birthrates, is bracing for an elderly population boom. PHOTO: PEXELS

CARPI – The older woman asked to hear a story.

“An excellent choice,” answered the small robot, reclined like a nonchalant professor atop the classroom desk, instructing her to listen closely.

She leaned in, her wizened forehead almost touching the smooth plastic head.

“Once upon a time,” the robot began, and when the brief tale ended, it asked her what job the protagonist had.

“Shepherd,” Ms Bona Poli, 85, responded meekly.

The robot did not hear so well. She rose out of her chair and raised her voice.

“Shep-herd!” she shouted.

“Fantastic,” the robot said, gesticulating awkwardly. “You have a memory like a steel cage.”

The scene may have the dystopian “what could go wrong?” undertones of science fiction at a moment when both the promise and perils of artificial intelligence (AI) are coming into sharper focus.

But for the exhausted caregivers at a recent meeting in Carpi, a handsome town in Italy’s most innovative region for elder care, it pointed to a welcome, not-too-distant future when humanoids might help shrinking families share the burden of keeping the Western world’s oldest population stimulated, active and healthy.

“Squat and stretch,” said the French-made robot, Nao, climbing to its feet and leading posture exercises. “Let’s move our arms and raise them high.”

The people in the room, mostly women, looked on – some amused, some wary, but all desperate to know how new technology could help them care for their ageing relatives.

Together, they listened to the robot’s calm, automated voice and offered real-world feedback at a focus group organised by a non-profit advocacy group representing so-called family caregivers.

The goal was to help the robot’s programmers design a more engaging and helpful machine that might one day lighten the load on increasingly overwhelmed Italian families.

Italy, which has one of Europe’s lowest birth rates, is bracing itself for an elderly population boom.

Already, more than seven million of Italy’s nearly 60 million people are older than 75. And 3.8 million are considered non-self-sufficient.

Diseases such as dementia and chronic illnesses weigh on the health system and families.

“The revolution”, said Dr Olimpia Pino, a professor of psychology at the University of Parma who designed the robot project, would be if a “social robot can assist in care”.

Leaps in AI would only make robots more responsive, she said, keeping older people self-sufficient longer and providing more relief to caregivers.

“We all have to look for all the possible solutions – in this case, technological,” Ms Loredana Ligabue, president of caregiver advocacy group Not Only Elderly, told the participants.

“We’ve seen the big fear of being alone.”

Robots are already interacting with the old in Japan and have been used in nursing homes in the United States.

But in Italy, the prototype is the latest attempt to recreate an echo of the traditional family structure that kept ageing Italians at home.

The Italy of popular imagination, where multi-generational families crowd around the table on Sunday and live happily under one roof, is being buffeted by major demographic headwinds.

Low birth rates and the flight of many young adults for economic opportunities abroad have depleted the ranks of potential caregivers.

Those left burdened with the care are often women, taking them out of the workforce, providing a drag on the economy and, experts say, further shrinking birth rates.

Yet home care remains central to the notion of ageing in a country where nursing homes exist but Italians vastly prefer finding ways to keep their old with them.

For decades, Italy avoided a serious reform of its long-term care sector by filling the gap with cheap and often off-the-books live-in workers, many from post-Soviet Eastern Europe – and especially Ukraine.

“That’s the long-term care pillar of this country,” said Dr Giovanni Lamura, director of Italy’s leading socio-economic research centre on ageing. “Without that, the whole system would collapse.”

In January, unions representing legal Badanti, as the workers are called there, won a pay rise that added as much as about €145 (S$210) a month for in-home care.

Struggling Italians say their pay cheques and pension benefits have not kept pace, forcing many to do the caring themselves.

When it comes to family caregivers, Italy has for decades provided government benefits to a single person in a family with a gravely ill person.

Later in 2023, paid leave and other relief will be allowed to be shared in a family, in practice meaning that more men can help.

In Emilia-Romagna, the region that includes Carpi, there are also plans to create a workforce of caregivers with experience caring for their own family members who can ultimately, when their own loved ones die, be employed to care for others.

“There is an enormous demand,” Ms Ligabue said.

This past week, Prime Minister Giorgia Meloni celebrated the passage of a new law intended to streamline access to services for the elderly and to bring greater government engagement in the growing field of long-term care.

But the law does not include specific measures to support family caregivers.

Italy’s Minister for Disabilities Alessandra Locatelli explained that the government did not want to prioritise Italians who cared for older family members over those who tended to younger disabled ones.

She said she expected a new measure by the end of the year to provide tax breaks and other benefits for “live-in family caregivers” for “all of the types of non-self-sufficient people”.

But the meeting in Carpi made it clear that many Italians do not necessarily live with the parents and grandparents they care for.

Some of those women are already looking beyond the government – to machines – for help.

As Nao, the posture-performing robot from France, made erratic movements on the desk, Mr Leonardo Saponaro, a psychology student who ran the focus group and whose grandfather suffered from dementia outside Rome, explained that the robot was not “a replacement for socialising with other people”.

“It can nevertheless be company,” he said. NYTIMES

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