News

PARO

The robotic harp seal pup

BY MARTIN ZEILIG
Winnipeg Health Region
Wave Magazine, Fall 2009

Aime Campbell is just getting comfortable on a couch in a lounge at Deer Lodge Centre when a white, furry little creature named PARO makes his appearance.

Resting on a pillow on Campbell's lap, the baby harp seal look-alike turns his head upward, opens his big brown eyes and lets out a joyful little squawk.

"Yes, yes, PARO," murmurs Campbell as he strokes the little critter's fur, tears rolling down his cheek. Clearly, these are tears of joy.

"I think it is bringing good memories back to him," offers Lisa Franchi, a recreational facilitator at Deer Lodge who spends a lot of time with Campbell.

The scene is becoming a common one at Deer Lodge. The hospital is conducting research to determine whether PARO, a furry robot developed in Japan, can help boost the spirits of elderly patients who are living with Alzheimer's disease, a condition that attacks the brain and undermines a person's ability to think clearly or function normally.

Campbell, a 94-year-old Second World War veteran, has been spending some quality time with PARO, and the sessions have generated positive results.

"PARO is very effective," Franchi explains while watching the interaction between Campbell and the robot. "When he holds PARO, he responds to me in whole sentences. If he's anxious or frustrated, I get PARO and he'll usually respond. It has a calming effect on him," she says.

PARO's charms are evident to anyone who comes into contact with the furry critter. Now in its eighth generation, PARO blinks and coos with pleasure upon being caressed - much like a wild seal pup would do in response to being near its mother on an ice floe off the northwest coast of Newfoundland. It also responds to being tickled under the chin or to specific voices.

Technically, the research project is trying to determine whether PARO can enhance the social and communication skills of residents with cognitive and sensory limitations. It is being conducted under the Interdisciplinary Summer Research Program (ISRP) at Deer Lodge under the auspicies of Dr. Lorna Guse, Associate Professor in the Faculty of Nursing at the University of Manitoba. The three fellow principal researchers in this program are U of M colleagues Dr. Kerstin Roger, of the Faculty of Human Ecology, Dr. Elaine Mordoch, Faculty of Nursing, and Angela Osterreicher, of the U of M Library.

The project is being funded by the Deer Lodge Foundation, which provided $15,000 for this summer's project, which includes the research as well as the training of two university students as research assistants. As part of the study, three residents interact with PARO three days a week. "The results are preliminary, but videotapes of the interactions clearly demonstrate that residents take great enjoyment interacting with PARO, by smiling, touching and talking to PARO," says Guse. "Our staff members are expert at speaking to a person with dementia. The disease of dementia creates a barrier that separates people from their environment. So, PARO is one more tool that can be used to help residents with dementia connect with their surroundings. PARO enhances the quality of life of people with dementia."

Franchi says Campbell responds to PARO much like he does to music - with tears, emotion and enhanced verbal skills. "I have worked with other residents in our unit and most have responded positively to PARO," she adds.

Although Campbell is not part of the research project, the staff felt that he would benefit from being with PARO, says Guse. The robot was invented by Dr. Takanori Shibata, an engineer/researcher at Japan's National Institute of Advanced Industrial Science and Technology (AIST), who was trained at MIT and began developing this robot in the late 1990s, according to the official PARO website.

The concept behind PARO draws on the research into pet therapy, which shows that animals can help relieve mental stress and boost spirits. Shibata's goal was to create a robot that could emulate the benefits of a pet but without the challenges that come with having or taking care of a live animal in a hospital or extended care setting.

In 2007, Guse saw a video clip about PARO being used in a nursing home in Japan at a Manitoba Gerontological Nursing Association meeting in Winnipeg. Then, in October 2007, she had an opportunity to attend an International Psycho Geriatric Association Conference in Japan.

"So, I contacted Dr. Shibata beforehand and he connected me with Dr. Kazuyoshi Wada of the Metropolitan University of Tokyo," says Guse. "Much of the reported research on the use of PARO in Japanese nursing homes has come from Dr. Wada's work. So, Dr. Wada took me to the nursing home, and I said, 'I'd like to do something similar in Canada.'"

Upon her return, Guse spoke to Jo-Ann Lapointe McKenzie, who is the Chief Nursing Officer at Deer Lodge and the Program Director in Rehabilitation and Geriatrics with the Winnipeg Health Region, about the work being done with PARO in Japan.

Lapointe McKenzie was enthusiastic about the idea, and Deer Lodge subsequently purchased two of the robotic seals. "They arrived in early 2008 in a box marked PARO," adds Lapointe McKenzie.

PARO consists of a hard metal skeleton, covered by a soft layer of material and hypo-allergenic synthetic fur. "This soft layer has a tactile sensor that measures human contact," says Guse, noting that each robot costs $4,000 (U.S.).

PARO has four other primary senses: temperature, visual (light sensor); auditory, and balance. "It can determine the direction of sound and speech recognition, and balance," says Guse, noting that 20 U.S. nursing homes and hospitals have purchased PAROs for testing.

"PARO has been programmed with several poses and movements. It has a longterm memory. It is programmed to prefer stimulation such as stroking. The more you interact with PARO, the more it interacts with you, and this is retained in its longterm memory. PARO sits easily in your lap or on a table."

In Japan, evaluation of the outcome of PARO with older adults has been based on the use of Face Scales, observational tools used in analysis of facial expression and interaction, counting of utterances or verbalizations, and physiological tests (urine samples to measure stress levels). The Japanese have been conducting research on robot-assisted activity in one nursing home since 2003. "In fact, research on these robots in Japan has been grounded in concern that as the proportion of older adults increases, the number of skilled and unskilled caregivers is decreasing," Guse says.

PARO is so popular in Japan that more than 1,000 units have been sold to care providers in nursing homes and hospitals, as well as to consumers who want a robotic companion, says an article in the May 2009 issue of iEEE Spectrum Inside Technology - an online journal. It notes, " . . . researchers at the Danish Technological Institute's Centre for Robot Technology began the first long-term study of PARO's potential in elderly care. The researchers distributed 30 units to residents of nursing homes with various levels of senile dementia," says the article. "PARO not only makes patients feel better but can also help them communicate better with others, including caregivers. Shibata wants to make a version of PARO that would stimulate more verbal communication in patients with dementia who are losing their language skills. Another version would try to elicit more interaction between autistic people and their caregivers."

The positive benefits of PARO are also being noticed by family members. "One family member said, 'My mother just melted. She just relaxed. She just smiled . . . She was happy.'"

Staff members were also asked about how they felt about this technology, and most indicated a positive perspective on the use of PARO, adds Guse. "There were also positive comments on the research project itself. One staff member said, 'Keep up the good ideas,' and another said, 'Great project. Thank you for enhancing lives at Deer Lodge.'"

While it's clear that PARO offers residents many of the same benefits as a real pet would, Guse and Lapointe McKenzie say they are unsure about why it works so effectively as a therapeutic tool. "Why does a summer's day work or a beautiful piece of music? But at this point when you're working with people with severe dementia and you want to bring comfort to them, you'll try anything," Lapointe McKenzie says.

The bottom line for Guse: "You can't help but smile when you are around PARO."

Martin Zeilig is a Winnipeg writer.

	About Wave Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books. Read the Fall 2009 issue of Wave