Japan is at a historical turning point on its demographic path. Because the country houses what the world calls its most advance aging society, facing plummeting birth rates, the country is faced with problems that are unprecedented. It paints a sobering picture of a country that is fast becoming a minefield of senior citizens thanks to Japan's 'baby boomer' generation who have all turned at least 75 by the end of 2024 and births continue to fall for the ninth year in a row to a record low of 720,988 people in 2024. Such a demographic imbalance has become a perfect storm in the healthcare industry, especially the elderly care.
Just one applicant for every 4.25 job openings in the nursing industry is a situation that is far worse than the national norm, which highlights the current crisis regarding undersupply of nurses. Foreign recruitment efforts have largely failed to attract sufficient numbers of foreign workers to be more than 3% of the overall elderly care workforce. "Finally, Tonketsu is barely keeping our heads above water and in 10, 15 years, the situation will become quite bleak," bluntly stated Takashi Miyamoto, a director at elderly-care operator Zenkoukai. In this context, technology, with AI driven robots being probably the most effective solution to address this growing crisis.
The Current State of Robotic Care
The idea of robotic caregivers may seem futuristic, but the research on welcoming that idea in soils into care facilities and research labs in Japan is in motion. Professor Shigeki Sugano at Waseda University is studying AIREC, a 150kg AI driven humanoid robot developed for future “caregiver,” where he is the lead researcher. Through our prototype, we can assist patients in changing positions, which is key to preventing bed sores, and change diapers.
Technology integration is limited in Tokyo’s care facilities as it has commenced. Expressive small, doll size robots encourage residents in simple exercises and entertainment so that human caregivers have time for more complex tasks. The most practical current application probably has to do with sleep sensors under mattresses used to monitor residents' conditions at night, which frees up staff from having to consistently check on clients at night.
These implementations are merely the first beginning. The real potential of robotic care is to develop sophisticated humanoid robots that allow safe, intuitive physical interaction to elderly patients. Professor Sugano, who presides over the Robotics Society of Japan also notes: "Humanoid robots are being developed worldwide. Which is why they rarely come directly in contact with humans... But that changes when we start adding humans into the mix — safety and how to work with a robot’s actions relative to each person on the field come up immediately."
The Technical Challenges
Such robots for elderly care are not identical to the industrial or household robots. Prototype AIREC is designed to demonstrate capabilities that are essential for caregiving: helping patients get sit up, dressing, feeding with a simple meal, as well as handling household tasks such as folding laundry. But that rendering of precise human frailty poses a technical challenge: programming robots to safely interact with human frailty has proved too complex for robots to reliably match what their current technology is capable of.
Another reason for this is why Professor Sugano does not anticipate AIREC to be ready for implementation in care facilities until around 2030 and at a heavy up-front price that would be about 10 million yen ($67,000). It reflects the fine attention that has to be paid to developing these robots so they can handle the individual based on needs, or recognize characteristics about the person, and respond to the unexpected situation that you will inevitably find in a caregiving environment.
The Human Element
Though promises of technology abound, healthcare professionals hold a nuanced point for adopting robots. "If we have AI robots equipped with cameras who understand the conditions of each living care receiver's personal traits, then there will be a future of them directly providing nursing care," says Takaki Ito, a care worker at a Zenkoukai facility.
But Ito suggests, however, 'I don't think that robots comprehend everything about nursing care.' "I hope for my future to be working with robots and with humans for improving nursing care." The industry echoes this sentiment: robot are being viewed as collaborative tools, not replacing human caregivers. Quality care will always need the like of emotional intelligence, empathy and adaptability that human caregivers bring.
The Economic Imperative
Reasons for Japan's restrictive immigration policies have limited the organization’s capacity for labor shortages to be addressed through the international recruitment of labor. The number of foreign workers in elderly care has increased, amounting to some 57,000 in 2023, but that is a very small fraction of the number needed. Seeing that all these constraints exist, it is no longer just desirable, but in fact necessary.
Miyamoto from Zenkoukai believes that "Technology is our best chance to avert" the future near certain care crisis. It is a view of demographic challenges in Japan that cannot be resolved by traditional means alone. As the proportion of working age citizens to elderly dependants continues to decline the economic imperative for robotic care solution grows stronger.
Looking Ahead
What we can expect for the elderly care in Japan in future is a hybrid model where robots with AI would take care of routine physical, intensive monitoring and basic care functions and human caregivers will remain for personalized interaction, emotional support and complex decision making. Such division of labor has the potential to greatly expand and increase the efficiency of care facility while also enhancing the resident’s quality of life as well as that of the caregivers.
And considering that we live in a country of highly advanced ageing society and falling birthrate, we will need robot support in medical caregiving and the daily lives, says Professor Sugano. In this quote, Japan’s decision to invest in robotic caregiving technology is explained by the practical necessity of it.
AIREC still belongs in development, but once robots do eventually enter care facilities, a lone robot will be just one small way in which care facilities adapt to a global reality of demographic change. Japan’s experience will offer a valuable lesson to other nations experiencing a similar demographic reality.
Societies have found a way of integrating AI robots into their elderly care, and this is how we can use technology to meet profound demographic challenges. The journey towards the implementation of rolling out robotic caregivers is long, but the progress achieved until now indicates that robotic caregivers may well develop into a crucial tool supporting Japan’s ageing population, not as a substitute for human care but as a basic part of helping elderly people retain dignity and quality of life in what seems a hyper changing society.
