Enhancing Aged Care through Human-Robot Collaboration: A Case Study of Chore Robots.

Enhancing Aged Care through Human-Robot Collaboration: A Case Study of Chore Robots. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Enhancing Aged Care through Human-Robot Collaboration: A Case Study of Chore Robots. Valeria Alessandra Macalupu Chira, Glenda Caldwell, Evonne Miller This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3977206/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Robots are not yet mainstream in aged care, despite decades of experimentation and technological advancements. Alongside technological, regulatory, and societal considerations, part of the challenge has been limited to end-user engagement in co-designing robots for aged care. This project asked ten leaders in aged care to participate in a co-design workshop to collaboratively imagine and co-design a chore robot for aged care, followed by individual interviews to identify the tasks or activities where robotic assistance could be most beneficial, focussing on any specific workforce implications and the economic rationale needed to justify this change. Alongside documenting the co-design processes and tools deployed, this article shares the expectations and experiences of executive leaders in aged care, reflecting on the challenges and opportunities for robotic design and adoption in the unique setting that is aged care. Architecture, Design and Planning Robotics Geriatrics & Gerontology aged care codesign chore robot human-robot collaboration technology adoption robotics Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 1 Introduction Despite decades of experimentation and technological advancements, robots are not yet mainstream in aged care. While there have been numerous successful demonstrator and pilot studies showcasing the potential of robots in improving the lives of older people in residential aged care (see, for example, the therapeutic robot Paro the Seal [ 1 ][ 2 ] and the transport/chore robot, Rosie [ 3 ]), the leap to widespread adoption of robots has proven elusive – in part because of limited end-user engagement in the design phase. Despite a paradigm shift where the development of robotic technologies increasingly uses a human-robot collaboration lens, research documenting how to co-design a robot for aged care is virtually non-existent. This paper addresses this knowledge gap. 2 Background Robots, best defined as “ information technology in a physical embodiment, providing customized services by performing physical as well as nonphysical tasks with a high degree of autonomy ” [ 4 ], come in various forms, each designed for specific tasks and needs. Service robots are designed to perform tasks in non-industrial and non-manufacturing environments, interacting with, assisting, or providing services to humans in various real-world settings, including the home, retail, hospitality, healthcare, and aged care. In the context of aged care, interactions between humans and service robots can be broadly categorised into three key activity domains: chores, companionship, and care activities, as visually depicted in Fig. 1 . To date, the majority of the limited research in aged care has been conducted on service robotics designed for companionship (e.g., limited conversations, playing bingo, quizzes, collaborative singing) and basic care tasks, monitoring and activities (e.g., monitoring health vitals, exercise, movement). Most attention has focussed on companion robots, such as Pepper (humanoid robot) and Paro the Therapeutic Seal (animaloid robot). While several studies have demonstrated Paro has a positive impact on quality of life and pain medical usage [ 1 ], Pepper - which was trialled in libraries, banks, stores, and aged care as a friendly interactive robot – often failed due to limited functionality and unreliability, and was withdrawn from the market in 2021 [ 5 ] [ 6 ]. Some studies with Pepper in aged care [ 7 ] [ 8 ] [ 9 ] recorded an increase in caregivers’ responsibilities to ensure the correct functioning of the robot and to facilitate its social acceptability with residents, particularly those with dementia. Moreover, in some instances where caregivers were skilful, they found Pepper’s standardised activities and programs to be too limiting and hinder their care performance and relationships with residents. When interacting in scenarios with multiple residents who spoke in diverse tones and dialects, Pepper’s performance fell short of understanding commands, disregarded residents’ dynamic feelings and emotional needs, and impacted and confused them with its responses. These limitations have been found in other social robot prototypes like Kompai [ 10 ], SCITOS G5 [ 11 ], and YORISOI Ifbot [ 12 ]. The focus on social companion/ entertainment/ socialisation robots means that there is very little research or practice in aged care on either care or chore robots [ 13 ]. This is surprising, given that chore robots have the potential to do some of the more routine or so-called “dirty” tasks (laundry, cleaning, showering, toileting), which involve urine, faeces, and bodily fluids, thus freeing staff up for preferred care tasks [ 14 ] [ 15 ]. Performing these tasks can be physically demanding, time-consuming and challenging for caregivers, who may experience physical strain from lifting, moving and manoeuvring residents (lifting, bending, carrying tests strength and endurance, straining muscles) and their belongings. The current reality is that there is simply not enough skilled staff in aged care [ 16 ] [ 17 ], which leads to increased workloads for existing caregivers, leading to burnout, increased staff turnover, and higher recruitment and training costs. The reduced and often changing care staff can negatively impact residents’ quality of care, resulting in “missed” or “unfinished” care: residents wait because staff are busy elsewhere [ 18 ]. Miller [ 19 ], for example, documents how one aged care resident felt that staff were “ always rushed, always sharing everybody and everything... ” (p.122). Staff want to deliver quality care, but aged care is a busy environment, limiting caregivers' availability to engage in more meaningful, person-centred interactions; as one staff member explained: We have a roster of what we are supposed to... including taking people for walks at 9.30 am. That time, we have just finished showers, we have got to make the beds, do the pad bins... then at 10 am it’s morning tea... supplement drinks, 10.30 am activities start... so we don’t always get to it. We all try and spend that five minutes here and there to talk to them [ 19 ]. To create more time for staff to interact with residents and reduce the physically demanding aspects of the care role, automation, assistive and advanced technology (such as robots) must be better integrated into residential aged care settings. By leveraging technology, caregivers can optimize their workflow and focus more on engaging with residents while the technology handles certain tasks. To date, although technology has the potential to help alleviate some of the challenges facing care staff, the adoption of service robots into residential aged care – especially those focussed on reducing the physical workload by assisting with chores - remains limited and piecemeal. A notable exception is research from a regional aged care facility in South Australia, where robotic systems (Lamson AMR RoboCarts) have been employed to transport and deliver various items such as linen, clean clothes, and food across the large, dispersed facility [ 4 ]. Drawing on government grants and partnerships with robotic manufacturers, this aged care facility has become a chore robot trial, testing and development site. Management estimates that these robots can handle up to 25% of the tasks typically performed by humans, and as the robots cover a substantial distance (~ 9,000 kilometres per year/ 24 kilometres per day), there has been significant cost savings (2.5 full-time equivalent positions and approximately $ 200,000 annually, which has been redirected to staff care hours). However, this transition has not been straightforward: the 70-year-old building was not originally designed for such technology, with multiple modifications required (including replacing swinging doors with wide and automated sliding ones, adjusting the lift to accommodate the robots, strong Wi-Fi connectivity), with management and staff also expecting the technology to work much easier, quicker, and independently than it did. As robots are only of value if care staff and residents can meaningfully collaborate with them, and easily incorporate them into their workflow and ongoing care practices, issues of usability, acceptability and functionality are key to acceptance and uptake [ 20 ] [ 21 ] Indeed, as Hornecker et al. [ 22 ] remind us, social robots require significant human (staff) oversight to integrate into practice, and are not, in fact, the social-cultural, scientific and media portrayal of “ skilful, autonomous and quasi-conscious entities… acting in isolation, working independently, and replacing human work ” (p.2). As the context of aged care involves both residents and staff, Hornecker et al. [ 22 ] suggest that the field of care should move from HRI (Human-Robot Interaction) to HHRI (Human-Human Robot Interaction) so as to account for both the “ physical reduction of the caregivers’ workload but also to an emotional enrichment for the residents ” (p.9). Alongside moving from a dyadic to a triadic interaction structure, it is essential that robotic developers have a better understanding of what senior management (those who make the ultimate decision about technological adoption) in aged care think robotic technology could and should do for them, and what they would prioritise paying for. 3 Co-designing a chore robot for aged care. The current study, therefore, asked senior aged care stakeholders to collaboratively imagine and co-design a chore robot for aged care, focussing on (1) identifying the tasks or activities where robotic assistance would be of most value; (2) assessing expectations and past experiences of robots in aged care; and (3) conceptualising the ideal chore robots appearance, features, and functionality. Leveraging an existing real-world functional prototype of a chore robot, HELPII, from our robotic colleagues (with a mobile base, grasping technology, AI-enabled voice command, and a personality [ 23 ]), this co-design research explored the wishes, expectations, and preferences of executive aged care stakeholders. Co-design directly involves users in the design process, to design with, not for, so that end users have an active role in knowledge development, idea generation, and concept development – thus helping to ensure the final product truly meets their requirements [ 24 ]. The co-design process is a necessary step to assist the mechatronic engineers and the designers to better understand the needs of the chore robot’s end-users. There are numerous design factors that need to be addressed and taken into account when considering the development and implementation of robotic technology, more specifically collaborative robots (cobots) and for human-robot collaboration. Human-robot collaboration (HRC) refers to the collaboration resulting from a human and a robot working on the same task or in close proximity to one another [ 25 ]. Safety is a primary factor driving how a human and a robot can collaborate and interact with one another typically mitigated by sensors, monitoring, power limitations and force control [ 26 ]. Cobots have a number of attributes and characteristics ranging from payload, reach, degrees of freedom to costs and programming [ 26 ]. Additional factors to consider are the context and environment of robot use, purpose of use or task definition, experience of users, control of the robot, size and weight. For the aged care sector all of these factors are relevant to the design of a chore robot requiring input from stakeholders beyond researchers, engineers and designers. Therefore, including the perspectives of experts from the aged care sector is a first step in developing a chore robot that can work alongside humans safely and collaboratively, one that is fit for purpose, aesthetic, user friendly, and acceptable to residents and families, and that aged care decision makers would support and pay for. 4 Methodology Leveraging the knowledge and expertise of executive aged care stakeholders, we conducted a qualitative co-design study comprising of a workshop/roundtable and individual in-depth interviews focussed on understanding, imagining and co-designing what a chore robot designed for aged care should look like and do. Ethics approval was granted by our university ethics committee (7765), with the research conducted in late 2023. 4.1 Industry Leaders Workshop/Roundtable and Interviews A 2-hour robotic demonstration workshop/roundtable was held in our university seminar room in late November 2023, with executives in residential aged care recruited through our professional networks and snowball sampling. Participants included seven representatives from 4 care providers in the Greater Brisbane (Australia) area, as well as a venture capitalist (1), architect (1) and accountant/business advisor (1). These key sector stakeholders were invited due to their knowledge about how a robot might work in the aged care setting and also be commercially viable. After a tour of the robotics research centre and a demonstration of the prototype robot, they participated in a design thinking workshop, starting by reflecting on their own knowledge, beliefs, and experience with robotics in care settings and ending with a co-design/design thinking sprint to re-design this chore robot. Figure 2 outlines the custom co-design canvas we developed for teams to complete, with 8 reflective/prompting questions: (1) activities, routines and tasks - the purpose of the robot; (2) its location; (3) who it interacts with; (4) its physical form; (5) how it communicates; (6) its impact on the aged care home; (7) ethics to consider; and (8) the narrative that would convince the aged care board to fund/invest in/trial this robot. Groups then completed a one-page pitch outline, with a sketch of their idea, a robot name, and the key compelling points (from design features to business model), before verbally presenting their solution (see Figs. 3 – 6 ). In the month after the roundtable/workshop, follow-up online interviews (~ 30 minutes) were held with 5 of the participants to follow up on and clarify the final decision concepts and narrative that would best engage and convince aged care leaders that a chore robot would of value to their organisation. 5 Findings: Co-Designing a chore robot for aged care 5.1 General Sector Knowledge of Robotics is Low The session started with an open discussion about what participants knew about robotics, asking if (1) they had deployed a robot, and their experience, as well as (2) what the sector experience was. Overall, participants had very low levels of knowledge, awareness, and practical experience of robotics. Two organisations had direct experience with a service robot, a chore robot (also a Lamson) and a humanoid robot (Pepper). Both returned them after 2 months, as described below. Pepper, the Robotic Receptionist - from “wow” to “what”. This aged care facility was excited to trial Pepper, describing how they thought it was “ novel and nice... the funkiest, coolest little thing ”. Pepper was deployed to act as receptionist in their gym area, to enable bookings for exercise programs. However, despite the original excitement, there was ultimately a sense of disappointment in that Pepper did not really add significant value, with the initial “ wow ” factor becoming “ so what? ”. While they acknowledged that they did not fully activate the robot, there was a sense that Pepper did not significantly enhance the experience or streamline processes – and after two months, they returned the robot. Rosie, the Lamson Transport Robot - “excitement became struggle”. A second aged care facility described their experience, in 2019, with a robotic laundry and food transport system in their new 150 bed facility. Intentionally designed to be non-institutional without long corridors, there were 5 x 30-bedroom communities (each with their own dinning and lounge rooms) featuring widened corridors to enable a robot transport system. Their chosen system was a Lamson Autonomous Mobile Robot (AMR) designed to save staff time by automating trolley transport and transporting meals, linen, waste, supplies, and clothing, see Fig. 4 . This RACF was an early adopter, working with a USA-based supplier. Unfortunately, they were unable “ to get the robot to the point of efficiency ”. As the CEO explained, “ excitement became struggle ”, with two months of challenge where “ more time was spent re-setting the robot than using ”. It was unable to operate autonomously and always seemed to require one person to supervise it, “ stopping at every turn, always needing someone to follow up – it needed to be able to do things away from the team... and that was not our experience ”. They experienced three specific issues. Firstly, navigation challenges. Despite intentionally designing wider corridors to facilitate movement, the robot was unable to efficiently navigate the shorter corridors and the dynamic, often cluttered, environment of aged care – which meant it could not reliably and independently transport laundry and food without supervision. Secondly, operational errors. They reported that the robot frequently experienced operational errors (technical malfunctions, software issues, difficulties in handling various tasks), leading it to often being “ in a thousand pieces, on the floor ”. The robot required continuous supervision, with “ more time spent re-setting the robot than using it ". Thirdly, safety concerns. They described a notable incident where the robot failed to sense the presence of an older resident in an elevator, leading to the resident being trapped. While this was a one-off event, combined with the ongoing operational challenges and the fact that the robot could not operate autonomously, they ultimately decided to return the robot after only two months of use. Their experience with robotic transport was disappointing, with their original high expectations not met. The challenges they encountered, including navigation issues, operational errors, a notable safety incident and the need for constant supervision, highlight the complexity of adapting robotic technology to real-world environments. However, they noted that occurred several years ago, in 2019, and felt that many of the problems they encountered had likely been resolved – and thus were keen to experiment with robots again. 5.2 Reimagining and co-designing a chore robot Most of the workshop centred on reimagining the chore robot, HELPII, with teams (2–3 industry participants, working with 1 research team member) completing the custom design canvas we developed. First, however, there was a group brainstorming session to consider what the robot could do, as reported in Table 1 . Teams then picked one idea (or generated another) to develop as a concept, completing the canvas in Fig. 2 . They were also given a printed image of HELPII with a series of pre-cut pieces of papers with textures, colours, and robot parts to use for collaging and drawing their concept further. Table 1 Tasks assigned to chore robot. Category Task Kitchen/Garden Clear tables and serve residents Garden weed, water and mow Clean/Laundry Clean bathrooms Operate laundry machine – washing, folding, sorting, and delivery. Shampoo carpets. Move and fetch Move residents to and from activities. Move furniture and set up activity spaces and rooms (before/after meals). Fetch things, such as tissues; remote control: pick up rubbish; socks; water, etc. Install a vending machine on top, and have it circulate offering food (note that it is restricted to the resident’s diet). Social and Care tasks Prompt residents: meals, activities, medications De-escalate behaviour, distract or influence moods (people with dementia). Monitor health: sleep, blood pressure, etc. Provide therapeutic touch, especially in palliative care context, for example, by holding a warm wheat bag. Link with nurse call system. Each group developed and then pitched their ideas, articulating the value proposition, the business model, their design concept, and the name of their chore robot. Three teams focussed on versions of cleaning robots, and one on catering food. Group 1: The Green, Clean, Calming Machine. Group 1's robot concept, named the Green, Clean, Calming Machine, is an environmentally friendly cleaning robot. This robot performs cleaning tasks, including vacuuming, mopping, upholstery cleaning, air filtering and scent diffusing, while simultaneously monitoring residents in the background for distress or hazards. The robot's features include retractable arms for dusting and mopping, multidirectional wheels, and a height that allows it to fit beneath dining tables like a Roomba. To enhance its usability, the robot is operated and programmed by cleaning staff using tablets and voice commands, considering the staff's diverse multicultural and language skills. The robot's soft, fabric-based material covering, soft edges, and warm-toned calming glow aim to make it approachable but still look like a machine, especially for patients with dementia. It is strategically placed in common areas, with one robot per facility wing, collaborating with the cleaning staff. Apart from its cleaning functions, the Green Cleaning Machine incorporates UV sterilization for infection control, and it is designed to clean its own body, including wheels and the outer shell. The group envisions that the implementation of this robot will not only free up staff time but also help in hazard identification and preventing trips and falls. The overall goal is to positively impact the quality of life for aged care residents. Group 2: Sadie. Group 2 reimagined the chore robot as a professional, engaging, and non-gender-specific robot designed for a variety of tasks within an aged care facility. The robot's primary responsibilities include cleaning general areas three times a day (post-meals), air purification, utilising fresheners, and implementing infectious disease prevention measures, such as those against viruses like coronavirus. Also, it is designed to comply with food safety standards. The robot's physical attributes are characterized by friendly eyes, a small and functional design in white, and multiple arms equipped for tasks like picking up items, using microfiber cloths, vacuuming, dusting, and sanitising. As an additional touch, the robot might even play music. Group 2 considered that residents will actively participate in its design. Practical considerations involve a docking station, but the robot is intended for routine work throughout the entire aged care facility. Importantly, it respects privacy by requiring consent before accessing individual rooms. The robot is designed to interact with both staff and managers, fostering a collaborative environment. To ensure ongoing performance and support, the robot will be contracted through a lease plan, with maintenance and support services readily accessible locally. At the end of each day, the robot provides a comprehensive report, contributing to transparency and accountability in its operations. Group 3: Speedy x3. Group 3 envisions "Speedy x3," a functional and unassuming robot with a primary focus on efficiency in completing laundry chores and navigating residential aged care settings. Unlike other concepts, Speedy x3 does not have a gender or personality, prioritising a purely functional role to support residents in tasks they can no longer perform themselves. The robot's core responsibilities focus on "getting the basics right," emphasizing seamless navigation through various environments within the aged care facility, including lifts, ramps, indoors, outdoors, and open doors. Its inconspicuous design ensures it does not stand out, contributing to a quiet and unobtrusive presence. Speedy x3's priority tasks revolve around the laundry process. It adeptly collects laundry, transfers it to laundry machines, turns the machines on, folds the laundry, re-labels items, and returns them to residents' rooms. The design considerations include a focus on being inconspicuous, quiet, equipped with a smell eliminator, capable of remote maintenance, and autonomous based on staff schedules while allowing for manual override. The business model is structured to be more cost-effective than a staff member, with the robot's annual cost not exceeding $ 130,000. Speedy x3 operates seven days a week, responding to voice commands and central control on the robot. The main impact Group 3 aims for is to free up staff time, minimise facility damage, and reduce exposure to noise and smells, contributing to an enhanced and efficient care environment. Group 4: Cookii/ Foodii, your friendly catering companion. Group 4's concept, named "Cookie" or "Foodii" (name yet undecided), presents a friendly catering companion for the aged care facility. Gender-neutral and characterised by a loving personality, this robot takes on priority tasks such as menu ordering, delivery and cleanup, food quality control compliance, and engaging in social interactions with residents, staff, and all stakeholders. Designed for easy manoeuvrability and multifunctionality and equipped with visual and voice interaction capabilities, Cookie or Foodii is a versatile addition to the care environment. The robot adopts a human-like appearance with two arms and features warm colours to stimulate appetites. Limbs are uniquely coloured to assist residents in identifying safe interaction points. In terms of functionalities, Cookie or Foodii communicates through voice-to-text or iPad technology, collaborating seamlessly with staff to serve both them and residents. It moves about as needed, ensuring it reaches various locations within the facility. Special attention is given to residents suffering from social isolation, as the robot interacts with and accompanies them, motivating social engagement during meals. Importantly, Cookie or Foodii avoids delivering an automated, impersonal service. It recognises declines in a resident's well-being and promptly reports it, showcasing a commitment to personalised care. The robot can also assist in the physical positioning of residents before feeding, ensuring their comfort and safety. The main impact of Cookie or Foodii is the realignment of staffing priorities, allowing staff to focus more on direct care. By handling catering tasks and providing companionship to residents, the robot aims to enhance the overall care experience while fostering meaningful connections within the community. Communication through voice-to-text or iPad technology further facilitates seamless collaboration between the robot, staff, and residents. In the follow-up interviews, which focussed on the practicality of deployment, participants (4 aged care providers and one architect) remained excited about how a chore robot might benefit, with all providers volunteering to trial the robot when needed. There was agreement that general cleaning and laundry are massively time-consuming tasks. In larger aged care facilities, such tasks are performed by cleaners and catering staff. However, in many, care staff often have to perform cleaning duties as well. Overall, there was a sense that a chore robot might potentially replace 1.5- 2FTE for general cleaning, laundry services and infection control, and this value proposition was of significant interest. Laundry, in particular, was a massive issue, especially for many regional facilities where the laundry is often externally located up to 1km from rooms [ 3 ]. 6 Discussion In the process of identifying the value proposition for ‘chore’ robots in aged care, participants in the workshop exhibited a strong interest in the potential benefits that robotic technology could bring, despite having limited direct experience. Several key aspects emerged from the discussion. 6.1 Value - Cost and Task Efficiency Participants acknowledged the potential cost savings and increased task efficiency that chore robots could bring to aged care facilities. Automating various tasks could lead to reduced operational costs and improved resource allocation, making robotics a financially attractive option, especially considering the recent Royal Commission into Aged Care Quality and Safety recommendations [ 17 ]. These have mandated that, from 1 October 2023, residential aged care homes will be required to deliver at least 200 care minutes per resident per day, including 40 minutes with a registered nurse [ 17 ]. The discussion highlighted the potential for robots to free up staff time, allowing for more personalized care delivery. For instance, Group 1's Green, Clean, Calming Machine combines cleaning functions with monitoring capabilities, aiming to free up staff time for more personalised care delivery. Group 2's Sadie focuses on professional cleaning tasks, air purification, and infectious disease prevention, aligning with food safety standards. Group 3's Speedy x3 streamlines laundry chores efficiently, prioritising cost-effectiveness. Group 4's Cookie or Foodii, the catering companion, aims to reallocate staffing responsibilities, enhancing the dining experience and decreasing malnutrition. 6.2 Trust in Technology Trust is crucial for the acceptance and successful implementation of chore robots in aged care settings – and this was already challenged, with two care homes trialling and returning robots. One participant noted that, as robots are not part of our environment now, it may be hard for residents and staff to quickly accept them. Previously mentioned experiences with Pepper and Rosie point to a trial-and-error approach that emphasises the importance of matching the robot's capabilities with staffing resources in an effective application to gain success. The diverse concepts of reimagined HELPII showcased different approaches to building trust. Group 1 emphasised the collaborative operation of the Green, Clean, Calming Machine by cleaning staff, considering their multicultural and language skills. Group 2's Sadie engages residents in its design, fostering a sense of participation and ownership. Group 3's Speedy x3 prioritises an unassuming and functional design to ensure acceptance and minimal disruption. Group 4's Cookie or Foodii focuses on personalised care, recognising declines in residents' well-being and avoiding automated, impersonal service. That said, all were excited about and interested in trialling the chore robot, particularly with the younger generation of carers who are interested in engaging with technology such as robots. One group suggested that it could be a draw card to obtain and retain more staff. Supervision and maintenance challenges were acknowledged, emphasising the need for staff training and potential job creation opportunities. 6.3 The design, the tasks and the users There is a need for user-friendly interfaces, safety features, and rigorous testing to build trust in the technology and ensure its seamless integration into the care environment. The discussion envisioned the tasks that the proposed robot, HELPII, might undertake. From clearing tables to operating machines, shampooing carpets, and even serving residents, the chore robot would have a multifaceted role, catering to various needs within the aged care facility. Its potential tasks expanded to include menu choice/prompting, baseline observations, pain checks, and vital assessments for potential fractures. Incorporating a residents' database was deemed crucial to personalise interactions based on individual conditions, likes, and dislikes. Special attention was given to providing assistance with falls, bathroom cleaning, rubbish collection, and linen distribution, aiming to alleviate mundane, repetitive tasks for staff and enhance the overall resident experience. Design considerations touched upon critical aspects such as its physical form, interaction capabilities, and the need for dementia-friendly aspects (e.g., colours and interactions). Human-like limbs and clothing were suggested to enhance the robot's acceptance, and the colour red, known to stimulate appetite, was considered for certain applications. The consensus was that it should not resemble a person to avoid potential disturbance, and its role should be perceived as a tool rather than a humanoid, and a zoomorphic form was not part of the discussion. Interaction modes were discussed, with voice commands, scheduled tasks, and reporting back findings highlighted as essential features. The diverse language skills of staff highlighted the importance of easy commands with voice activation and use of current familiar technologies, like tablets. The robot's ability to navigate corners safely was identified as a key issue, and leasing was considered a preferred option due to the need for ongoing service and maintenance. Considering the user perspective, the roundtable identified that older residents, possibly with dementia, would benefit from voice interaction. Familiarity and hygiene were emphasised, along with the need for an opt-out option for certain maintenance tasks if residents require so. However, it was essential to consider their limited skills and experience with technology. Cost implications were acknowledged, emphasising that the robot should not require constant supervision to avoid wasting staff time. Overall, participants’ expectations of HELPII as a chore robot for aged care varied in form and functions. Participants’ concepts were cleaned up to represent each team’s ideas and potentially use as tangible consequences in a following iteration session with personal care workers (staff) and residents (Fig. 7 ). 6.4 Tech literacy of staff, especially CALD Participants noted that many care staff are from culturally and linguistically diverse (CALD) backgrounds, which impeded technology literacy. Additionally, as a sector, aged care can be risk-adverse; looking at change in terms of Everett Rogers Diffusion of Innovation theory [ 27 ] (which explains how new innovations spread through society and how they are adopted at different rates by different individuals or organisations), we can conceptualise the uptake of robotics in aged care into three groups: Innovators and Early Adopters typically, the first to embrace the technology. These forward-thinking individuals or organisations are willing to take risks and invest in the latest robotic solutions. They may have the resources and a willingness to experiment, even if it means encountering initial challenges. Early and Late Majority The slow adoption of robots can be attributed to the attitudes and behaviours of the early and late majorities. These groups tend to be more risk-averse and cautious. They are waiting to see evidence of the robots' benefits, including improved care, cost savings, and safety, before committing to widespread adoption. Laggards Laggards are the last to adopt new technologies. They are typically resistant to change and may have deeply ingrained traditional practices. The slow adoption of robots may be partially due to resistance from this group, which can be found in some healthcare and aged care institutions that are hesitant to deviate from established caregiving methods. The participants in the room represented early adopters and early majority, and were willing to be convinced that robots could help them deliver a better care experience in a cost-effective manner. What was notable, however, is that truly imagining the possibilities of robots to transform care was a challenge, given their disciplinary, non-technological backgrounds and limited exposure to date. They were all, however, keen to stay connected, to be trial sites, and to embark on this journey of transformation. Co-design activities such as these, which bring together sector stakeholders to imagine if and how robotics might transform aged care, are critical tools for facilitating engagement and helping to ensure that any design meets the needs of end-users. 7 Conclusions This study addresses the pivotal gap in aged care research by exploring the co-design of chore robots, shedding light on the challenges faced by existing service robots and presenting innovative concepts to enhance the caregiving landscape. The research highlights the transformative potential of chore robots, offering relief to caregivers by addressing routine and physically demanding tasks. Concepts from industry leaders envision not only improved task efficiency but also a more personalised and compassionate care experience for residents. Collaboration, trust-building, and user-friendly interfaces emerge as critical elements for successful implementation. While acknowledging challenges such as limited technology literacy among staff, the study identified a willingness among early adopters and the early majority within the aged care sector to explore the benefits of chore robots. The value proposition aligned with evolving care standards, emphasising cost savings, task efficiency, and improved care delivery. Participants believed that robots should not “take jobs”, and, as senior leaders charged with ensuring financial viability, they needed to be convinced of the value and return on investment. As we navigate the path toward chore robot integration, ongoing human-robot collaboration, usability testing, and functionality assessments become paramount. This research serves as a catalyst for further exploration involving personal care workers (staff) and potentially older adult residents, envisioning a future where chore robots seamlessly contribute to a technologically empowered and compassionate caregiving environment in aged care. Through continued engagement and openness to innovation, we can pave the way for a more efficient and transformative era in aged care. Declarations CRediT author statement. Evonne Miller : Conceptualization, Methodology, Formal analysis, Writing – original draft preparation. Valeria Macalupu : Methodology, Workshop tool design/visualisations; Writing – review and editing. Glenda Caldwell : Conceptualization, Methodology, Writing – review and editing. Acknowledgments. We acknowledge the robotics and university-industry engagement team, who designed this robot prototype and engaged us to test its viability in aged care. References Robinson, H., Macdonald, B., Kerse, N. and Broadbent, E. (2013) The Psychosocial Effects of a Companion Robot: A Randomized Controlled Trial. Journal of the American Medical Directors Association, 14, 661-667. https://doi.org/10.1016/j.jamda.2013.02.007 Wang, X, Shen., J, & Chen Q. (2022). How PARO can help older people in elderly care facilities: A systematic review of RCT. Int J Nurs Knowl. 33(1):29-39. doi: 10.1111/2047-3095.12327 Herath, D., Martin, L., Doolan, S. & Grant, J. (2023). Robots and Aged Care: A Case Study Assessing Implementation of Service Robots in an Aged Care Home. In: Proceedings of the 32nd IEEE International Conference on Robot and Human Interactive Communication (IEEE RO-MAN 2023, August 28-31). Busan: Korea. Jörling, M., Böhm, R., & Paluch, S. (2019). Service robots: Drivers of perceived responsibility for service outcomes. Journal of Service Research, 22(4), pp 405. Blindheim K, Solberg M, Hameed I, & Alnes, R. (2023). Promoting activity in long-term care facilities with the social robot Pepper: a pilot study. Inform Health Soc Care, 48(2):181-195. doi: 10.1080/17538157.2022.2086465 Inada, M. (2021). Humanoid Robot Keeps Getting Fired From His Jobs. Wall St Journal. Carros F, Meurer J, L¨offler D, et al (2020) Exploring human-robot interaction with the elderly: results from a ten-week case study in a care home. In: Proceedings of the 2020 CHI conference on human factors in computing systems, Association for Computing Machinery, New York, NY, USA, CHI ’20, pp 1–12. https://doi.org/10.1145/3313831.3376402 Carros F, Schwaninger I, Preussner A, et al (2022) Care workers making use of robots: results of a three-month study on human-robot interaction within a care home. In: Proceedings of the 2022 CHI conference on human factors in computing systems, Association for Computing Machinery, New York, NY, USA, CHI ’22. https://doi.org/10.1145/3491102.3517435 Wright J (2019) Robots vs migrants? Reconfiguring the future of Japanese institutional eldercare. Crit Asian Stud 51(3):331–354. https://doi.org/10.1081/14672725.2019.1612765 Caleb-Solly P, Dogramadzi S, Huijnen CAGJ et al (2018) Exploiting ability for human adaptation to facilitate improved human-robot interaction and acceptance. Inf Soc 34(3):153–165. https://doi.org/10.1081/01972243.2018.1444255 Hebesberger D, Koertner T, Gisinger C, et al (2016) Lessons learned from the deployment of a longterm autonomous robot as companion in physical therapy for older adults with dementia a mixed methods study, pp 27–34. https://doi.org/10.1109/HRI.2016.7451730 Kanoh M, Oida Y, Nomura Y et al (2011) Examination of practicability of communication robotassisted activity program for elderly people. J Robot Mechatron 23(1):3 Shishehgar, M., Kerr, D., & J. Blake (2018). A systematic review of research into how robotic technology can help older people. Smart Health, 7-8, 1-18. doi: https://doi.org/10.1016/j.smhl.2018.03.002. D'hondt, A., Kaasalainen, S., Prentice, D., & Schindel Martin, L. (2012). Bathing residents with dementia in long-term care: Critical incidents described by personal support workers. International Journal of Older People Nursing, 7(4), 253-263. https://doi.org/10.1111/j.1748-3743.2011.00283.x Rosendal, K., Lehn, S. & Overgaard, D. (2022). Body care of older people in different institutionalized settings: A systematic mapping review of international nursing research from a Scandinavian perspective. Nursing Inquiry, early access online. https://doi.org/10.1111/nin.12503 Eagar, K., Westera, A., Snoek, M., Kobel, C., Loggie, C & Gordon, R (2019). How Australian residential aged care staffing levels compare with international and national benchmarks. Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong. Briggs, L., & Pagone, T. (2021). Royal Commission into Aged Care Quality and Safety. Final Report: Care, Diginity and Respect. Canberra: Royal Commission into Aged Care Quality and Safety. Ludlow, K., Churruca, K., Mumford, V., Ellis, L. A., & Braithwaite, J. (2020). Staff members’ prioritisation of care in residential aged care facilities: a Q methodology study. BMC health services research, 20, 1-14. Miller, E. (2021). Creative Arts-Based Research in Aged Care: Photovoice, Photography and Poetry in Action. Routledge. pp 122, 123. Yuan, S., Coghlan, S., Lederman, R. et al. Ethical Design of Social Robots in Aged Care: A Literature Review Using an Ethics of Care Perspective. Int J of Soc Robotics 15, 1637–1654 (2023). https://doi.org/10.1007/s12369-023-01053-6 Jang, M., Ahn, H. S., Choi, J. S., Kirstein, F., & Yoichi, L. (2021). Special issue on social human–robot interaction for human-care robots. Intelligent Service Robotics, 14, 327-328. Eva Hornecker, Andreas Bischof, Philipp Graf, Lena Franzkowiak and Norbert Krüger. 2020. The Interactive Enactment of Care Technologies and its Implications for Human-Robot-Interaction in Care. In Proceedings of the 11th Nordic Conference on Human-Computer Interaction: Shaping Experiences, Shaping Society (NordiCHI '20), October 25-29, 2020, Tallinn, Estonia. ACM, New York, NY, USA, https://doi.org/10.1145/3419249.3420103 Rana, K., Haviland, J., Garg, S., Abou-Chakra, J., Reid, I., & Suenderhauf, N. (2023). Sayplan: Grounding large language models using 3d scene graphs for scalable task planning. arXiv preprint arXiv:2307.06135. Elizabeth B.-N. Sanders & Pieter Jan Stappers (2008) Co-creation and the new landscapes of design, CoDesign, 4:1,5-18, DOI: 10.1080/15710880701875068 Aaltonen, I., & Salmi, T. (2019). Experiences and expectations of collaborative robots in industry and academia: Barriers and development needs. Procedia Manufacturing, 38, 1151-1158. Guertler, M. R., Brackemann, T., Burden, A., & Caldwell, G. (2023). Mapping socio-technical dependencies to enable the successful adoption of collaborative robots in industry. Procedia CIRP, 119, 564-569. Rogers, E. M. (1995). Diffusion of Innovations. (4th ed.) New York: Free Press, 1995. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3977206","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":274205260,"identity":"588c983b-b40d-4730-b09a-a5d4f7e2abf9","order_by":0,"name":"Valeria Alessandra Macalupu Chira","email":"","orcid":"https://orcid.org/0000-0002-1450-9110","institution":"QUT","correspondingAuthor":false,"prefix":"","firstName":"Valeria","middleName":"Alessandra Macalupu","lastName":"Chira","suffix":""},{"id":274205261,"identity":"0a60f6c4-4c89-42eb-a991-fec9284dc89f","order_by":1,"name":"Glenda Caldwell","email":"","orcid":"https://orcid.org/0000-0003-0837-9310","institution":"QUT","correspondingAuthor":false,"prefix":"","firstName":"Glenda","middleName":"","lastName":"Caldwell","suffix":""},{"id":274205262,"identity":"236be435-f424-40b2-b637-1f45a55e11d1","order_by":2,"name":"Evonne Miller","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIiWNgGAWjYJCCAw8KGBj4IWxmIrUkGDAwSDYwMDYQrYUBpMXgALFa+Bm4E4G22OQbH88xf8BQYZ3YwH7GAK8WyQbeDUAtaZbbzrwxbGA4k57YwJODX4vBAbCWwwZmN3IMGxjbDic2MBDQYg/R8t/AeAZIyz+gFv43BGxhAGs5YGAgAdLSANQiQcAWicNgLckGEmeeFc5IOJZu3CbxrACvFv723s0fPlTYGfC3J2/48KHGWrafP3kDXi1IEZEARgxs+NWjgAQS1I6CUTAKRsGIAgDGNkdRgkYQxgAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-0577-3438","institution":"QUT","correspondingAuthor":true,"prefix":"","firstName":"Evonne","middleName":"","lastName":"Miller","suffix":""}],"badges":[],"createdAt":"2024-02-22 01:25:13","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-3977206/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3977206/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":51564512,"identity":"dbad0564-a100-4bcc-ab5e-3e2915f8f5b9","added_by":"auto","created_at":"2024-02-23 18:56:53","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":806988,"visible":true,"origin":"","legend":"\u003cp\u003eChore, companion, and care robots in aged care (Source: Project Team).\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/992976f20cd00f065f2621f8.png"},{"id":51565481,"identity":"18fcd644-5645-4719-9c11-b27faf7f434b","added_by":"auto","created_at":"2024-02-23 19:04:53","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":919644,"visible":true,"origin":"","legend":"\u003cp\u003eThe robot in aged care co-design canvas.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/4c0ebfa1ebb1fbcafbd4358a.png"},{"id":51564510,"identity":"897e466d-4b1d-46e4-914d-360bff7d148a","added_by":"auto","created_at":"2024-02-23 18:56:53","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":519157,"visible":true,"origin":"","legend":"\u003cp\u003ePepper the robot. Author Credit: Paju~commonswiki, (Source: \u0026nbsp;\u003ca href=\"https://commons.wikimedia.org/wiki/File:Kalasataman_terveys-_ja_hyvinvointikeskus_-_Helsinki_-_4.jpg)).\"\u003ehttps://commons.wikimedia.org/wiki/File:Kalasataman_terveys-_ja_hyvinvointikeskus_-_Helsinki_-_4.jpg).\u003c/a\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/e6e73bb14e1cc47636517ef0.png"},{"id":51564514,"identity":"22c058e2-bb49-4849-88c2-4497d8b3bb3c","added_by":"auto","created_at":"2024-02-23 18:56:53","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":383411,"visible":true,"origin":"","legend":"\u003cp\u003eLamson’s AMR (Source: https://www.lamson.com.au/solutions/aged-care/).\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/0d0a4cff305bea6c6b4a9410.png"},{"id":51565482,"identity":"e97ea46a-62bd-4df8-977a-bb9b4f2b72df","added_by":"auto","created_at":"2024-02-23 19:04:53","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":457704,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFig. 3. \u003c/strong\u003eGroup 1. final pitch\u003cstrong\u003e – The Green, Clean, Calming Machine.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/8bfda552700ec81818d13e76.png"},{"id":51564518,"identity":"2d5586f4-23f8-41e0-ae9c-5e7b5e09406c","added_by":"auto","created_at":"2024-02-23 18:56:53","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":631042,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFig. 4.\u003c/strong\u003e Group 2 final pitch – Sadie.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/a13fb5a729f491e25a0842a2.png"},{"id":51564517,"identity":"47285752-52f0-4d43-95bc-65501e62537c","added_by":"auto","created_at":"2024-02-23 18:56:53","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":491735,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFig. 5.\u003c/strong\u003eGroup 3 final pitch - Speedy x3.\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/3e07a677a0e9401baf866f0a.png"},{"id":51564516,"identity":"ebdbdfd2-b024-487a-bbce-3c7cfaef4c85","added_by":"auto","created_at":"2024-02-23 18:56:53","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":496909,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFig. 6.\u003c/strong\u003e Group 4 final pitch - \u003cstrong\u003eCookii/ Foodii.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"8.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/da928c3e9d4de17572f7650a.png"},{"id":51564519,"identity":"b20e335e-9059-4547-ac59-274c43b4a462","added_by":"auto","created_at":"2024-02-23 18:56:53","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":1301901,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFig. 7.\u003c/strong\u003e Polished concepts resulting from the workshop with industry leaders.\u003c/p\u003e","description":"","filename":"9.png","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/28d0018aa0db0017f9de8ff2.png"},{"id":51566368,"identity":"74ccda59-d53e-42fe-9386-11f9f28dc9e6","added_by":"auto","created_at":"2024-02-23 19:12:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":5433821,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3977206/v1/b63e6d1c-0f26-44e9-bfc8-a2aef1f8fde6.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eEnhancing Aged Care through Human-Robot Collaboration: A Case Study of Chore Robots.\u003c/p\u003e","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eDespite decades of experimentation and technological advancements, robots are not yet mainstream in aged care. While there have been numerous successful demonstrator and pilot studies showcasing the potential of robots in improving the lives of older people in residential aged care (see, for example, the therapeutic robot Paro the Seal [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e][\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] and the transport/chore robot, Rosie [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]), the leap to widespread adoption of robots has proven elusive \u0026ndash; in part because of limited end-user engagement in the design phase. Despite a paradigm shift where the development of robotic technologies increasingly uses a human-robot collaboration lens, research documenting how to co-design a robot for aged care is virtually non-existent. This paper addresses this knowledge gap.\u003c/p\u003e"},{"header":"2 Background","content":"\u003cp\u003eRobots, best defined as \u0026ldquo;\u003cem\u003einformation technology in a physical embodiment, providing customized services by performing physical as well as nonphysical tasks with a high degree of autonomy\u003c/em\u003e\u0026rdquo; [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], come in various forms, each designed for specific tasks and needs. Service robots are designed to perform tasks in non-industrial and non-manufacturing environments, interacting with, assisting, or providing services to humans in various real-world settings, including the home, retail, hospitality, healthcare, and aged care.\u003c/p\u003e \u003cp\u003eIn the context of aged care, interactions between humans and service robots can be broadly categorised into three key activity domains: chores, companionship, and care activities, as visually depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. To date, the majority of the limited research in aged care has been conducted on service robotics designed for companionship (e.g., limited conversations, playing bingo, quizzes, collaborative singing) and basic care tasks, monitoring and activities (e.g., monitoring health vitals, exercise, movement).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eMost attention has focussed on companion robots, such as Pepper (humanoid robot) and Paro the Therapeutic Seal (animaloid robot). While several studies have demonstrated Paro has a positive impact on quality of life and pain medical usage [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], Pepper - which was trialled in libraries, banks, stores, and aged care as a friendly interactive robot \u0026ndash; often failed due to limited functionality and unreliability, and was withdrawn from the market in 2021 [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Some studies with Pepper in aged care [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] recorded an increase in caregivers\u0026rsquo; responsibilities to ensure the correct functioning of the robot and to facilitate its social acceptability with residents, particularly those with dementia. Moreover, in some instances where caregivers were skilful, they found Pepper\u0026rsquo;s standardised activities and programs to be too limiting and hinder their care performance and relationships with residents. When interacting in scenarios with multiple residents who spoke in diverse tones and dialects, Pepper\u0026rsquo;s performance fell short of understanding commands, disregarded residents\u0026rsquo; dynamic feelings and emotional needs, and impacted and confused them with its responses. These limitations have been found in other social robot prototypes like Kompai [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], SCITOS G5 [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], and YORISOI Ifbot [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe focus on social companion/ entertainment/ socialisation robots means that there is very little research or practice in aged care on either care or chore robots [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. This is surprising, given that chore robots have the potential to do some of the more routine or so-called \u0026ldquo;dirty\u0026rdquo; tasks (laundry, cleaning, showering, toileting), which involve urine, faeces, and bodily fluids, thus freeing staff up for preferred care tasks [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Performing these tasks can be physically demanding, time-consuming and challenging for caregivers, who may experience physical strain from lifting, moving and manoeuvring residents (lifting, bending, carrying tests strength and endurance, straining muscles) and their belongings.\u003c/p\u003e \u003cp\u003eThe current reality is that there is simply not enough skilled staff in aged care [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], which leads to increased workloads for existing caregivers, leading to burnout, increased staff turnover, and higher recruitment and training costs. The reduced and often changing care staff can negatively impact residents\u0026rsquo; quality of care, resulting in \u0026ldquo;missed\u0026rdquo; or \u0026ldquo;unfinished\u0026rdquo; care: residents wait because staff are busy elsewhere [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Miller [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], for example, documents how one aged care resident felt that staff were \u0026ldquo;\u003cem\u003ealways rushed, always sharing everybody and everything...\u003c/em\u003e\u0026rdquo; (p.122). Staff want to deliver quality care, but aged care is a busy environment, limiting caregivers' availability to engage in more meaningful, person-centred interactions; as one staff member explained:\u003c/p\u003e \u003cp\u003e \u003cem\u003eWe have a roster of what we are supposed to... including taking people for walks at 9.30 am. That time, we have just finished showers, we have got to make the beds, do the pad bins... then at 10 am it\u0026rsquo;s morning tea... supplement drinks, 10.30 am activities start... so we don\u0026rsquo;t always get to it. We all try and spend that five minutes here and there to talk to them\u003c/em\u003e [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo create more time for staff to interact with residents and reduce the physically demanding aspects of the care role, automation, assistive and advanced technology (such as robots) must be better integrated into residential aged care settings. By leveraging technology, caregivers can optimize their workflow and focus more on engaging with residents while the technology handles certain tasks. To date, although technology has the potential to help alleviate some of the challenges facing care staff, the adoption of service robots into residential aged care \u0026ndash; especially those focussed on reducing the physical workload by assisting with chores - remains limited and piecemeal.\u003c/p\u003e \u003cp\u003eA notable exception is research from a regional aged care facility in South Australia, where robotic systems (Lamson AMR RoboCarts) have been employed to transport and deliver various items such as linen, clean clothes, and food across the large, dispersed facility [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Drawing on government grants and partnerships with robotic manufacturers, this aged care facility has become a chore robot trial, testing and development site. Management estimates that these robots can handle up to 25% of the tasks typically performed by humans, and as the robots cover a substantial distance (~\u0026thinsp;9,000 kilometres per year/ 24 kilometres per day), there has been significant cost savings (2.5 full-time equivalent positions and approximately \u003cspan\u003e$\u003c/span\u003e200,000 annually, which has been redirected to staff care hours).\u003c/p\u003e \u003cp\u003eHowever, this transition has not been straightforward: the 70-year-old building was not originally designed for such technology, with multiple modifications required (including replacing swinging doors with wide and automated sliding ones, adjusting the lift to accommodate the robots, strong Wi-Fi connectivity), with management and staff also expecting the technology to work much easier, quicker, and independently than it did. As robots are only of value if care staff and residents can meaningfully collaborate with them, and easily incorporate them into their workflow and ongoing care practices, issues of usability, acceptability and functionality are key to acceptance and uptake [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIndeed, as Hornecker et al. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] remind us, social robots require significant human (staff) oversight to integrate into practice, and are not, in fact, the social-cultural, scientific and media portrayal of \u0026ldquo;\u003cem\u003eskilful, autonomous and quasi-conscious entities\u0026hellip; acting in isolation, working independently, and replacing human work\u003c/em\u003e\u0026rdquo; (p.2). As the context of aged care involves both residents and staff, Hornecker et al. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] suggest that the field of care should move from HRI (Human-Robot Interaction) to HHRI (Human-Human Robot Interaction) so as to account for both the \u0026ldquo;\u003cem\u003ephysical reduction of the caregivers\u0026rsquo; workload but also to an emotional enrichment for the residents\u003c/em\u003e\u0026rdquo; (p.9). Alongside moving from a dyadic to a triadic interaction structure, it is essential that robotic developers have a better understanding of what senior management (those who make the ultimate decision about technological adoption) in aged care think robotic technology could and should do for them, and what they would prioritise paying for.\u003c/p\u003e"},{"header":"3 Co-designing a chore robot for aged care.","content":"\u003cp\u003eThe current study, therefore, asked senior aged care stakeholders to collaboratively imagine and co-design a chore robot for aged care, focussing on (1) identifying the tasks or activities where robotic assistance would be of most value; (2) assessing expectations and past experiences of robots in aged care; and (3) conceptualising the ideal chore robots appearance, features, and functionality.\u003c/p\u003e \u003cp\u003eLeveraging an existing real-world functional prototype of a chore robot, HELPII, from our robotic colleagues (with a mobile base, grasping technology, AI-enabled voice command, and a personality [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]), this co-design research explored the wishes, expectations, and preferences of executive aged care stakeholders. Co-design directly involves users in the design process, to design with, not for, so that end users have an active role in knowledge development, idea generation, and concept development \u0026ndash; thus helping to ensure the final product truly meets their requirements [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe co-design process is a necessary step to assist the mechatronic engineers and the designers to better understand the needs of the chore robot\u0026rsquo;s end-users. There are numerous design factors that need to be addressed and taken into account when considering the development and implementation of robotic technology, more specifically collaborative robots (cobots) and for human-robot collaboration.\u003c/p\u003e \u003cp\u003eHuman-robot collaboration (HRC) refers to the collaboration resulting from a human and a robot working on the same task or in close proximity to one another [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Safety is a primary factor driving how a human and a robot can collaborate and interact with one another typically mitigated by sensors, monitoring, power limitations and force control [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Cobots have a number of attributes and characteristics ranging from payload, reach, degrees of freedom to costs and programming [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Additional factors to consider are the context and environment of robot use, purpose of use or task definition, experience of users, control of the robot, size and weight.\u003c/p\u003e \u003cp\u003eFor the aged care sector all of these factors are relevant to the design of a chore robot requiring input from stakeholders beyond researchers, engineers and designers. Therefore, including the perspectives of experts from the aged care sector is a first step in developing a chore robot that can work alongside humans safely and collaboratively, one that is fit for purpose, aesthetic, user friendly, and acceptable to residents and families, and that aged care decision makers would support and pay for.\u003c/p\u003e"},{"header":"4 Methodology","content":"\u003cp\u003eLeveraging the knowledge and expertise of executive aged care stakeholders, we conducted a qualitative co-design study comprising of a workshop/roundtable and individual in-depth interviews focussed on understanding, imagining and co-designing what a chore robot designed for aged care should look like and do. Ethics approval was granted by our university ethics committee (7765), with the research conducted in late 2023.\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Industry Leaders Workshop/Roundtable and Interviews\u003c/h2\u003e \u003cp\u003eA 2-hour robotic demonstration workshop/roundtable was held in our university seminar room in late November 2023, with executives in residential aged care recruited through our professional networks and snowball sampling. Participants included seven representatives from 4 care providers in the Greater Brisbane (Australia) area, as well as a venture capitalist (1), architect (1) and accountant/business advisor (1). These key sector stakeholders were invited due to their knowledge about how a robot might work in the aged care setting and also be commercially viable.\u003c/p\u003e \u003cp\u003eAfter a tour of the robotics research centre and a demonstration of the prototype robot, they participated in a design thinking workshop, starting by reflecting on their own knowledge, beliefs, and experience with robotics in care settings and ending with a co-design/design thinking sprint to re-design this chore robot. Figure\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e outlines the custom co-design canvas we developed for teams to complete, with 8 reflective/prompting questions: (1) activities, routines and tasks - the purpose of the robot; (2) its location; (3) who it interacts with; (4) its physical form; (5) how it communicates; (6) its impact on the aged care home; (7) ethics to consider; and (8) the narrative that would convince the aged care board to fund/invest in/trial this robot.\u003c/p\u003e \u003cp\u003eGroups then completed a one-page pitch outline, with a sketch of their idea, a robot name, and the key compelling points (from design features to business model), before verbally presenting their solution (see Figs.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). In the month after the roundtable/workshop, follow-up online interviews (~\u0026thinsp;30 minutes) were held with 5 of the participants to follow up on and clarify the final decision concepts and narrative that would best engage and convince aged care leaders that a chore robot would of value to their organisation.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"5 Findings: Co-Designing a chore robot for aged care","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e5.1 General Sector Knowledge of Robotics is Low\u003c/h2\u003e \u003cp\u003eThe session started with an open discussion about what participants knew about robotics, asking if (1) they had deployed a robot, and their experience, as well as (2) what the sector experience was. Overall, participants had very low levels of knowledge, awareness, and practical experience of robotics. Two organisations had direct experience with a service robot, a chore robot (also a Lamson) and a humanoid robot (Pepper). Both returned them after 2 months, as described below.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePepper, the Robotic Receptionist - from \u0026ldquo;wow\u0026rdquo; to \u0026ldquo;what\u0026rdquo;.\u003c/b\u003e This aged care facility was excited to trial Pepper, describing how they thought it was \u0026ldquo;\u003cem\u003enovel and nice... the funkiest, coolest little thing\u003c/em\u003e\u0026rdquo;. Pepper was deployed to act as receptionist in their gym area, to enable bookings for exercise programs. However, despite the original excitement, there was ultimately a sense of disappointment in that Pepper did not really add significant value, with the initial \u0026ldquo;\u003cem\u003ewow\u003c/em\u003e\u0026rdquo; factor becoming \u0026ldquo;\u003cem\u003eso what?\u003c/em\u003e\u0026rdquo;. While they acknowledged that they did not fully activate the robot, there was a sense that Pepper did not significantly enhance the experience or streamline processes \u0026ndash; and after two months, they returned the robot.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRosie, the Lamson Transport Robot - \u0026ldquo;excitement became struggle\u0026rdquo;.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA second aged care facility described their experience, in 2019, with a robotic laundry and food transport system in their new 150 bed facility. Intentionally designed to be non-institutional without long corridors, there were 5 x 30-bedroom communities (each with their own dinning and lounge rooms) featuring widened corridors to enable a robot transport system. Their chosen system was a Lamson Autonomous Mobile Robot (AMR) designed to save staff time by automating trolley transport and transporting meals, linen, waste, supplies, and clothing, see Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eThis RACF was an early adopter, working with a USA-based supplier. Unfortunately, they were unable \u0026ldquo;\u003cem\u003eto get the robot to the point of efficiency\u003c/em\u003e\u0026rdquo;. As the CEO explained, \u0026ldquo;\u003cem\u003eexcitement became struggle\u003c/em\u003e\u0026rdquo;, with two months of challenge where \u0026ldquo;\u003cem\u003emore time was spent re-setting the robot than using\u003c/em\u003e\u0026rdquo;. It was unable to operate autonomously and always seemed to require one person to supervise it, \u0026ldquo;\u003cem\u003estopping at every turn, always needing someone to follow up \u0026ndash; it needed to be able to do things away from the team... and that was not our experience\u003c/em\u003e\u0026rdquo;.\u003c/p\u003e \u003cp\u003eThey experienced three specific issues. Firstly, navigation challenges. Despite intentionally designing wider corridors to facilitate movement, the robot was unable to efficiently navigate the shorter corridors and the dynamic, often cluttered, environment of aged care \u0026ndash; which meant it could not reliably and independently transport laundry and food without supervision. Secondly, operational errors. They reported that the robot frequently experienced operational errors (technical malfunctions, software issues, difficulties in handling various tasks), leading it to often being \u0026ldquo;\u003cem\u003ein a thousand pieces, on the floor\u003c/em\u003e\u0026rdquo;. The robot required continuous supervision, with \u0026ldquo;\u003cem\u003emore time spent re-setting the robot than using it\u003c/em\u003e\". Thirdly, safety concerns. They described a notable incident where the robot failed to sense the presence of an older resident in an elevator, leading to the resident being trapped. While this was a one-off event, combined with the ongoing operational challenges and the fact that the robot could not operate autonomously, they ultimately decided to return the robot after only two months of use.\u003c/p\u003e \u003cp\u003eTheir experience with robotic transport was disappointing, with their original high expectations not met. The challenges they encountered, including navigation issues, operational errors, a notable safety incident and the need for constant supervision, highlight the complexity of adapting robotic technology to real-world environments. However, they noted that occurred several years ago, in 2019, and felt that many of the problems they encountered had likely been resolved \u0026ndash; and thus were keen to experiment with robots again.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e5.2 Reimagining and co-designing a chore robot\u003c/h2\u003e \u003cp\u003e Most of the workshop centred on reimagining the chore robot, HELPII, with teams (2\u0026ndash;3 industry participants, working with 1 research team member) completing the custom design canvas we developed. First, however, there was a group brainstorming session to consider what the robot could do, as reported in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Teams then picked one idea (or generated another) to develop as a concept, completing the canvas in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. They were also given a printed image of HELPII with a series of pre-cut pieces of papers with textures, colours, and robot parts to use for collaging and drawing their concept further.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTasks assigned to chore robot.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTask\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKitchen/Garden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClear tables and serve residents\u003c/p\u003e \u003cp\u003eGarden weed, water and mow\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClean/Laundry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClean bathrooms\u003c/p\u003e \u003cp\u003eOperate laundry machine \u0026ndash; washing, folding, sorting, and delivery.\u003c/p\u003e \u003cp\u003eShampoo carpets.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMove and fetch\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMove residents to and from activities.\u003c/p\u003e \u003cp\u003eMove furniture and set up activity spaces and rooms (before/after meals).\u003c/p\u003e \u003cp\u003eFetch things, such as tissues; remote control: pick up rubbish; socks; water, etc.\u003c/p\u003e \u003cp\u003eInstall a vending machine on top, and have it circulate offering food (note that it is restricted to the resident\u0026rsquo;s diet).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial and Care tasks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrompt residents: meals, activities, medications\u003c/p\u003e \u003cp\u003eDe-escalate behaviour, distract or influence moods (people with dementia).\u003c/p\u003e \u003cp\u003eMonitor health: sleep, blood pressure, etc.\u003c/p\u003e \u003cp\u003eProvide therapeutic touch, especially in palliative care context, for example, by holding a warm wheat bag.\u003c/p\u003e \u003cp\u003eLink with nurse call system.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eEach group developed and then pitched their ideas, articulating the value proposition, the business model, their design concept, and the name of their chore robot. Three teams focussed on versions of cleaning robots, and one on catering food.\u003c/p\u003e \u003cp\u003e \u003cb\u003eGroup 1: The Green, Clean, Calming Machine.\u003c/b\u003e Group 1's robot concept, named the Green, Clean, Calming Machine, is an environmentally friendly cleaning robot. This robot performs cleaning tasks, including vacuuming, mopping, upholstery cleaning, air filtering and scent diffusing, while simultaneously monitoring residents in the background for distress or hazards. The robot's features include retractable arms for dusting and mopping, multidirectional wheels, and a height that allows it to fit beneath dining tables like a Roomba.\u003c/p\u003e \u003cp\u003eTo enhance its usability, the robot is operated and programmed by cleaning staff using tablets and voice commands, considering the staff's diverse multicultural and language skills. The robot's soft, fabric-based material covering, soft edges, and warm-toned calming glow aim to make it approachable but still look like a machine, especially for patients with dementia. It is strategically placed in common areas, with one robot per facility wing, collaborating with the cleaning staff.\u003c/p\u003e \u003cp\u003eApart from its cleaning functions, the Green Cleaning Machine incorporates UV sterilization for infection control, and it is designed to clean its own body, including wheels and the outer shell. The group envisions that the implementation of this robot will not only free up staff time but also help in hazard identification and preventing trips and falls. The overall goal is to positively impact the quality of life for aged care residents.\u003c/p\u003e\u003cp\u003e \u003cb\u003eGroup 2: Sadie.\u003c/b\u003e Group 2 reimagined the chore robot as a professional, engaging, and non-gender-specific robot designed for a variety of tasks within an aged care facility. The robot's primary responsibilities include cleaning general areas three times a day (post-meals), air purification, utilising fresheners, and implementing infectious disease prevention measures, such as those against viruses like coronavirus. Also, it is designed to comply with food safety standards.\u003c/p\u003e \u003cp\u003eThe robot's physical attributes are characterized by friendly eyes, a small and functional design in white, and multiple arms equipped for tasks like picking up items, using microfiber cloths, vacuuming, dusting, and sanitising. As an additional touch, the robot might even play music. Group 2 considered that residents will actively participate in its design.\u003c/p\u003e \u003cp\u003ePractical considerations involve a docking station, but the robot is intended for routine work throughout the entire aged care facility. Importantly, it respects privacy by requiring consent before accessing individual rooms. The robot is designed to interact with both staff and managers, fostering a collaborative environment.\u003c/p\u003e \u003cp\u003eTo ensure ongoing performance and support, the robot will be contracted through a lease plan, with maintenance and support services readily accessible locally. At the end of each day, the robot provides a comprehensive report, contributing to transparency and accountability in its operations.\u003c/p\u003e \u003cp\u003e \u003cb\u003eGroup 3: Speedy x3.\u003c/b\u003e Group 3 envisions \"Speedy x3,\" a functional and unassuming robot with a primary focus on efficiency in completing laundry chores and navigating residential aged care settings. Unlike other concepts, Speedy x3 does not have a gender or personality, prioritising a purely functional role to support residents in tasks they can no longer perform themselves.\u003c/p\u003e \u003cp\u003eThe robot's core responsibilities focus on \"getting the basics right,\" emphasizing seamless navigation through various environments within the aged care facility, including lifts, ramps, indoors, outdoors, and open doors. Its inconspicuous design ensures it does not stand out, contributing to a quiet and unobtrusive presence. Speedy x3's priority tasks revolve around the laundry process. It adeptly collects laundry, transfers it to laundry machines, turns the machines on, folds the laundry, re-labels items, and returns them to residents' rooms. The design considerations include a focus on being inconspicuous, quiet, equipped with a smell eliminator, capable of remote maintenance, and autonomous based on staff schedules while allowing for manual override.\u003c/p\u003e \u003cp\u003eThe business model is structured to be more cost-effective than a staff member, with the robot's annual cost not exceeding \u003cspan\u003e$\u003c/span\u003e130,000. Speedy x3 operates seven days a week, responding to voice commands and central control on the robot. The main impact Group 3 aims for is to free up staff time, minimise facility damage, and reduce exposure to noise and smells, contributing to an enhanced and efficient care environment.\u003c/p\u003e \u003cp\u003e \u003cb\u003eGroup 4: Cookii/ Foodii, your friendly catering companion.\u003c/b\u003e Group 4's concept, named \"Cookie\" or \"Foodii\" (name yet undecided), presents a friendly catering companion for the aged care facility. Gender-neutral and characterised by a loving personality, this robot takes on priority tasks such as menu ordering, delivery and cleanup, food quality control compliance, and engaging in social interactions with residents, staff, and all stakeholders. Designed for easy manoeuvrability and multifunctionality and equipped with visual and voice interaction capabilities, Cookie or Foodii is a versatile addition to the care environment. The robot adopts a human-like appearance with two arms and features warm colours to stimulate appetites. Limbs are uniquely coloured to assist residents in identifying safe interaction points.\u003c/p\u003e \u003cp\u003eIn terms of functionalities, Cookie or Foodii communicates through voice-to-text or iPad technology, collaborating seamlessly with staff to serve both them and residents. It moves about as needed, ensuring it reaches various locations within the facility. Special attention is given to residents suffering from social isolation, as the robot interacts with and accompanies them, motivating social engagement during meals. Importantly, Cookie or Foodii avoids delivering an automated, impersonal service. It recognises declines in a resident's well-being and promptly reports it, showcasing a commitment to personalised care. The robot can also assist in the physical positioning of residents before feeding, ensuring their comfort and safety.\u003c/p\u003e \u003cp\u003eThe main impact of Cookie or Foodii is the realignment of staffing priorities, allowing staff to focus more on direct care. By handling catering tasks and providing companionship to residents, the robot aims to enhance the overall care experience while fostering meaningful connections within the community. Communication through voice-to-text or iPad technology further facilitates seamless collaboration between the robot, staff, and residents.\u003c/p\u003e\u003cp\u003eIn the follow-up interviews, which focussed on the practicality of deployment, participants (4 aged care providers and one architect) remained excited about how a chore robot might benefit, with all providers volunteering to trial the robot when needed. There was agreement that general cleaning and laundry are massively time-consuming tasks. In larger aged care facilities, such tasks are performed by cleaners and catering staff. However, in many, care staff often have to perform cleaning duties as well. Overall, there was a sense that a chore robot might potentially replace 1.5- 2FTE for general cleaning, laundry services and infection control, and this value proposition was of significant interest. Laundry, in particular, was a massive issue, especially for many regional facilities where the laundry is often externally located up to 1km from rooms [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"6 Discussion","content":"\u003cp\u003eIn the process of identifying the value proposition for \u0026lsquo;chore\u0026rsquo; robots in aged care, participants in the workshop exhibited a strong interest in the potential benefits that robotic technology could bring, despite having limited direct experience. Several key aspects emerged from the discussion.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e6.1 Value - Cost and Task Efficiency\u003c/h2\u003e \u003cp\u003eParticipants acknowledged the potential cost savings and increased task efficiency that chore robots could bring to aged care facilities. Automating various tasks could lead to reduced operational costs and improved resource allocation, making robotics a financially attractive option, especially considering the recent Royal Commission into Aged Care Quality and Safety recommendations [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. These have mandated that, from 1 October 2023, residential aged care homes will be required to deliver at least 200 care minutes per resident per day, including 40 minutes with a registered nurse [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe discussion highlighted the potential for robots to free up staff time, allowing for more personalized care delivery. For instance, Group 1's Green, Clean, Calming Machine combines cleaning functions with monitoring capabilities, aiming to free up staff time for more personalised care delivery. Group 2's Sadie focuses on professional cleaning tasks, air purification, and infectious disease prevention, aligning with food safety standards. Group 3's Speedy x3 streamlines laundry chores efficiently, prioritising cost-effectiveness. Group 4's Cookie or Foodii, the catering companion, aims to reallocate staffing responsibilities, enhancing the dining experience and decreasing malnutrition.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e6.2 Trust in Technology\u003c/h2\u003e \u003cp\u003eTrust is crucial for the acceptance and successful implementation of chore robots in aged care settings \u0026ndash; and this was already challenged, with two care homes trialling and returning robots. One participant noted that, as robots are not part of our environment now, it may be hard for residents and staff to quickly accept them. Previously mentioned experiences with Pepper and Rosie point to a trial-and-error approach that emphasises the importance of matching the robot's capabilities with staffing resources in an effective application to gain success.\u003c/p\u003e \u003cp\u003eThe diverse concepts of reimagined HELPII showcased different approaches to building trust. Group 1 emphasised the collaborative operation of the Green, Clean, Calming Machine by cleaning staff, considering their multicultural and language skills. Group 2's Sadie engages residents in its design, fostering a sense of participation and ownership. Group 3's Speedy x3 prioritises an unassuming and functional design to ensure acceptance and minimal disruption. Group 4's Cookie or Foodii focuses on personalised care, recognising declines in residents' well-being and avoiding automated, impersonal service. That said, all were excited about and interested in trialling the chore robot, particularly with the younger generation of carers who are interested in engaging with technology such as robots. One group suggested that it could be a draw card to obtain and retain more staff. Supervision and maintenance challenges were acknowledged, emphasising the need for staff training and potential job creation opportunities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e6.3 The design, the tasks and the users\u003c/h2\u003e \u003cp\u003eThere is a need for user-friendly interfaces, safety features, and rigorous testing to build trust in the technology and ensure its seamless integration into the care environment. The discussion envisioned the tasks that the proposed robot, HELPII, might undertake. From clearing tables to operating machines, shampooing carpets, and even serving residents, the chore robot would have a multifaceted role, catering to various needs within the aged care facility. Its potential tasks expanded to include menu choice/prompting, baseline observations, pain checks, and vital assessments for potential fractures. Incorporating a residents' database was deemed crucial to personalise interactions based on individual conditions, likes, and dislikes. Special attention was given to providing assistance with falls, bathroom cleaning, rubbish collection, and linen distribution, aiming to alleviate mundane, repetitive tasks for staff and enhance the overall resident experience.\u003c/p\u003e \u003cp\u003eDesign considerations touched upon critical aspects such as its physical form, interaction capabilities, and the need for dementia-friendly aspects (e.g., colours and interactions). Human-like limbs and clothing were suggested to enhance the robot's acceptance, and the colour red, known to stimulate appetite, was considered for certain applications. The consensus was that it should not resemble a person to avoid potential disturbance, and its role should be perceived as a tool rather than a humanoid, and a zoomorphic form was not part of the discussion.\u003c/p\u003e \u003cp\u003eInteraction modes were discussed, with voice commands, scheduled tasks, and reporting back findings highlighted as essential features. The diverse language skills of staff highlighted the importance of easy commands with voice activation and use of current familiar technologies, like tablets. The robot's ability to navigate corners safely was identified as a key issue, and leasing was considered a preferred option due to the need for ongoing service and maintenance.\u003c/p\u003e \u003cp\u003eConsidering the user perspective, the roundtable identified that older residents, possibly with dementia, would benefit from voice interaction. Familiarity and hygiene were emphasised, along with the need for an opt-out option for certain maintenance tasks if residents require so. However, it was essential to consider their limited skills and experience with technology. Cost implications were acknowledged, emphasising that the robot should not require constant supervision to avoid wasting staff time.\u003c/p\u003e \u003cp\u003eOverall, participants\u0026rsquo; expectations of HELPII as a chore robot for aged care varied in form and functions. Participants\u0026rsquo; concepts were cleaned up to represent each team\u0026rsquo;s ideas and potentially use as tangible consequences in a following iteration session with personal care workers (staff) and residents (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e6.4 Tech literacy of staff, especially CALD\u003c/h2\u003e \u003cp\u003eParticipants noted that many care staff are from culturally and linguistically diverse (CALD) backgrounds, which impeded technology literacy. Additionally, as a sector, aged care can be risk-adverse; looking at change in terms of Everett Rogers Diffusion of Innovation theory [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] (which explains how new innovations spread through society and how they are adopted at different rates by different individuals or organisations), we can conceptualise the uptake of robotics in aged care into three groups:\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eInnovators and Early Adopters\u003c/strong\u003e \u003cp\u003etypically, the first to embrace the technology. These forward-thinking individuals or organisations are willing to take risks and invest in the latest robotic solutions. They may have the resources and a willingness to experiment, even if it means encountering initial challenges.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEarly and Late Majority\u003c/strong\u003e \u003cp\u003eThe slow adoption of robots can be attributed to the attitudes and behaviours of the early and late majorities. These groups tend to be more risk-averse and cautious. They are waiting to see evidence of the robots' benefits, including improved care, cost savings, and safety, before committing to widespread adoption.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eLaggards\u003c/strong\u003e \u003cp\u003eLaggards are the last to adopt new technologies. They are typically resistant to change and may have deeply ingrained traditional practices. The slow adoption of robots may be partially due to resistance from this group, which can be found in some healthcare and aged care institutions that are hesitant to deviate from established caregiving methods.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eThe participants in the room represented early adopters and early majority, and were willing to be convinced that robots could help them deliver a better care experience in a cost-effective manner. What was notable, however, is that truly imagining the possibilities of robots to transform care was a challenge, given their disciplinary, non-technological backgrounds and limited exposure to date. They were all, however, keen to stay connected, to be trial sites, and to embark on this journey of transformation. Co-design activities such as these, which bring together sector stakeholders to imagine if and how robotics might transform aged care, are critical tools for facilitating engagement and helping to ensure that any design meets the needs of end-users.\u003c/p\u003e \u003c/div\u003e"},{"header":"7 Conclusions","content":"\u003cp\u003eThis study addresses the pivotal gap in aged care research by exploring the co-design of chore robots, shedding light on the challenges faced by existing service robots and presenting innovative concepts to enhance the caregiving landscape. The research highlights the transformative potential of chore robots, offering relief to caregivers by addressing routine and physically demanding tasks. Concepts from industry leaders envision not only improved task efficiency but also a more personalised and compassionate care experience for residents. Collaboration, trust-building, and user-friendly interfaces emerge as critical elements for successful implementation.\u003c/p\u003e \u003cp\u003eWhile acknowledging challenges such as limited technology literacy among staff, the study identified a willingness among early adopters and the early majority within the aged care sector to explore the benefits of chore robots. The value proposition aligned with evolving care standards, emphasising cost savings, task efficiency, and improved care delivery. Participants believed that robots should not \u0026ldquo;take jobs\u0026rdquo;, and, as senior leaders charged with ensuring financial viability, they needed to be convinced of the value and return on investment.\u003c/p\u003e \u003cp\u003eAs we navigate the path toward chore robot integration, ongoing human-robot collaboration, usability testing, and functionality assessments become paramount. This research serves as a catalyst for further exploration involving personal care workers (staff) and potentially older adult residents, envisioning a future where chore robots seamlessly contribute to a technologically empowered and compassionate caregiving environment in aged care. Through continued engagement and openness to innovation, we can pave the way for a more efficient and transformative era in aged care.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eCRediT author statement.\u003c/h2\u003e \u003cp\u003e \u003cb\u003eEvonne Miller\u003c/b\u003e: Conceptualization, Methodology, Formal analysis, Writing \u0026ndash; original draft preparation. \u003cb\u003eValeria Macalupu\u003c/b\u003e: Methodology, Workshop tool design/visualisations; Writing \u0026ndash; review and editing. \u003cb\u003eGlenda Caldwell\u003c/b\u003e: Conceptualization, Methodology, Writing \u0026ndash; review and editing.\u003c/p\u003e\u003ch2\u003eAcknowledgments.\u003c/h2\u003e \u003cp\u003e We acknowledge the robotics and university-industry engagement team, who designed this robot prototype and engaged us to test its viability in aged care.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eRobinson, H., Macdonald, B., Kerse, N. and Broadbent, E. 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Journal of Service Research, 22(4), pp 405.\u003c/li\u003e\n\u003cli\u003eBlindheim K, Solberg M, Hameed I, \u0026amp; Alnes, R. (2023). Promoting activity in long-term care facilities with the social robot Pepper: a pilot study. Inform Health Soc Care, 48(2):181-195. doi: 10.1080/17538157.2022.2086465 \u003c/li\u003e\n\u003cli\u003eInada, M. (2021). Humanoid Robot Keeps Getting Fired From His Jobs. Wall St Journal.\u003c/li\u003e\n\u003cli\u003eCarros F, Meurer J, L\u0026uml;offler D, et al (2020) Exploring human-robot interaction with the elderly: results from a ten-week case study in a care home. 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Crit Asian Stud 51(3):331\u0026ndash;354. https://doi.org/10.1081/14672725.2019.1612765 \u003c/li\u003e\n\u003cli\u003eCaleb-Solly P, Dogramadzi S, Huijnen CAGJ et al (2018) Exploiting ability for human adaptation to facilitate improved human-robot interaction and acceptance. Inf Soc 34(3):153\u0026ndash;165. https://doi.org/10.1081/01972243.2018.1444255\u003c/li\u003e\n\u003cli\u003eHebesberger D, Koertner T, Gisinger C, et al (2016) Lessons learned from the deployment of a longterm autonomous robot as companion in physical therapy for older adults with dementia a mixed methods study, pp 27\u0026ndash;34. https://doi.org/10.1109/HRI.2016.7451730 \u003c/li\u003e\n\u003cli\u003eKanoh M, Oida Y, Nomura Y et al (2011) Examination of practicability of communication robotassisted activity program for elderly people. J Robot Mechatron 23(1):3 \u003c/li\u003e\n\u003cli\u003eShishehgar, M., Kerr, D., \u0026amp; J. Blake (2018). 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How Australian residential aged care staffing levels compare with international and national benchmarks. Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong.\u003c/li\u003e\n\u003cli\u003eBriggs, L., \u0026amp; Pagone, T. (2021). Royal Commission into Aged Care Quality and Safety. Final Report: Care, Diginity and Respect. Canberra: Royal Commission into Aged Care Quality and Safety.\u003c/li\u003e\n\u003cli\u003eLudlow, K., Churruca, K., Mumford, V., Ellis, L. A., \u0026amp; Braithwaite, J. (2020). Staff members\u0026rsquo; prioritisation of care in residential aged care facilities: a Q methodology study. BMC health services research, 20, 1-14.\u003c/li\u003e\n\u003cli\u003eMiller, E. (2021). Creative Arts-Based Research in Aged Care: Photovoice, Photography and Poetry in Action. Routledge. pp 122, 123.\u003c/li\u003e\n\u003cli\u003eYuan, S., Coghlan, S., Lederman, R. et al. Ethical Design of Social Robots in Aged Care: A Literature Review Using an Ethics of Care Perspective. Int J of Soc Robotics 15, 1637\u0026ndash;1654 (2023). https://doi.org/10.1007/s12369-023-01053-6 \u003c/li\u003e\n\u003cli\u003eJang, M., Ahn, H. S., Choi, J. S., Kirstein, F., \u0026amp; Yoichi, L. (2021). Special issue on social human\u0026ndash;robot interaction for human-care robots. Intelligent Service Robotics, 14, 327-328.\u003c/li\u003e\n\u003cli\u003eEva Hornecker, Andreas Bischof, Philipp Graf, Lena Franzkowiak and Norbert Kr\u0026uuml;ger. 2020. The Interactive Enactment of Care Technologies and its Implications for Human-Robot-Interaction in Care. In Proceedings of the 11th Nordic Conference on Human-Computer Interaction: Shaping Experiences, Shaping Society (NordiCHI \u0026apos;20), October 25-29, 2020, Tallinn, Estonia. ACM, New York, NY, USA, https://doi.org/10.1145/3419249.3420103\u003c/li\u003e\n\u003cli\u003eRana, K., Haviland, J., Garg, S., Abou-Chakra, J., Reid, I., \u0026amp; Suenderhauf, N. (2023). Sayplan: Grounding large language models using 3d scene graphs for scalable task planning. arXiv preprint arXiv:2307.06135.\u003c/li\u003e\n\u003cli\u003eElizabeth B.-N. Sanders \u0026amp; Pieter Jan Stappers (2008) Co-creation and the new landscapes of design, CoDesign, 4:1,5-18, DOI: 10.1080/15710880701875068\u003c/li\u003e\n\u003cli\u003eAaltonen, I., \u0026amp; Salmi, T. (2019). Experiences and expectations of collaborative robots in industry and academia: Barriers and development needs. Procedia Manufacturing, 38, 1151-1158.\u003c/li\u003e\n\u003cli\u003eGuertler, M. R., Brackemann, T., Burden, A., \u0026amp; Caldwell, G. (2023). Mapping socio-technical dependencies to enable the successful adoption of collaborative robots in industry. Procedia CIRP, 119, 564-569.\u003c/li\u003e\n\u003cli\u003eRogers, E. M. (1995). Diffusion of Innovations. (4th ed.) New York: Free Press, 1995.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Queensland University of Technology","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"aged care, codesign, chore robot, human-robot collaboration, technology adoption, robotics","lastPublishedDoi":"10.21203/rs.3.rs-3977206/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3977206/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eRobots are not yet mainstream in aged care, despite decades of experimentation and technological advancements. Alongside technological, regulatory, and societal considerations, part of the challenge has been limited to end-user engagement in co-designing robots for aged care. This project asked ten leaders in aged care to participate in a co-design workshop to collaboratively imagine and co-design a chore robot for aged care, followed by individual interviews to identify the tasks or activities where robotic assistance could be most beneficial, focussing on any specific workforce implications and the economic rationale needed to justify this change. Alongside documenting the co-design processes and tools deployed, this article shares the expectations and experiences of executive leaders in aged care, reflecting on the challenges and opportunities for robotic design and adoption in the unique setting that is aged care.\u003c/p\u003e","manuscriptTitle":"Enhancing Aged Care through Human-Robot Collaboration: A Case Study of Chore Robots.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-23 18:56:48","doi":"10.21203/rs.3.rs-3977206/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"20684969-642a-4a3c-8010-2903ad1093a9","owner":[],"postedDate":"February 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":28902865,"name":"Architecture, Design and Planning"},{"id":28902866,"name":"Robotics"},{"id":28902867,"name":"Geriatrics \u0026 Gerontology"}],"tags":[],"updatedAt":"2024-02-23T18:56:48+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-23 18:56:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3977206","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3977206","identity":"rs-3977206","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}