At ten to five in the afternoon, the bed alarm goes off. Betty (not her real name) is calling for assistance. She’s had a big day for anyone, let alone an elderly woman in her nineties, having had a visit to the local hospital for day-surgery to remove some skin cancers, an operation which also involved skin grafts. Her head and arms are bandaged and she is sore. After returning home from the hospital she was tucked into bed for a well-earned rest, but now she wants to get up. For Betty, home is RSL LifeCare’s Kokoda Care Home, on the grounds of its Sydney facility in Narrabeen.

5pm in a care home is “peak hour”. Meals are being prepared, tray service is underway, dining room service is in full swing and the staff is busy assisting residents into the dining room for dinner. The hallways are full of residents, walking aids, wheelchairs, hustle and bustle.

Cathy Walker, Kokoda’s Care Manager, answers Betty’s call. She helps Betty visit the bathroom, pops her in a wheelchair and takes her into the dining area for close observation and dinner. Betty is restless and uncomfortable, so Cathy reaches for PARO, a revolutionary robotic seal, and places PARO on Betty’s lap. What happens next is quite remarkable. Her restlessness subsides as Betty engages with this soft, gentle, intelligent “carebot”. It turns its head to look at her as she speaks and she giggles in surprise. PARO’s eyes close when Betty strokes his back. Her arms cradle him and he gently moves his limbs to signal his enjoyment. Betty momentarily forgets about her hard day, her bandaged head and arms, as she strokes PARO, chatting and cooing to him in a completely calm voice, now oblivious to the busyness around her.

This ability to divert residents’ attention off the “here and now” – especially when the here and now includes discomfort, confusion or upset – is the gift that PARO gives within an aged-care setting. As Cathy Walker explains, “PARO is used as an adjunct to good nursing, not as a replacement to good nursing. In Betty’s case, she needed something to take her mind off her present situation. When Betty got up from her nap,  she came with us to the general dining area so she didn’t feel alone and so we could keep a close eye on her. But she was still flustered and the environment was very busy. As soon as we gave her PARO to cuddle, however, she forgot about everything going on around her. She was so delighted with this furry little creature that turned its head to look at her with its enormous dark eyes as she spoke and chortled to it. It was an absolute delight to see.”

PARO the Therapeutic Robot is the brainchild of AIST, a Japanese automation pioneer company. The research, development, technology, design and construction cost $15 million and took ten years to fully develop. Currently, PARO is in its 8^th generation of design and is now being use to assist residents, hospital patients and their nursing staff all over the world.

RSL LifeCare owns two PARO Seals, which are shared across 6 care homes. The technology is incredible – far beyond any battery-powered toy that may spring to mind. PARO can see, hear, balance, register touch and recognise its own name. He/she looks at you when spoken to or approached and actively makes eye contact, searching for your face. In a social setting, PARO joins in the conversation, adding his or her pup sounds to the audience. PARO loves cuddles and responds to gentle strokes by going to sleep. With sensors all over its body and the ability to “learn” names, faces and voices, PARO’s artificial intelligence is quite spellbinding. RSL LifeCare’s own trial of PARO showed decreased levels of agitation and stress, improved relaxation and socialisation between residents and staff, and between residents themselves.

Erris Mullins, Manager of Kokoda Care Home, identifies certain times when PARO is of particular help. “From 4-7pm PARO is of great therapeutic assistance. Not only is it a busy time of day for staff, when otherwise they might have the time to sit one-on-one with residents, but for residents it can be a confusing and exhausting time of the day. The Sundowner Syndrome can be a factor at the end of the day, with residents experiencing a mental overload as a result of the accumulation of all that has taken place in the day; they can be simply fatigued and therefore irritable and hormones sometimes fluctuate at the end of the day. As a result, in the afternoons you can get those behaviours of concern, such as residents attempting to stand unassisted, which can be dangerous. To be able to provide our residents with a safe, enjoyable experience at this time of day is a wonderful thing.”

While sceptics may question the use of a “carebot” in nursing practice, Cathy is quick to defend PARO. “For our cognitively intact residents, PARO is a wonder of new technology. For our residents with differing levels of dementia, PARO is whatever they want PARO to be. Part of the reason PARO is a seal is because humans rarely have previous real-life experience with seal pups (as opposed to dogs and cats), so they can project whatever they like onto it such as whether it’s a boy or a girl. For some residents with dementia, PARO is clearly understood and appreciated as a carebot, for others PARO is a simple pleasure to enjoy and experience in the moment.”