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Key points
- There is a growing trend to use AI and sophisticated robots as companions for older people with dementia.
- Social robots could offer comfort and counteract loneliness but can't build human connection or belonging.
- Without proper foresight and care, these technologies can have unintended consequences.
When I went on tour for my book On Belonging, I was often asked a simple but profoundly important question: “What can I do to build belonging in my community?”
The answer, I’d explain, isn’t necessarily about reaching out to a friend, starting a book club, or joining a community service organization—although all those actions can be valuable.
The answer starts with the willingness to put yourself in another person’s shoes—and, when possible, to put yourself in the shoes of the person facing the most profound isolation in the community. Feel what they feel. Act from that understanding.
A slew of recent stories in the New York Times, BBC, the Financial Times, and other major news outlets has reminded me of the importance of this practice. The articles have documented a growing trend of using AI and increasingly sophisticated robots as companions for older people with dementia. The reports have emphasized how such robot companions could compensate for understaffing at long-term care facilities and address issues of loneliness and isolation that have reached epidemic levels.
Yet there’s a question that’s often missing from the recent reporting on this technology trend.
What would it truly feel like to be on the receiving end of these technologies?
The Role of Social Robots
Put yourself in the shoes of an 85-year-old woman with early-stage dementia. Really feel what life would be like. Perhaps your kids stop by the long-term care home once a week, but they’re busy with their jobs and their own problems and raising their own kids. The staff do the best they can, but they’re overworked and under-supported. It’s not as easy as it once was to communicate what you want to say—and the result is that you sometimes get frustrated, making it harder to connect with the people caring for you and your neighbors at the facility. You cherish simple pleasures—time outside in the sunshine, the sight of your granddaughter’s smile. But life, on the whole, is isolating.
Could a robot companion be a source of joy and help? The answer might be yes. While some of these robots are cute lifelike animatronic pets, others are increasingly sophisticated AI-based systems that focus on helping people spark creativity, artistic expression, and even a sense of life purpose. At the most basic level, these robots can provide physical and cognitive engagement that can help manage the symptoms of dementia. There’s the comfort of consistency—these technologies can be present when human beings aren’t available. In a 2022 meta-analysis of 66 studies of social robots and similar technologies used to serve people with dementia, Clare Yu of University College London and her colleagues found that short-term use often resulted in self-reported reductions in loneliness and isolation as well as anxiety.
But look deeper, and there’s reason to believe that we don’t yet fully understand the implications of this experiment.
Building Genuine Connections
Kat McGowan, a journalist whose two parents are living with dementia, has written that the “superpower” of social robots is “not strength, not speed or precision, but vibes. They grab hold of our psyche. They get under our skin. Even though we know better, we respond to them as if they were alive.”
So, what happens when people form these relationships and then—perhaps inevitably—grasp that they are not, in fact, alive? It’s important to honor the possibility that even people with the most advanced dementia can grasp this fact—even if only at the level of intuition. While intelligent machines may help with some symptoms of dementia, over-reliance on robotic companions could worsen isolation and loneliness over time as people sense the artificiality of these relationships.
Over decades of study in cultures around the world, I’ve found an essential but sometimes overlooked requirement for genuine connection and the experience of belonging: reciprocity. We share our presence with others, and they share it with us. We give gifts of care and receive them in return. Intelligent machines—no matter how intelligent—aren’t conscious, which means that they can’t engage in true reciprocity.
To rely on robots to address the isolation of older people with dementia is to accept the premise that their need for belonging is a technical problem that we can outsource to machine and ultimately ‘solve’ through technology.
I believe this is a fundamental misunderstanding of what it means to belong—and even what it means to be alive as a conscious being.
Bracing for Unintended Consequences
Predictions now show that 135 million people worldwide could be affected by dementia by mid-century. Across societies, we face a massive shortage of care workers. In this context, the concerns I’m expressing here may sound like high-minded but impractical ideas. It’s easy to look at the rise of social robots as a harmless supplement to human interaction where it’s badly needed.
But consider how technologies—without wisdom, care, and foresight—can often have unintended consequences. Think of how smartphones and social media have replaced in-person connection across the world—or how screen time has come to dominate the lives of children.
As sophisticated social robots gain greater acceptance, we need to accept that intelligent machines cannot and should not replace human care. We need to redouble our investments in human caregiving—training more caregivers and ensuring that they have decent livelihoods.
The University of Washington gerontologist Clara Berridge recounted a story from a colleague in a recent article in Nature: An older man in a nursing facility was given a companion robot that looked like a cute stuffed animal, and he grew attached to it. Soon after, he became ill and passed away, and the nursing-home staff found him alone clutching the robot.
It’s a heartbreaking image. But some may consider the story and say that it could have been worse—he could have been alone with no companion to hold.
I look at the story and think: we can do so much better.
