Garmi, a robot nurse and companion for Germany’s elderly population | Hacker News Reader

Garmi, a robot nurse and companion for Germany’s elderly population

popsci.com

44 pointsmennaali40 comments

An elderly lady just died in the neighborhood at the age of 67 from something diabetes related. It shocked me to see me how well dressed and with which expensive car their kids arrived to clear the rented place. The lady could barely walk, but was living in the 1st floor. She wasn’t able to reach ground floor alone in most days.

What I want to say is I am still shocked from the heartless western society where it is the norm to put one’s parents into ugly understaffed, but very expensive care facility waiting them to die. Even a modern one with a crate on wheels with a display in it.

Have you considered what was the dynamic between them? how mentally stable that elderly people are?

I've spent over one year living with person with alcoholic dementia

and I've heard stories of other people with similar problems and this is pure terror that you cannot even imagine unless you live thru it.

Sorry to hear your story. But I don’t think, that it is a major population problem. I am rather from East, there were hard cases but or complex medical needs of the elderly in my childhood, but most parents died in the same living space with their kids. Here in Germany it is standard to put old people in care homes and complain how expensive they are.

Have you considered how expensive is it not to put them in a care home? When you are personally liable for everything those people do and experience because you're their legal guardian? At some point you may have to quit your job to take proper care of them. Can you afford that?

> Here in Germany it is standard to put old people in care homes and complain how expensive they are.

Yeah. Well, go figure. 24/7 care is 3 people working shifts taking care of someone, or being at least on standby. Your payment goes for a wage of minimum 3, facility heating, electricity, their expenses, food, and so on.

If you don’t want to be a dead weight to your children, you have options. You can pay extra money privately into the system, or you can buy a house which the retirement provider will happily accept as a payment, or your children can sell, or accumulate wealth in another way. However, as being rich or owning a house is quickly falling out of fashion, your options could be a bit limited.

>Have you considered what was the dynamic between them?

I don't think we need to speculate about the details of the individual case. In general the OP is absolutely right. In the West we by and large treat the elderly like burdens, or even worse, disposable. I moved from Germany to Japan shortly before the pandemic and the difference in respect for the elderly and their safety during that time was considerable.

My elderly mother is determined to end her days in the city she spent most of her life in. Fair enough, but that's at least five hours drive away from where I'm living with my family and job. She has had a couple of minor strokes already and has dizzy spells that make continuing to walk up the stairs increasingly perilous, and she routinely forgets to take her medicines. So she needs routine hands-on care. I could provide a poor version of this by incessantly shuttling across the country (destroying my own family - her grandchildren - in the process), I could try to browbeat her into moving cities & become public enemy #1, or I can keep with the current project of moving her into the nicest & most supportive residential care I can find.

Years ago I worked in a startup also trying to develop such robots, to care for both disabled and elderly people. We were too early, but alas.

The complaint this would increase loneliness was often heard, mostly by the human caretakers employed by the care homes we were testing in.

Especially the younger disabled people did not have much issue with the robots: they hoped to get a way to be more independent. Friends & family enough to not be lonely anyways. And sometimes you just want to get a drink, grab a dropped pen or go to the bathroom without needing to push a button and wait for someone to come help you.

IIRC, this held true for the elderly as well, to a lesser extent. Ideally, robot clear up time from menial, mechanical labor to offer more social interaction to avoid loneliness. This is far off though and our world is far from ideal...

  Ideally, robot clear up time from menial, mechanical labor to offer more social interaction to avoid loneliness. This is far off though and our world is far from ideal...

That has never happened in the history of "efficiency", it's a lie people use to pretend that jobs won't be cut. What actually happens is the savings are repurposed for administrative bloat.

Our dishwasher, washing machine and vacuum robot have all given my wife and I more quality time with our kids and ourselves.

It could be argued that those modern conveniences just made it possible for both parents in a family to work. Nowadays, dual full time income is normal.

They didn't, though. What they actually did was allow your wife to have the second full-time job which is now required in order to own a home.

Still makes them a benefit to that family: if his wife was at home doing more housework the 1920s way then they wouldn't have the same house.

And, to the GPs point, they obsoleted the job of a housemaid that well-off (and even not-so-well-off) families used to employ a hundred years ago or so.

I have very little experience with old people.

When I grow up I want a robot who can pick me up when I fall over because the lady in the flat above me had to bang on the floor for ages at 2am before I woke up and organised help for her.

And I'd like the robot to be able to take dinner off the stove if I get distracted while I'm cooking my dinner because the nice old man in the flat a few doors down burnt his dinner and there was tons of smoke. He was fine but his dinner wasn't.

I don't know what the robot will be able to do to help with social isolation but I've got some time to figure out ideas. I don't really want my kids to take care of me when they are in their 50s and 60s. They should be able to enjoy themselves.

Until a hundred or so years ago globally, and still almost everywhere - with the exception of the richest countries - kids enjoy themselves in their 50s and 60s while sharing space and time with the elderly.

No isolation, no robots, no aimlessness for the elderly as they continue contributing while imprinting the history of their lineage into the younger generations.

The fast food approach to birth, living, aging and dying may not be the best possible approach.

Let's just take care of eachother like human beings

Not a popular opinion here apparently. "Disruption" I guess. When VC tech touches on caring for people, the psychopathy becomes more evident.

It's not "an unpopular opinion", it's equivalent to "let's just all be friendly, we won't need a police", "let's just all promise to not access other people's email, we don't need passwords" etc: naive to a dangerous degree.

Elderly care is expensive. Resources are limited. Denying basic reality doesn't work.

I read no lies in this comment.

That will be a tough order with the projected demographic development, according to which elderly will soon outnumber working population.

Having a short look at the population pyramid of Germany makes this pretty clear:

https://commons.m.wikimedia.org/wiki/File:Population_Pyramid...

https://en.m.wikipedia.org/wiki/Demographics_of_Germany#/med...

If we get our shit together and tax the people with all the money at a rate that allows us to handle basic care for the vast majority of people without a lot of money, we can do this. Otherwise, we cannot.

What are you proposing the community does with the collected money to help the elderly?

Pay people living wages to take care of them.

My sister managed a high dollar retirement home and it was nearly impossible to keep people on staff because the pay was so pitiful and the work so difficult. The for profit business are tons of money, but they did it on the backs of their low level laborers.

What community? In a society of hundreds of millions of people, the social safety net needs to work to protect the wellbeing of everyone, not just those who are part of this or that community. There are already many programs at various levels of government that help the elderly, as well as many non-profits, and all of them need more money, so that's an easy place to start.

Here is a program in California that I am familiar with and is absolutely life-changing for elderly people who wish to remain independent (or cannot afford other options). If this program had more money, it could hire more and better workers at higher rates with better retention and serve more people. Low-hanging fruit. A 1% tax on investment income over $100k would fund it to the moon and back. Twice.

https://www.cdss.ca.gov/in-home-supportive-services

Great answer. I'm a big fan of wealth taxes.

For the record I was using the word community to mean old people, younger people and the government they vote in. In my country care of older people is organised by local councils (sadly not very efficiently)

That scheme is great but I do worry that the demographics mean there won't be enough carers to go around even when they are paid will.

I am sure robot assistants will be quite integral to our society later but am I just uninformed or does there seem to be lack of progress for the actual mechanical engineering of robots? They all still seem these big, hulking and clunky metal pieces with very rigid movements (not very flexible). One of them might also just slip on a banana peel and crush someone.

They’re just very complicated.

A good exercise is to think of all of the computations required to point at something across the room. From a biomechanics perspective, there is a lot going on. Even if you just model each muscle in your arm/hand/finger as attached at two points and contracting, the force diagram of all the bones/joints quickly becomes exhausting.

The biomechanics of what humans do for basic locomotion is extremely complicated to model/recreate. While robots don’t need all the details (wheels, for example, make things easier) there is still a lot to deal with to make machines that can interact with our world.

It’s one thing to design an assembly-line robot that performs a single task. Making a robot that can do multiple useful things quickly explodes in complexity. There is steady progress in the field, but it’s slow.

We need laws to prevent pawning off people we dont care about onto automated care. Everybody should be against this.

But we do care about those people, but if there's not enough people to properly take care of all people we want to care for, shifting some of the tasks (not all, that is not desirable nor possible) seems the best solution. Giving more care in total with the same amount of people.

In an ideal world, there's enough care for everyone, but in an aging population, that is not possible.

It's not care, it's pawning them off, it's the opposite of care.

Read Bullshit Jobs. An easy fix for countries with socialized healthcare would be to get rid of bureaucrats and hire front line workers that actually contribute something. Programs like this are the end-state of bureaucrat-run societies, where nobody who actually does any useful work is left.

The point of caring for someone is caring, through real interaction. It's one thing, if horrible, to force people to interact with a voice-menu system when they call in somewhere. This is like a nightmare version of that.

The fact that people seem to now think a chatbot that strings word patterns together is sentient will only make this worse, as the ignorant (just saw a sibling comment) will believe that "AI" will fix the problem, instead of actual personal interaction.

> Read Bullshit Jobs

Read my comment again

> hire front line workers

What if you already got rid of the bureaucrats, hired everyone you can and still don't have enough people? Pay more? Sure, but that also has limits in both the amount of people you can pay and the money running out.

Let those robot distribute fresh clothes and collect laundry, stock the fridges, clean the bathroom, all those menial tasks that allow people to have a decent life. Clear up the time from humans to actually interact with people.

I don't like the prospect of needing someone to wipe my ass when I'm old, I'd feel ashamed. Maybe not when a robot does it. Not sure about that yet, I hope that day is far far away.

By 2055, Japan's population is projected to fall to 90 million, with (medium fertility/medium mortality):

8 million being children aged 0-14

46 million being "working aged" 15-64

36 million being 65 or older

Population Projections for Japan: 2006-2055 Outline of Results, Methods, and Assumptions (PDF) https://www.ipss.go.jp/webj-ad/WebJournal.files/population/2...

Let's ignore the assertion that 15 and 16 year olds are "working aged" no matter how you allocate resources 46 million workers cannot support 36 million retirees.

Today there are around 3 million healthcare workers in Japan out of a working aged population of 80 million. In 30 years the number of retirees will be the same but the working aged population will roughly halve. This is just people working in hospitals, in-home care specialists are not counted. Nor are bureaucrats, only workers in 24 categories of direct-support healthcare fields are counted.

Human Resources for Health Country Profiles: Japan (PDF) https://apps.who.int/iris/rest/bitstreams/1147882/retrieve

There are already critical shortages of healthcare workers and in 30 years the demand will be the just about the same (most healthcare resources are consumed by the elderly) but the labor pool will be smaller.

If there were 0 bureaucrats there still wouldn't be enough people.

Many European nations face the same demographic challenges that Japan does, to a very slightly less severe degree.

Robots are one solution.

  If there were 0 bureaucrats there still wouldn't be enough people

Whether or not that's true, making the denial of basic human interaction the front line of creating "efficiency" is not the place to start. Not only is it dehumanizing, it encourages all of the wrong kind of behaviors, particularly administrative bloat, and ignores the reason we have social programs in the first place. If we've collectively decided we want to care for a group, we have to actually do it, not pay administrators to pretend it's being done.

Like your computer is pretending you're submitting a comment, rather than actually coming to my house to explain your point of view?

> Japan's population .. Robots are one solution.

FYI, the last episode of the "Tech Won't save us" podcast focuses on robots for elder care in Japan. Entitled "Robots Aren’t the Solution to Elder Care w/ James Wright"

https://podcasts.apple.com/gb/podcast/robots-arent-the-solut...

Related to his recent book on the subject: https://www.goodreads.com/book/show/63199878-robots-won-t-sa...

This is the same problem healthcare has in general. There just are not enough healthcare workers to see to every person carefully.

Even if we massively raised the incentives and lowered the barriers for entry, the situation would still be nearly as bad. The human body is incredibly complicated and each person has a long medical history. Each person needs personalized care, but we can't devote 50% of the population to healthcare either.

The only viable long-term solution is automated tools. We're no-where near it yet (maybe in a hundred years) but gAI will eventually be our solution.

What's the alternative? No care at all? Devote all assets to only care for the elderly? End people's lives at 75 so we don't have too many old people to care for? Have forced labor take care of it?

The monetary system works by (a) government spending (b) lending from banks. The money from the banks pretty much just gloms onto the supply chain that grows up around the government spending… banks just lend to things that already have money, and the things that already have money before banks tend to get it from direct government spending. As debt is paid off, liquidity is removed from the system. Also as the filthy rich stock money into their hedge funds, it is also removed from the system for practical purposes. So without a constant inflation pressure, we instead get deflation. Now imagine if instead of supplying that inflation pressure by keeping a low interest rate for banks, we supplied it by spending money on an army of caretakers? Well you’d end up with people having money in their pockets for a change which would cause short term inflation like we just saw from the stimulus, but then once people had their needs supplied m, it would calm down and we’d just have more people employed. The downside for the rich would be that more of the population would have savings and thus be harder to manipulate. But i think lots of people would find more satisfaction at that than their current jobs, many of which only exist for the sake of “We need to create jobs,” or because of some bloated financial middleman industry we created through government spending that had lobbyists get in the mix

My father told me once to raise at least 3 children, to improve my chances of having someone looking after me at a certain age. It worked for him, he had 3 children and my sister takes care of his needs now that he's 70.

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