A Multicenter Survey About Companion Robot Acceptability in Caregivers of Patients with Dementia

In the frame of the European Community funded MARIO, caregivers of 139 dementia patients were recruited in National University of Ireland (NUIG), in Geriatrics Unit of IRCCS “Casa Sollievo della Sofferenza”-Italy (IRCCS) and in Alzheimer Association Bari-Italy (AAB) for a multicenter survey on to determine the needs and preferences of caregivers for improving the assistance of dementia patients, and guiding technological development of MARIO. A six minute video on technological devices and functions of MARIO was showed, and all caregivers fulfilled a 43-item questionnaire that explored four areas: (A) Acceptability, (B) Functionality, (C) Support devices, and (D) Impact. Caregivers declared that to facilitate acceptance (over 17.5%) and to improve functionality of MARIO (over 29%) should be important/likely/useful. Over 20.3% of caregivers reported that following support devices in MARIO could be useful for their patients: (1) for monitoring bed-rest and movements, (2) for monitoring the medication use, (3) for monitoring the ambient environmental conditions, (4) for regulating heating, humidity, lighting and TV channel, (5) for undertaking comprehensive geriatric assessment, (6) for link to care planning, (7) for monitoring physiological deterioration, and (8) for monitoring cognitive deterioration. Over 21.8% of caregivers declared that MARIO should be useful to improve quality of life, quality of care, safety, emergency communications, home-based physical and/or cognitive rehabilitation programs, and to detect isolation and health status changes of their patients. MARIO is a novel approach employing robot companions, and its effect will be: (1) to facilitate and support persons with dementia and their caregivers, and (2) reduce social exclusion and isolation.


Introduction Introduction
Information and Communication Technologies (ICT) solutions can be used to increase psychological skills like resilience (Norris et al., 2008), and to manage active and healthy aging with the use of caring service robots as will be explored with the EU funded MARIO project (http://www.mario-project.eu/portal/).

Partners
• To address and make progress on the challenging problems of loneliness, isolation and dementia in older persons through multifaceted interventions delivered by service robots.
• To conduct near project length interaction with end users and assisted living environments.
• To assist caregivers and physicians in the comprehensive geriatric assessment (CGA) through the use of service robots.
• The use of near state of the art robotic platforms that are flexible, modular friendly, low cost and close to market ready.
• To make MARIO capable to support and receive "robot applications" similar to the developer and app community for smartphones.
• Through novel advances in machine learning techniques and semantic analysis methods to make MARIO more personable, useful, and accepted by end users (e.g. gain perception of nonloneliness).
• To bring MARIO service robot concepts out of the lab and into industry.

Survey of the needs
At the first stage of the MARIO project, Focus groups were performed and a questionnaire was designed to find out perceptions of the caregivers about robot companions, especially what they would like such a robot to do for them, and how robots could be designed to build the patient resilience.
The goal of these activities were to determine the needs and preferences of formal and informal caregivers for improving the assistance of dementia patients, and guiding the technological development of MARIO though a questionnaire. -The ability to provide an informed consent or availability of a proxy for informed consent.

Exclusion criteria:
-Caregivers of patients with serious comorbidity, tumors and other diseases that could be causally related to cognitive impairment (ascertained blood infections, vitamin B12 deficiency, anaemia, disorders of the thyroid, kidneys or liver), history of alcohol or drug abuse, head trauma, psychoactive substance use and other causes of memory impairment.
The following parameters were collected by a systematic interview about the caregivers: -Gender -Age -Educational level (in years) -Caregiving type:  Informal caregiver (unpaid)  Informal caregiver (paid)  Formal caregiver (Geriatrician)  Formal caregiver (Psychologist)  Formal caregiver (Nurse) 1) A five-minute video on the first model of robot suggested at the begin of the MARIO project: (video weblink: https://www.youtube.com/watch?v=v1s2Hbad1l0).

3) Responses were expressed as:
-"Extremely important/likely/useful" or "YES, very useful" to -"Not at all important/ likely/useful" or "Not useful at all".

Customization of the CGA
The principal objective is to translate the CGA from a personal subjective based administration to a robotic objective system that can autonomously and continuously monitor a subject during an predefined time interval and can expand the possibility, accuracy and intervention efficacy Reviewing process about ICT used for CGA domains were performed: Finally, the collected data show a satisfactory integration between the patient and the system along with a great level of acceptability of MARIO by the end-user, both the patients themselves and the caregivers or medical providers, those who, day by day, take care and assist their patients.

Implementation stage
For MARIO implementation the following sensors and apps are developping: