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Giorgia Feltrin
Matrikelnummer 108022239219

JAPANESE SILVER MARKET
AND
TECHNOLOGY FOR ELDERLY CARE

Ruhr-Universität Bochum

Gender, Technology and Wellbeing
Individual Report for 6CPS

INDEX
1

Introduction to Robotics and Japan’s Silver Market
1
...
2 The Creation of Society 5
...
1 Classification of Robotics by Application
2
...
Introduction to Robotics and Japan’s Silver Market
The Japanese Silver Market is a successful example of innovation for its implementation of Robotics to
overcome contemporary society’s problematics
...
Nowadays, the field has greatly
advanced with the exploitation of new technologies and has expanded its range of application, contributing to
the creation of Japan’s Silver Market
...
With this, the thought of serving – for a single firm – the whole industry became infeasible
...

The Silver Market is considered a new market for two reasons: first, the products are labelled as new whether
they include small changes to already existing products or distinctively novel changes; second reason is related
to the target group – differing from the already existing “Gerontological” Market for disabled elder people, it
includes also healthy consumers
...

o Luxury goods for wealthy seniors, not exclusively age-related
...

And the end-products of the industry include:
o Specialized products from relatively low-tech to high-tech devices
...

o Universal designs (UD), exploitable by people with and without special needs
...

o Previously existing technologies combined with other products
...

The expression Quality of Life Technologies is used to describe novel technologies specifically designed to
affect the life of those who use them, whether to maintain or enhance the physical, cognitive, social, or
emotional functioning of humans
...
Hence, technologies for elderly are a
subset of QoL technologies that (a) take into account life-span developmental changes in sensory-motor
functioning, cognition, and motivation, and (b) address issues of major concern, namely health, autonomy, and
psychological well-being
...

Addressing two types of autonomy – social autonomy enhancing communication and physical autonomy – is
generally possible with Robotics; in financial autonomy, however, the devices are akin to luxury for most
families, especially for those individuals who need them most, not receiving any external help from relatives
...
For this and other reasons, despite a general
enthusiasm, in Japan the current implementation in elderly care is small and mainly limited to healthcare
facilities
...
This, assuring being able to identify which products

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will meet the most needs of customers
...
Something that
may ease the reluctance of adopting these devices in private household is the feeling of shame from receiving
help or care from others, which one would not feel towards a robot, whose existence is also easier to hide
...

1
...
Japan is considered a forerunner in the Silver Industry, the idea of exploiting robots in the care of
elderly has spread with the rising concerns for the population’s progressive aging and the lack of young people
to take care of them
...
While aging-related issues are a
common problem of developed nations, comparison studies between 2000 and 2008 showed how Japan would
have suffered the heaviest consequences in the upcoming years, given that at the beginning of the century its
citizens were already more over-aged than other OECD1 countries, and the 22% of the population in 2009
consisted of 65-or-more-year-old people, expected to raise up to 34% before year 2035
...

In 2007, Japan was already labelled as chokoreika shakai, hyper-aged society; Europe and the USA, on the
other hand, were bound to be facing similar aging problems soon after and slowly started to invest – even if
never as much as Japan – in the field
...
44 million people, the 11th most populous State in the world
– presented a total of 35
...
1% of the total population)
...
1%), Italy (33
...
7%) and China (30
...

Another demographic change, caused by reduced birth rates, is shown by the same analysis: in 2018, the
number of children between 0 and 14 years old amounted to only 12
...
2% by year 2060, while the number of elderlies will reach 38
...
1)
...
32 years of life and men 81
...
9 and 62
...
As a consequence, quitting work to take care of family members (kaigo
rishoku) became an issue that affects every year as many as 100,000 people in their 40s/50s – an age where
gained experience represents a huge value for a company
...
Confucianism teachings about devotional piety are the main reason why this practice is still
pursued, the feeling of oyakoko – obligation to one’s parents – and chuukou itchi – obedience and respect to
seniors –, which contributed in the shaping of Japan’s ‘seniority-based society’ since the early stages
...
4
trillion yen, one third of the national medical care expenditure (42
...
At the same time, according to the study, Japan in 2015 was in need for 380,000 caregivers, to
contrast the increasing number of dementia patients
...

1

Organization for Economic Cooperation and Development
The Statistics Bureau of Japan or SB/SBJ (統計局, Tōkeikyoku) is the statistical agency of Japan, subordinate to
the Ministry of Internal Affairs and Communications
...

3
To bear in mind that those percentages – even if higher that Japan’s – are calculated on a smaller population
...
As these societies tend to show
techno-paranoia and overall scepticism towards new technologies, Japan has always displayed the perception
of symbiotic relationships between people and robots as natural
...
The positive attitude and respect Asian
cultures have always displayed towards aging and older people is then another feature clashing with the stigma
that capitalistic societies associate with it
...
Besides, the
way these realities are collectively constructed at the basis plays a huge influence, from the interdependently
construed Japanese society to the independent, individual one of Western countries
...
At the present time, techno-animism is much
more diffused at the global level than people realise and many individuals interpret interactions with these
machines in a human-like way
...
et al
(2018), different tendences that could be appointed to cultural factors have been individuated
...
The end results showed a general propension of Japanese
people to welcome more positively the introduction of robots in healthcare working facilities, meanwhile only
less than half of the Finnish participants thought that they could be helpful in performing heavy household
works (40%), moving elderly patients (39%), performing light household work (34%) and helping with
dressing and washing (16%)
...
Moreover,
72% of the Japanese participants believe that robots could ease feelings of anxiety and loneliness, to which
only the 33% of Finnish caretakers agreed
...
The major discrepancies must be
appointed to general fears (by 30% of Finnish participants) that the use of care robots could make the treatments
be perceived as inhumane (only 8% of the Japanese share the feeling), and 57% also thought this could add to
the sense of loneliness from hospitalization (to which the 32% of Japanese care workers agree)
...

Generally, given the mutual reinforcement between religion and popular culture, in Japan ethical concerns are
less likely to arise, compared to Europe, regardless if the question is the reliability on machines for social
interactions or their employment in healthcare facilities
...
To prevent the loss of world-leader position in the field, the Ministry of
Economy, Trade, and Industry (METI) in year 2001 issued a report by Japan Robotic Industry Association,
addressing the need for a new Robotic Technology strategy, in order to expand the field from simply developing
Industrial Robots to include new prototypes
...
Another reason for governmental intervention were the expected labour shortages, because of
the increasingly share of old citizens and the major discrepancies with natality indexes
...

The shift from Industrial Robotics to Service Robots began around 2005, as the aging problem was already an
issue and robotic systems were thought to be nearly ready to adapt to more complex environments, where they
would have been required to assist people in specific living arrangements and real-life scenarios
...
2 trillion yen by the end of 2025
...
& Coates, K
...
”

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purchase robots have been going on since 2015, when nearly one-third of the population was over 65 years
old
...
2 The Creation of Society 5
...
”
- Japanese Cabinet Office on Society 5
...
0, a ‘super smart society’ expected to facilitate human
welfare, an evolution of Society 4
...

The main purpose is making goods and services available to people the moment they need them and in the
right amount, enabling the proper response to a variety of social needs, and most importantly without limits of
age, gender, region and language
...
0 is programmed to respond to the different problematics
contemporary Japan is facing: (1) shrinking population and industrial competitiveness, (2) hyper-aged society
and lack of active participation of women in it, (3) terrorism and outdated infrastructures, and (4)
environmental catastrophes, lack of resources and clean water
...

Concretely, this will be a space where humans and robots (or AI) coexist, working together to improve quality
of life; here robots will possess a higher degree of autonomy and decision-making, providing services without
human operators and instructions
...
0 will allow elderly to connect and share information for medical
purposes, receive remote medical care, and of course benefit from robots and AI in care facilities as well
...
Patients ended up ‘bonding’ with these devices and the Japan Medical Research and
Development Agency reported how their autonomy, social skills, mood, and communication capabilities
increased
...
2)
...
Different Classifications and Applications of Robotics
2
...
Nowadays, the
field of Robotics include a wide variety of subcategories for its products, divided mainly basing on their
application in four main categories – Industrial Robots, Service Robots, Humanoid Robots and Rescue Robots
–, two of which have been applied in the healthcare sector
...
The increased exploitation of these machines
during the phenomenon of the bubble economy of the ‘80s ended up increasing efficiency levels and, with
years passing by, the quantity and quality of tasks that robots can perform also expanded
...
This fruitful industry set
the basis to expand towards new possible scopes of application, starting from Service Robots, nowadays
employed to perform tasks meant for humans – with the exclusion of industrial automation duties –, that
involve partial or full autonomy in the overcoming
...


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In 2011, in Japan, about 2
...

For previously mentioned reasons, METI has been heavily promoting the next generation of robots belonging
to this category, in order to be used in daily life as security guards, cleaners, guides, receptionists, and
childminders, among other uses
...

University researchers in particular have been increasing their efforts in Robots for Burden Reduction, an
example of which are ‘wearable robots’, powered suits with the ability of enhancing the physical strength of
those who wear them, allowing both people with mobility difficulties and caretakers in charge of heavy tasks,
to find the right model for their needs
...
The device can
also be worn by care workers to reduce the risk of back pain, by reducing the burden on the lumbar area while
helping the elderly in their movements
...
The primary
scope, expected by 2018, was to place them in public facilities for general work and the Japanese government
committed very soon to this sector of Robotics, investing 5 billion yen in a 5-year project – Humanoid Robotics
Project (HRP)
...
This project involved the National Institute of
Advanced Industrial Science and Technology, Manufacturing Science and Technology Centre, eleven
university labs and twelve companies, all of them active in a two-stages plan: develop platforms for humanoid
research and focus on their application in concrete environments
...
Soon, with regards to elderly care, eight focus areas have been individuated:
1
...

2
...

3
...

4
...

5
...

6
...

7
...

8
...

Being this an especially fast-changing sector, uneven results have been obtained; nonetheless, research and
development on Humanoid Robotics are still actively progressing
...
Pet Therapy, as this
practice is known, in Japan has been implementing robot pets in long-term care settings since the early 1990s
...
2 Classification of Robotics by Function in Elderly Care
A broad categorization of robots in the healthcare sector can start by diving them in (1) robots that help with
physical care, mainly sustaining physical abilities, and (2) robots that help maintaining the psychological
stability of patients
...
First of all, every practice
should be in line with human rights and shared human values – human welfare, ownership and property, privacy,
freedom from bias, universal usability, trust, autonomy, informed consent, accountability, identity, calmness,
and environmental sustainability, according to researchers Friedman and Kahn (2003)
...
and Sharkey, N
...


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2) Help monitor the patients’ health and behaviors
...

The first category, whose aim is assisting the elderly and their carers in daily tasks, range from the Japanese
Secom’s automatic feeding robot “My Spoon”, to the Riba Robot (Robot for Interactive Body Assistance), able
to pick up and carry humans from a bed to a wheelchair, all while recognizing faces and voices, and provided
with communication capabilities
...
Nevertheless, assistive robots are thought to
possibly increase the person’s feeling of objectification and lack of control over their own life, since older
people are especially vulnerable to dignity loss, after losing decision-making capacities
...
The scientific-proven phenomenon of social buffering displays how highly social
mammals show better recovery from distress when in the company of conspecifics; social contact has clearly
demonstrable biochemical effects on a person’s body, especially elderly, therefore depriving them of it is
considered unethical, for the health implication that social isolation has
...
In this regard, robots will never be a threat because they will never be too tired,
stressed or overworked, to the point of displaying overreacting or dangerous behaviors; still, they will also
never be able to feel real compassion, empathy or understanding
...

- Aspirational dignity, depending on the context analyzed
...
This can be changed
accordingly to the treatment they receive, therefore an insensitive use of robots could lead to humiliation and
loss of self-respect, in the case – for instance – of movement without permission and in an impersonal way,
without the use of names or accordingly to preferences
...

The philosopher Martha Nussbaum developed the Capability Approach focused on social justice and inviolable
dignity, in order to define what is necessary for a life to be considered worthy of its definition
...
With this in mind, she highlighted ten
central capabilities: (1) life, of a worth-living length; (2) bodily health, with adequate nourishment and shelter;
(3) bodily integrity, as being able to move freely from place to place, secured from assaults; (4) senses,
imagination, and thoughts, in freedom of expression and religious practice; (5) emotions, to feel for other
people and things; (6) practical reason, to engage in critical reflection about one’s own life; (7) affiliation,
engaging in social interactions while maintaining bases of self-respect and equality; (8) other species, living
with concern for animals, plants and nature; (9) play, to enjoy recreational activities; and (10) control over
one’s environment, being able to engage in politics, or to hold property rights, or again enter the working
industry
...

Another ethical concern in this aspect is that often the use of technology and robots to take care of people,
whether elderly, disabled or babies, is actually exploited to caregivers’ benefits more than that of the person in
actual need, just for the amount of work and costs reduction
...
Patients themselves have stated that doing things independently is
incidental to their self-worth and they may actually prefer the assistance of a robot over a real person
...
If
necessary, there is always the possibility for a trained operator to run the robot and, for more complex situations,
a could use them to remotely interact with the patient
...

The second category, revolving around the monitoring of behaviors and health, fully utilizes all the benefits of
remotely controlled telepresence
...
, a
talking robot equipped with cameras and microphones, designed to interact with family members (actually
distinguish ten different users by faces and voices, and recognizing about 650 words), walk around and dance
autonomously, developing its own personality over time through interacting with humans; or CareBot from
Gecko Systems International Corp, equipped with multiple vital sign sensors, instruments for verbal
interactions, delivery of medicines and reminders, and an “upgraded” version of video monitoring, where the
robot actually follows the person from room to room
...

This specific category arises concerns as whether privacy will still be maintained and to what degree that can
be guaranteed, if the person’s mental state deteriorates due to age, to the point that they could not assert
permission nor comprehend the situation
...
Similarly, if while being
monitored the person enters a potentially dangerous situation, will they legitimately be saved or will that mean
getting deprived of their freedom, if the robot in charge takes steps to stop or prevent the action? With current
technologies, prototypes of scenarios can be developed and installed in the devices to suggest the line of
intervention, however, with just a slight variation (as is most likely to happen in real-life situations), it will be
necessary to trust and rely only on the robot’s identification and classification of potential dangers
...
With rather simpler functions, they have been found to offer similar effects
that animal assisted therapy provided in reducing loneliness, benefiting to dementia patients’ improved
communication abilities
...
Moreover, they will never be an adequate replacement for human love and attentions, in concrete reality,
as their effectiveness comes from the deception of elderly into thinking that they could build a real relationship
with these devices
...
In any case, creating these benefits
is subordinate to the skills and careful deployment of the robot by carers and family members
...

Lastly, the question of the possible infantilizing, disempowering and disparaging of older people, especially
those affected by dementia, entering a ‘second childhood’, arises while giving them ‘toys’ or ‘dolls’ to take
care of and spend their time with
...

Unfortunately for the good purpose of the implementation, there is also the possibility that elderly will maintain
their rationality and view the objects for what they actually are, or maybe develop a confusing in-between
perspective where they see them neither as sentient being nor as objects; both situations that undermine the

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actual efficacy of the deception and the utility of said robots as companionships
...

From the case studies analyzed by Turkle in Relational Artifacts/Children/Elders: The Complexities of
CyberCompanions (2005), it emerged how elderly appeared to be more comfortable impersonating family
scenarios with robotic dolls rather than traditional ones, for the former’s stimulating responsiveness and
interactivity, alongside the perception that – being robots included in ‘grownup activities’ – this was a more
socially accepted activity
...
Among seniors, it was possible to distinguish between Scientific-Exploratory Approach and
Relational-Animistic Approach
...
Seeing it for what it really is, an object,
his focus was on understanding how the device is able to communicate, where the sound comes from, and how
its reactions are activated
...
Given his lifelong solitude and marginalization from
society and family, Jonathan seems more attracted by computers and technology than real people, even
affirming that he would feel more comfortable to speak about his life and his most intimate matters with an
electronical device, rather than with a real human being
...
He
relates to robot dolls and pets as if they were sentient beings
...
He is strongly convinced that he is able to communicate with them, and – not surprisingly –
he displayed emotional attachment right from the start with the doll
...
He would speak directly to them and try to feed the dolls, introducing them to visitors
...
For example, in Andy’s case, this allowed him to express
his feelings of regret, frustration and attachment, to his former wife
...
Authenticity in relationships is a human purpose and clearly what is lacking with
technological devices
...
The
robot Pepper is currently used in 500 nursing homes to play games, do routine exercises, and have basic
conversations, as it is designed to interpret emotions through cameras and microphones
...
Paro serves as a therapy robot created by Intelligent System Co
...
Charles Kemp, the head of Healthcare Robotics Lab at the
Georgia Institute of Technology in Atlanta, invested in the combining of physics-based modelling and machine
learning, to install in robots the actual sensation of getting dressed, practicing virtual simulations in their
system
...
Of course, beside technological improvements, a societal shift involving
caregivers, older people and medical workers, is necessary to better implement these new technologies, while
on the same time finding a way to instruct robots on how to properly act around humans
...
Problematics Encountered by Robotics in Health Care
The Robotics industry is certainly a promising one on the global level, especially in a country with the
characteristics of Japan, but nonetheless it is bound to encounter some problematics
...
Contrary to other nations, in Japan this phenomenon did not lead to
moral issues, but to concerns for manufacturers, their risks and responsibilities, which required the formulation
of standards for appropriate and safe use of robots
...
To avoid this fuhyo higai effect, Japanese manufactures tend to be extremely cautious in placing

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new technologies in the market
...
This is another aspect where Japan and European societies diverge; first of all, Japanese safety
culture can be seen from a double perspective: users expect the products to be safe for use, while manufactures
expect institutional safeguards against possible negative side-effects
...
Undoubtedly, both
societies present a responsibility gap problem, but in Japan said problem is overlooked because the main driver
of the sector are the conjunct efforts of industries, government and academics, with little space given to legal
actors
...
In the end, Japan
aimed at safety authentication through a product certification system that is expected to enhance the safety of
robot use, as well as limit the responsibility of manufacturers (for products that meet the official standard
requirements)
...

Other relevant problematics to address are certainly related to robots’ degree of autonomy, given that full
autonomy of action in the healthcare sector is considered impractical, as decision-making and medication
prescriptions cannot be handed over to robots, for ethical and legal reason, and the presence of human
personnel will always be necessary
...

Next, robots will not be able to reach any time soon the current levels of human intelligence, here interpreted
as the ability to adapt to different real-world scenarios, at times unmapped or not fully in the understanding
capabilities of the device, consequently limiting their options to find suitable solutions
...
Facilitating
human-robot collaboration is therefore a primary need, as robots are bound to engage with humans in a multiple
variety of environments
...

Talking about expectations and requirements, building multi-functional robots in this highly competitive
business will be another challenge Robotics must conquer, as usually Industrial Robots were static and meant
to carry out a single task at a time
...
Lastly is the already mentioned question of privacy, mainly
related to devices adopted with the scope of monitoring patients, which arises concerns on the storage and use
of data acquired during the robot’s “life”
...
Conclusions
The overall sector of healthcare presents high tensions when it comes to balancing providing good care and
rising ‘productivity’ by increasing the number of patients, while at the same time limiting costs without
reducing the quality of care
...
In Japan, this falls into the category of the 3K jobs –
considered kiken, kitanai and kitsui, meaning unsafe, unclean and tough on physical and mental conditions of
employers
...

Quite often, the problematics related to the adoption of these devices in the field, whether in private household
settings or nursing facilities, lay beyond technology itself, but in the reasons for its implementation and its
subsequent use
...

From this paper, it is clearly visible how the field of Robotics is an example of successful innovation for Japan

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and a profitable market to invest in, which is why the numerous governmental initiatives and collaborations
with large firms and universities allowed for rapid growth of Robotics as well as its specialization to meet the
needs of the Silver Market
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Fig
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2

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