Big Eyes and AI: What Robots Can Do in Healthcare

“Paul” supports, but does not replace, a caregiver

Given the growing crisis, the question of what machines are allowed and expected to do in the care sector is also a concern for policymakers. According to the Federal Statistical Office, there will be a shortage of between 280,000 and 690,000 nursing professionals by 2049, depending on the scenario. The use of robots in nursing homes therefore raises expectations, but also leads to misunderstandings. Thuringia’s Minister of Social Affairs, Katharina Schenk (SPD), sees these technologies as offering new opportunities to engage residents, promote social participation, and enrich daily care routines. 

“It’s important to note that a social robot does not replace a caregiver and cannot replace human affection. Care thrives on relationships, trust, and personal interaction,” Schenk clarifies. Jülich, the nursing home director, agrees: “We have enough staff. It can’t replace staff, and it’s not supposed to either.”

Medical ethicist: Robots are not yet a game-changer in care

So how viable are such robotic systems really? Robert Ranisch, a medical ethicist at the University of Potsdam who is himself experimenting with several robotic systems in the lab, tempers exaggerated expectations. Social robots are all still in their infancy at this point. “You won’t find a single care facility where robots are currently a game-changer—neither in Germany nor abroad,” says Ranisch. According to his own account, he developed guidelines on robotics in elder care as a project manager for the Federal Ministry of Health.

Social assistants like Navel have indeed become significantly more capable than earlier systems—such as the therapy seal “Paro” or the humanoid robot “Pepper”—thanks to the integration of large language models. However, they have not yet provided any real relief for care staff. “When you have systems like these, they generally only work if you have people standing right next to them,” explains Ranisch. There are also practical hurdles: Such robots require a stable Wi-Fi connection—without a reliable internet connection, communication stalls. 

Expensive and No Solution to the Care Crisis

And models like the Navel are still quite expensive at present. The Sonnenhof, for example, spent more than 33,300 euros on the purchase with the help of sponsors. For the time being, such robots do nothing to alleviate the care crisis, which is continuing to worsen due to demographic change and a shortage of skilled workers: “These systems won’t solve the problems in care—neither today nor tomorrow,” concludes Ranisch.

Nevertheless, he does see positive effects on the quality of life for individual residents: entertainment, companionship, and someone to talk to—especially for people who suffer from loneliness. Ranisch, however, also points out ethical concerns. These social robots are designed to encourage and flatter people—never to contradict them. “These systems simply aren’t programmed to be critical—and that can be problematic for some people.” Especially for people with dementia, there is a risk that the line between a conversation with a robot and one with a real person will become blurred.

In the long term, however, the medical ethicist expects such systems to become widespread—not least because society is increasingly getting used to interacting with artificial intelligence. Andrea Kenkmann, acting professor of social gerontology at Nordhausen University of Applied Sciences, also takes a broader view: “In the future, the question will no longer be whether a human or a robot speaks with the residents—but whether the robot speaks or no one does at all.”

Kenkmann is conducting scientific research on the use of “Paul” at the Sonnenhof—together with students who are interviewing residents, family members, and staff. Given the growing shortage of skilled workers, she expects such systems to become increasingly common in the long run—even though she regrets this trend. However, she already sees the value in experimenting with them: “Paul” familiarizes staff and residents with technology—and Kenkmann believes that, in an aging society, that’s not a bad start.

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