The ageing demography, the shortage of health professionals and the economic constraints challenge the availability, accessibility and quality of the assistance provided to dependent older persons. In that context, the use of assistive devices and robotics is increasingly seen as a cost-effective solution to make our health care systems sustainable. In a recent report of July 2017, the United Nations (UN) Independent Expert on the Rights of Older People looked into how these technologies and robots impact older persons’ life.
Expanding role of digitalisation in care
Assistive technologies were first designed to perform simple, routine tasks to allow human staff to dedicate more time to complex tasks. Researchers and innovators are constantly developing new ones and improving them and robots are now taking on more and more medical and caregiving tasks. Their use focuses on three main areas:
- help monitor the behaviour and health of older persons,
- assist older people or the caregiver in their daily tasks, and
- provide for social interactions.
In a report released in July 2017, the United Nations (UN) Independent Expert on the enjoyment of all human rights by older persons, Rosa Kornfeld-Matte, warns that ‘those (three) areas touch inevitably on the enjoyment by older persons of their human rights, including their dignity and autonomy, informational self-determination and non-discrimination and equality.’
The UN expert therefore stresses the need for a human rights-based approach to underpin discussions in that field and make sure we will adequately address current and future challenges and ensure sufficient protection of older people’s rights.
Existing legal frameworks are insufficient
In her report, the Independent Expert looks at the existing legal and policy framework, including the Convention of the Rights of Persons with Disabilities and the Madrid International Plan of Action on Ageing (MIPAA). Although those frameworks acknowledge the needs for ensuring the availability, accessibility and quality of assistive technology, they do not cover the full potential of the use of assistive and robotics technology in supporting autonomy in old age.
By only focusing on medical technologies, the current frameworks fail to include assistive technologies as enablers of older people’s equal participation in society. Additionally, these frameworks make no mention of the use of these technologies in residential care settings.
UN Expert recommendations for a human-rights based approach
- The report insists on the need for assistive technologies to foster autonomy and independence but without increasing social exclusion. The reduction of human contacts and interactions is a possible result of the use of those technologies and making communities, services and the built environment accessible is here essential to support both independent living and social inclusion within the community.
- Equally important is to give older persons the choice to accept or refuse the technological support proposed to them. ‘Consent is not merely an administrative requirement. It is an essential element to a rights-based approach’, highlights the report. For this, simple and accurate information needs to be provided, in order for older persons to be able to properly assess the implications and possible risks as well as benefits he/she may receive.
- Further human rights requirements imply that older persons keep control over information that will be collected through technologies, e.g. on health conditions and living habits. Moreover, technologies should be flexible enough (‘self-learning’) to adapt to older persons’ preferences and lifestyles.
- The use of these technologies should not replace human care and do not substitute States’ obligation to support older people by creating the necessary structures, services and allocating budget for long-term care.
- To avoid creating further inequalities, the equal access to assistive technologies must be ensured to all older people regardless of their level of income, ethnic or cultural origin, religion, physical or mental ability, gender, or place of residence. The Independent Expert stresses that age limits constitute a form of discrimination as they impede older people from accessing the support they need.
- Assistive technologies and robotics should support older persons’ participation in social and public life – namely in decision making processes e.g. through online surveys, consultations, voting systems – and in other everyday activities (online shopping, government or banking services, leisure, etc.). The principle of participation also implies the direct involvement of older persons in the design and development of assistive solutions.
- The report calls for further exploring appropriate mechanisms to monitor these technologies – in particular robots. Mrs. Kornfeld-Matte suggests the establishment of a dedicated watchdog on artificial intelligence that would adequately address the situation of older persons and be grounded on human rights standards.
- The Independent Expert concludes with the need to explore further the substantive elements of a right to assisted living in old age, focusing on the intersection of ageing and disability and/or on how the right to care and support can be protected on the basis of a life-cycle approach.
AGE welcomes the Independent Expert’s report
The issue of automation and its impact on the human rights of older persons is of high interest and concern for AGE. Given the increasing use of assistive technologies and robotics in older people’s life, radical changes are to be foreseen in the provision of care and in the way older people participate in society.
AGE particularly welcomes the references to age-based barriers, which impede older people’s equal access to support and looks forward to engaging in further discussions on this critical issue that we have been highlighting in our contributions to the EU and to the UN Committee on the Rights of Persons with Disabilities. In addition, we want to underline the resource scarcity around care services being available within the community to enable old persons to live independently and the fact that many older people still lack access to basic assistive devices, such as hearing aids or wheelchairs. Therefore the right to assisted living in old age needs to include a range of affordable choices of support adapted to the needs and preferences of each individual. The UN Independent Expert report is in that respect very resourceful and will support AGE advocacy activities towards assistive technologies that match the reality of older people.
As a matter of fact, AGE is involved in several policy activities and projects supporting the development of assistive technologies and robotics, for instance the EU-funded projects SEED – Silver Economy Awards, which promotes digital innovations enhancing the quality of life of older persons, and Prosperity4all. Our participation in the Advisory Board of the Active and Assisted Living (AAL) funding programme enables us to advocate for the funding of future projects aligned with the needs and expectations of older persons and based on the principle of user involvement.
AGE also actively works on current EU policy dossiers linked to accessibility, a key issue to ensure digital inclusion. Together with ANEC (the European consumer voice in standardisation) and the European Disability Forum, we are campaigning for an ambituous European Accessibility Act to make sure future digital innovation will be fully accessible. We are also supporting the activities carried out in standards for accessibility following the Design for All principle.
Next to the European Public Health Alliance (EPHA), we campaign for a holistic and social-inclusive approach to the use of technology in public health. There are indeed a number of discussions and fora (such as the eHealth Stakeholder Group) at EU level in relation to eHealth, mHealth (mobile health) and data protection in which we can make the voice of older persons heard.