Application of AI and socially assistive robots in care of older adults

Declining birth rates and increased life expectancy have accelerated global population aging, placing significant pressure on social care systems. This demographic shift is compounded by a global shortage of approximately 17 million healthcare professionals and nursing staff (The Health Foundation, 2019). In response, social robotics has emerged as a promising technological solution to alleviate human resource constraints and economic burdens in the care of older adults. This study examines the integration of socially assistive robots (SARs) and artificial intelligence (AI) within Croatian care home environments, assessing their benefits, risks, challenges, and associated ethical implications. Guided by an interpretivist paradigm rooted in subjective ontology and epistemology, the research draws on qualitative data from semi-structured interviews with 63 participants, including 11 IT experts and academics, 23 care home residents, 14 nurses, 11 social workers, and 4 managers. Findings indicate strong support for the use of SARs in performing repetitive and non-clinical tasks, with 95.7% of users and most professionals citing their reliability and capacity to reduce staff workload. Nonetheless, ethical concerns persist, particularly regarding privacy, autonomy, data protection, and the limitations of robots in replicating human empathy in emotionally sensitive situations. This study examines the perceptions, opportunities, and limitations of implementing SARs in nursing homes, drawing on insights from academic experts, care home users, medical staff, social workers, and managers to inform ethical and effective adoption of these technologies. To address these challenges, the study proposes a multidisciplinary framework that integrates core ethical principles—beneficence, non-maleficence, justice, and respect for autonomy—with social and technical dimensions of SAR deployment. This framework provides both theoretical insight and practical guidance for care institutions by addressing barriers such as institutional resistance, financial constraints, technological inaccessibility, limited staff training, trust deficits, and public misperceptions. Emphasis is placed on stakeholder engagement, regulatory compliance, safety, accessibility, and the preservation of human dignity. A key strength of this research lies in its interdisciplinary design, bridging fields such as robotics, nursing, social work, philosophy, psychology, and sociology. By adapting interview content to each participant's expertise, the study upholds the principle of epistemic justice (Fricker, 2007), valuing both experiential knowledge and theoretical reflection. The research also proposes a strategic marketing and implementation framework to promote socially responsible adoption of SARs. This includes a three-tiered robot typology—comprising service-interactive, physical assistive, and entertainment-focused robots—alongside a comprehensive adoption strategy. Key recommendations include ethical oversight, regulatory frameworks, targeted staff training, government subsidies, and public education campaigns. Collectively, these initiatives offer a holistic and ethically grounded pathway for integrating SARs into care of older adults, aiming to enhance older adults' quality of life while safeguarding social and moral responsibilities.