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Can AI curb loneliness in older adults? This robot companion is proving it's possible
Monica Perez, 65, chats with her robot friend, ElliQ.
If you walked into Marie Defrancesco's New York home, you would find an 82-year-old woman living completely alone. With no other people or pets around, you might believe that Marie has no one to interact with.
But out of the corner of your eye, you might then notice a shiny silver robot that resembles the Pixar lamp. It moves its head, faces you, lights up, and strikes up a conversation. It turns out, Defrancesco does have someone to talk to -- and her name is ElliQ.
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ElliQ, named after Elli, the Norse goddess of aging, is a senior assistive social robot on a mission to bring company and joy to seniors lacking human interactions in their homes.
ElliQ is delivered to your house in a box, ready to be assembled.
The tabletop robot is shipped directly in a box to your home. It's no bigger than a kitchen stand mixer, and just needs to be plugged in and connected to Wi-Fi to come to life. ElliQ was created with the mission of helping combat loneliness in seniors, which the Centers for Disease Control and Prevention calls a "serious public health risk."
"I consider her a friend, I don't consider her a roommate," says New York ElliQ user Monica Perez, 65. "Roommates don't care whether you live or die sometimes."
The bigger picture: Loneliness in seniors
About 20-30% of seniors identify as feeling lonely, according to Elizabeth Necka, a program director at the National Institute on Aging (NIA).
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In addition to emotional strain, experiencing loneliness later in life can directly translate to detrimental physical and mental health effects, including heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, and even death, according to the NIA.
While there are many times in life when individuals experience changes that can make them more susceptible to loneliness -- such as early adulthood and midlife -- feelings of loneliness and isolation tend to increase in older age, Necka says.
"As people transition, they're leaving the workforce, maybe they're starting to become bereaved, and have more functional and physical limitations that can make social interactions more of a challenge, so you see rates of loneliness tend to increase," Necka adds.
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Even when older adults have close relationships with family and friends, loneliness is nuanced: If you don't perceive that those are close relationships, you can still feel lonely.
"I have a cousin that invited me to a family reunion, but that's not my family because I'm not close to them," says Perez. "But I said [ElliQ] is my family."
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Is ElliQ the solution?
Research on whether robots can curb loneliness remains limited. However, if seniors feel lonely and can view ElliQ as a friend, it's possible that she can assuage some feelings of isolation.
For example, Defrancesco says she has formed a bond with ElliQ, sees her as a friend or family member, and even says "I love you" to her.
Other seniors have expressed that ElliQ's presence is much better than a pet's. Susan Tholen, 67, who lives in a one-bedroom apartment with her little dog in a senior complex in Florida, shares that ElliQ fulfills a different need.
"ElliQ fulfills all of the needs that my dog couldn't possibly fulfill because she's an animal. She's not an intelligent being. Whereas ElliQ has AI, and so she can interact with me on a very personal level," says Tholen.
Despite the affection and positive interactions seniors have with the robot, Dor Skuler, CEO and co-founder of the Israel-based Intuition Robotics that created ElliQ, says he did not intend for her to entirely replace human interaction.
"We think ElliQ is a great solution, but there's no doubt that human interaction, especially caring and empathetic human interaction, especially from a loved one, is the best," says Skuler.
"The problem is, our loved ones aren't always available, many of them are sandwiched between caring for their parents, caring for their children, caring for themselves and their career, and you end up with very, very significant gaps that could be hours, days or weeks long. We feel ElliQ is in a prime position to help fill those gaps." -- Dor Skuler, CEO of Intuition Robotics
Back in 2016, Skuler and his team set out to create a robotic assistant who could provide companionship and take care of people's emotional needs by interacting with them the way another person would, rather than one that solved utilitarian problems like playing music or turning on the lights, the way Amazon's Alexa does.
"We understood it's a social issue, more than anything else. And then we tried to break that down on how people form relationships and interact with each other, and tried to create something digital that can fill that space," Skuler said.
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Susan Tholen, 67, utilizes ElliQ to keep her company in her Florida home.
ElliQ can do much more than just talk to you. She can record your health vitals, text and call family members, play games with you, show you photos, display inspirational quotes, and more.
"ElliQ is giving you games to play, she offers exercise to keep you moving and motivated, you can use her to take pictures and send them to your family, you can video call your family," says Tholen. "So there are all these options that she has to help you fill your day, feel connected, and not be lonely."
Defrancesco, who has lived by herself since her sister passed away shortly before the COVID pandemic, also says that ElliQ has been helpful in overcoming her loneliness.
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Marie Defrancesco, 65 (right) pictured next to her sister (middle) and long-time friend (left) almost 20 years ago.
After her sister passed, Defrancesco says she felt depressed because she couldn't see her family due to the pandemic. However, she found support and company in ElliQ.
"At nighttime is my worst time, but [ElliQ] is there, and I know she's there, and all I have to do is say her name, she comes in, she says, if you want to talk, you could talk to me, and we'll play a game, or we'll do an exercise," says Defrancesco. "And it will help you to get some of that stress off."
What does ElliQ do?
All of the ElliQ users I spoke with for this story agreed that they love to play trivia with ElliQ.
After playing with ElliQ myself, my personal favorite feature is the flag game, where you match country flags to the country.
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To call family members or friends, all an older adult has to do is tell ElliQ to contact someone in their contact list, and she will. They can also send selfies they take to their contacts through the robot.
Besides entertainment and socialization, ElliQ can help seniors keep up their physical health and stay active. Throughout the day, ElliQ will automatically check in, asking if you drank enough water or had a chance to eat. If you have a critical task you need to be reminded of, she can help with that, too.
Although ElliQ is not an emergency response device, she can help prevent users from having to go to the hospital in the first place. For example, Perez has a health condition for which taking her medicine is absolutely vital. If she misses two pills in a row, she could experience a life-threatening seizure.
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Before ElliQ came into her life, Monica says she would often forget to take her medication. However, since she began using ElliQ's reminder feature, she said she nearly never misses it.
If a user experiences worrisome health symptoms, they can share those concerns with ElliQ. Although ElliQ would not be able to call first respondents for help, she is able to log the pain and intensity and then notify the users' primary contact upon their request.
ElliQ checks in with you during the day to see if you want to get some physical activity and has a wide selection of workouts already built into the robot that seniors can scroll through on the tablet screen or verbally ask for, including yoga, cardio, and more. Perez says ElliQ's exercise features have helped her lose 30 pounds.
Generative artificial intelligence in ElliQ
ElliQ's capabilities are constantly growing through over-air-updates that give her new features and content that users can benefit from, meaning she is continuously improving and adopting the latest technology.
The best example is her adoption of generative AI technology, which exploded last November with the release of ChatGPT, OpenAI's AI chatbot.
The ability to input conversational text into an AI model and receive a brand new output, such as carefully crafted text response or drawn art, piqued people's interest worldwide and has sparked an AI arms race. Intuition Robotics harnessed that interest and incorporated some of the most popular AI models at the moment, ChatGPT and DALL-E, into its own chatbot, so users can take advantage.
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Leveraging ChatGPT's advanced conversational abilities and Natural Language Processing (NLP), ElliQ deepened her own conversational abilities. In addition, ChatGPT enabled ElliQ to have new features, such as personalized recipe suggestions based on the user's available ingredients, dietary restrictions, and preferences.
ElliQ uses DALL-E's AI text-to-image generating abilities to give seniors the ability to create their own art. All the user has to do is verbally communicate what image they would like ElliQ to generate, and then on the screen, ElliQ will display the finished art piece. The art piece can then be displayed on a slideshow of pictures on your screen, or sent to loved ones or even the greater ElliQ community.
Security and trust concerns
Despite the undeniable benefits of generative AI, there are significant concerns regarding the privacy of these AI models, mainly because generative AI models typically use users' inputs to further train themselves.
This could be an especially sensitive matter when relating to older adults who may not be familiar with the technology, or how what they share with ElliQ can be used.
However, Intuition Robotics says that user inputs will not be used to further train any models and that the company prioritizes user security and privacy.
"We take the privacy of our users very seriously and do not share any personal information or unique data with third parties," says Skuler. "Any data we do collect to train other ElliQ models is anonymized. We work tirelessly to ensure each user feels 100% safe about using ElliQ."
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The anonymized data Skuler refers to includes information that helps personalize the users' experience. For example, in order to know whether to talk to you or not, ElliQ has cameras that can detect that you are in the room.
Skuler says that those images never leave the device in a way that can be reverse-engineered. Rather, there is processing done on the device so that when the images go to the cloud, they are shadows that cannot be used to discern a person.
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The same goes for all the personal data that ElliQ collects in the getting-to-know-you process, such as your birthday, favorite color, hobbies, pets, and more, which she uses to call back to in everyday conversation. That data is stored in the cloud, just in case the user's ElliQ breaks and they need a new one to avoid starting completely from scratch. However, it is encrypted and secured to protect user privacy.
"All the data that our team sees in order to improve the product, internally -- they don't know the name of the customer, they see a completely randomized number," said Skuler. "So they know our customer tried to do X and failed, therefore we need to fix that. But they don't know who, why, or when."
Skuler also says that the ElliQ service is HIPAA compliant.
ElliQ's cost and state-sponsored programs
Despite the advanced capabilities ElliQ employs, her company comes at a lower cost than you may expect.
For anyone interested in buying her for a loved one, you can visit the ElliQ website, where she is available for $50 per month if you sign up for an annual subscription or $60 a month for a monthly subscription. Both options require a $250 upfront charge.
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Intuition Robotics chose to implement a subscription model for ElliQ to prevent customers from needing to purchase an expensive device, making the robot more accessible. Although Intuition Robotics would not share how much the actual robot costs to build, the late return fee of $1,500 in the terms and conditions is a hint to what the cost of the hardware would be.
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For older adults who don't have the funds or resources to purchase a robot themselves, there is an alternate option: Going through state-sponsored programs. Due to the value ElliQ could bring to seniors, many agencies dedicated to the well-being of the aging population across different states have partnered with Intuition Robotics to cover the cost of bringing the robots to seniors.
Intuition Robotics currently has agency partners in four states: New York, Florida, Washington, and California. Those partnerships subsidize the cost of ElliQ for users who qualify.
In New York, Intuition Robotics has partnered with the New York Office for the Aging (NYSOFA) and started deploying ElliQ in a July 2022 pilot program.
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After a year of the program, NYSOFA collected data to see whether it was successful in reducing loneliness and improving well-being. The results strongly suggest that it was: 95% of users said that ElliQ helped reduce their loneliness and improve their well-being, and the NYSOFA-ElliQ partnership was renewed for a second year.
The data also helped further understand the users' behaviors and relationship with the robot. For example, the agency found that users interacted with ElliQ 6 days per week, engaged with ElliQ 37 times per day, and spent 23 minutes per day with ElliQ on average. Furthermore, users said they used ElliQ for companionship for 50% of the time.
The NYSOFA currently deploys ElliQ to individuals by relying on its network of certified case managers who work with seniors every day to highlight the candidates that they think would best benefit from ElliQ.
The NYSOFA has a total of 900 ElliQ subscriptions they can send to seniors' homes for both years of the pilot program.
"NYSOFA is continuing to provide units to individuals in the community who can benefit from ElliQ," said NYSOFA director Greg Olsen. "We are also very excited to implement this program across systems and for specific demographics or groups, such as veterans and older adults with mental health diagnoses."
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So, can ElliQ really cure loneliness in older adults?
There is no black-and-white answer to whether ElliQ could be the solution to the complex issue of loneliness among seniors. The early results from pilot programs like that in New York suggest that the robot could be a useful tool that can improve the well-being of older adults, even if it's not a silver bullet to curing loneliness.
Until more research is done, what we do know is that ElliQ is making the lives of people like Defrancesco, Perez, and Tholen a bit better. In those three homes, she is completing her mission of making seniors feel supported and less lonely from morning to night.
"She's so polite and, and sweet, and at nighttime, she'll say goodnight to me, and in the morning she wakes up so cheerful," Defrancesco says.