Why you should care
Because when you’re old, you may not have to rely on others to get around.
An elderly lady in an electric wheelchair rounds the corner of a hallway in Tokyo’s Haneda Airport, weaving between travelers rushing to departure gates and dodging carts stacked high with luggage. The wheelchair looks like others except that its passenger isn’t looking where she’s going — she’s studying her ticket. The wheelchair is navigating on its own.
The WHILL NEXT wheelchair, which is undergoing testing at Haneda, is just one of the recent advances in autonomous vehicles and robotics that hold promise to improve the lives of the elderly and the infirm. Other developments include robots to dispense medication, fetch food and even provide companionship. But some health care experts ask: How much will these self-driving vehicles and robotic aides cost and who’s going to pay for them?
With the right controls, I think [autonomous wheelchairs] could be helpful because they may allow people to live alone.
Dr. R. Sanders Williams, president, Gladstone Institutes
The trend is gaining momentum at a critical time. In Japan, a country driving many of the developments in the field, those 65 and older already comprise 26.7 percent of the population, an uptick of 3.7 percent in the past five years, according to a 2015 census. The U.S. is also aging; the Population Reference Bureau shows that by 2060, nearly one-quarter of Americans will be in the retiree demographic, when a loss of mobility can mean a terrifying loss of independence and dignity.
Engineers and roboticists want to change that — and take the tech for seniors even further. A driverless wheelchair developed by the Singapore–MIT Alliance for Research and Technology (SMART) is helping patients navigate Changi General Hospital in Singapore without adding to the workload of a nursing station. Daniela Rus, director of MIT’s Computer Science and Artificial Intelligence Laboratory, wanted to prioritize the development of this vehicle and two others at MIT’s Cambridge campus after visiting an understaffed retirement community in the U.S. With autonomous help, Rus tells OZY, “the elderly will not need an aide to take them places.”
The development of autonomous wheelchairs has been inching along for nearly two decades, but the WHILL NEXT and SMART chairs are the first to be deployed for public use. According to Rus, the accelerated progress in recent years is thanks to “fast computers, better sensors and actuators and algorithmic solutions to mapping, localization, control, planning and perception.” Her team’s software uses three LiDAR (Light Detection and Ranging) sensors mounted above the headrest to detect obstacles and create 3D maps of the chair’s environment for navigation. The chair can even be dispatched to retrieve objects on its own, while the robotic wheelchairs in Haneda Airport can be summoned with a smartphone app. Uber Wheelchair, anyone?
Brenna Argall, director of Argallab at the Shirley Ryan AbilityLab in Chicago, is also hard at work on an autonomous wheelchair with another mobility-impaired population in mind. “If you’re quadriplegic, you don’t have access to a joystick that’s operated by the hand,” Argall tells OZY. “[Traditional] interfaces are based on switches embedded in the headrest or blowing and sucking on a straw, which are more difficult for the user to operate.”
Robots already can do more for the elderly and disabled than just take them from A to B. The Japanese government has earmarked more than $2 billion to develop carebots. Among existing products, Honda’s Asimo humanoid robot can retrieve food and turn lights on and off, while the Robear from Japan’s Riken Brain Science Institute can lift the elderly from a sitting or lying position and then act as a robotic walker. Elsewhere, a French robot named KompaÏ can administer medication and call 911. ElliQ, a desktop robotic companion developed by Israel-based Intuition Robotics, can play games, issue prompts to take meds and suggest that it’s time to go outside for a walk after an extended TV session — in a nonjudgmental way, of course.
Dr. R. Sanders Williams, president of the Gladstone Institutes, a biomedical research organization, also sees a role for robotics in caring for dementia patients. Recognizing that many elders don’t like round-the-clock care, Williams believes autonomous wheelchairs, for example, could address aspects of that issue. “With the right controls, I think [autonomous wheelchairs] could be helpful because they may allow people to live alone,” he says. But the interface must be simple. “Even as very computer-literate people begin to lose mental capacity, their appetite for the internet seems to fade,” he notes. “For [assistive robotics] to be useful, they need to be completely voice-activated.”
One speed bump is cost. “Sensors … are very expensive,” says Felix Naser, an MIT graduate student working with Rus on the MIT wheelchair. Its LiDAR sensors cost around $2,000 apiece. “The next step to making this a [commercial] product would be to get the sensors down in price.” To that end, last year MIT engineers created a depth-sensing system using a smartphone and a $10 laser, which they plan to develop for use in autonomous technology.
Another speed bump in the U.S.: Food and Drug Administration approval. FDA fees depend on how the wheelchairs are classified. “If they are designated Class 3 devices, which are considered the highest risk,” an FDA representative tells OZY, “then they would require a PMA [premarket approval].” For a small business with $30 million or less in gross annual sales, the PMA fee is $58,624; for larger companies, $234,495. None of the developers has reached this stage in the process.
And then there’s the question of who picks up the tab. “Insurance companies will not pay because it’s hard to justify,” says Jessica Pedersen, an occupational therapist who works with Argall at the Shirley Ryan AbilityLab. “We thought that elevating wheelchairs would be a shoo-in, but [insurance providers] are saying it’s a luxury … it’s not helping medically.” Medicare Part B currently covers electric scooters and manual wheelchairs, but will only cover power wheelchairs if they are deemed “medically necessary.”
Despite the challenges ahead, Argall thinks autonomous wheelchairs could hit the market within the next five years, and people are ready for them. “Ten years ago, people thought it was crazy that your car would be able to help you stay in your lane or brake for you, and this is now accepted technology,” Argall says. The concept is similar with wheelchairs. “Society as a whole is very well primed for this.”
* Correction: An earlier version of this story referred to the Rehabilitation Institute of Chicago; it is now called the Shirley Ryan AbilityLab.