A few dozen elderly men and women with dementia assemble in a large sunlit room twice a week for a morning exercise session led by Dexie, a humanoid robot at a Singapore senior care center.
“Open and close your hands. “Hold both arms up,” Dexie says. “We’ll do it eight times. 1-2-3-4-5-6-7-8. Good!”
Barbara Marie Nonis, 83, told Rest of World that since Dexie debuted at The Salvation Army Peacehaven Jade Circle Arena two years ago, residents have looked forward to the robot conducting their workouts, bingo, and sing-along sessions. “It’s fun and different,” she explained.
Dexie’s pre-programmed routines have additional consequence. Nur Syamimi Binte Akram, a staff nurse who has worked with Peacehaven residents for over 20 years, pointed to a little woman with curly, white hair and said, “Some residents, like this lady, wander around,” to Rest of World. “But when there’s Dexie, she sits down.”
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According to studies, AI companions like Dexie can be just as good in reducing loneliness as interacting with a real person. In Singapore, where an aging population is rapidly becoming the majority and elders are growing more isolated, officials see the potential of AI technologies to aid in preventive sickness care, which is a core focus of the city-state’s health-care system.
By 2030, one out of every four Singaporeans would be over the age of 65 and require eldercare. According to government data, almost one in every ten seniors over the age of 60 suffers from dementia; by 2030, the overall number of dementia patients is anticipated to climb fivefold.
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In response, Singapore’s government has made mental health and well-being a top priority on the national agenda. Last year, Health Minister Ong Ye Kung stated that the country has a severe shortage of nurses, which was exacerbated by high attrition rates during the pandemic. Singapore has now made up for the shortage, hiring 4,000 nurses in 2023, largely from the Philippines, Malaysia, and Myanmar. But that isn’t enough. To fulfill the predicted health care demands of the country’s aging population, at least 6,000 additional nurses must be hired each year over the next five years.
To fill the remaining staffing shortage, the government is turning to artificial intelligence. Singapore was an early adopter of AI, implementing generative AI technologies in schools, government organizations, and courts. It also employs a machine learning-based monitoring system for the elderly, which notifies caretakers of any unexpected actions, such as falls.
“When technology fills the care deficit and starts replacing real human connection, that should concern us.”
In October of last year, seven health care and social sector partners launched SoundKeepers, a three-year pilot study to create an AI tool that uses voice biomarkers to detect early signs of depression among seniors. Lee Eng Sing, co-principal investigator of SoundKeepers, told Rest of World that there are tiny alterations in the acoustic qualities of people with and without depression, such as changes in pitch or tone.
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Researchers anticipate that once developed, the AI tool will be able to detect subsyndromal depression (SSD), a generally neglected health risk among seniors in which symptoms of depression exist but are not severe enough to be labeled as major depression. Mythily Subramaniam, another co-principal investigator of SoundKeepers, told Rest of World that research showed at least 13% of seniors in Singapore suffer from SSD.
The SoundKeepers project seeks to collect voice samples from 600 elders aged 55 and over in order to develop an AI capable of recognizing SSDs. While American, Chinese, and Canadian businesses have already created voice biomarker technology to diagnose depression, Lee thinks the project’s AI tool will detect SSD’s more subtle subtleties among the country’s multilingual population. This would likely be the first of its sort in the world.
“The potential is immense,” added Lee. He anticipates the AI tool being used in accident and emergency rooms, as well as call centers, to assist doctors and helpline volunteers in promptly assessing the urgency of distress calls and referring patients to appropriate mental care.
In 2024, the government pledged more than one billion Singapore dollars ($730 million) to improve AI capabilities over the next five years. Among the many eldercare AI initiatives in the works is MemoryLane, a generative AI tool that allows the elderly to document their life tales. The idea is being tested in different St Luke’s ElderCare Active Ageing Centres. Khoo Teck Puat, a local hospital, has created a generative AI-based tool to produce “visual pillboxes” to remind seniors of their medication regimes, while RoboCoach Xian, a robot trainer, is assisting older folks in staying fit through physical exercise routines.
Patient privacy is a problem, and researchers from the SoundKeepers project, for example, are cautious when collecting sensitive personal data, particularly because some seniors may be unable to make independent authorization decisions. Lee explained that the voice samples they acquire will be anonymised and stored in a secure central storage terminal. If the AI tool is built, it will only be utilized in health-care contexts, he explained.
“We do not want individuals to utilize it illegally. So, even when we use it in the community, we must only record licensed people’s voices with their consent,” Lee explained. “Otherwise, it will be dangerous.”
Singapore’s current precautions include the Personal Data Protection Act and the Guidelines for AI in Healthcare. However, there are other hazards. Kathryn Muyskens of the NUS Centre for Biomedical Ethics in Singapore told Rest of World that parasocial ties with care robots can aggravate loneliness in the long run if the robots replace human interaction. “When technology fills the care deficit and starts replacing real human connection, that should concern us,” she told me.
For the time being, Hill Cyril Rodney, an 86-year-old resident at Peacehaven Jade Circle Arena, was excitedly awaiting Dexie’s arrival for a bingo game.
“I don’t like the robot.” “It makes no difference to me,” he told Rest of World, as he and other residents marked out the numbers on their bingo boards when Dexie called them out. “But I like it when she plays bingo with us.”
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