THE EXCERPT

Introduction

A Japanese care home at night. An older man wanders along an empty corridor, looking confused, until he comes face to face with “Pepper,” a four- foot- tall white plastic- and- metal humanoid robot, with big, illuminated eyes and a high- pitched chirpy voice. As the man walks up to the robot, it starts talking to him: “Good evening! Where are you off to so late?” and asks him a series of questions: “When’s your birthday? Tell me something you can be proud of. Where’s your home? Who do you live with?” Meanwhile, the robot covertly takes a photo of his face and emails it to a care worker, who rushes to the scene and escorts the man back to bed.

(Description of a staged 2016 promotional video for a “monitoring” app for the robot Pepper1)

A Japanese care home in daytime. A care worker, Fujita, spends several minutes booting up the same type of humanoid robot Pepper in the room where it is stored, and when it is ready to go, she wheels it into the corridor. She helps an older female resident, Suzuki, toward the robot, and quickly carries a chair over for her to sit on so that she is positioned in front of it. Suzuki seems excited to interact with Pepper. Fujita uses the robot’s touch screen to select its quiz app, and it begins the quiz with Suzuki. At first, every thing seems to go well, and Fujita goes off to do other tasks, although she continues to keep an eye on Suzuki’s interaction with the robot. But the background noise of the care home begins to interfere with Pepper’s speech recognition. It asks Suzuki, “What’s four times six?” She answers: “Twenty- four.” There is a pause. She repeats, “Twenty- four.” Pause. “Twenty- four!” “Wrong answer.” “Twenty- four!!”

“Wrong answer.” “What do you mean it’s the wrong answer, it’s twentyfour!” “Wrong answer.” Eventually, Suzuki loses patience with the robot and starts to get up. Fujita runs over to help her up and take her back to her usual seat, and then immediately wheels Pepper back to its storage area in case another resident trips over it. She says to me with a wry smile, “How much does this thing cost again?”

(Pepper in use at a nursing care home in Japan in April 2017, description based on field notes)

This is a book about robots, Japan, and the future of care. It is about state and corporate attempts to bring together increasingly sophisticated, but also exceedingly hyped, robotic technologies with the unprecedented number of older people requiring care. It is also a book about what it means to do care work with robots. Are robots an ideal solution to the “problem” of aging, or do they create new problems of their own? Could a machine, or a suite of machines, partially or fully replace the need for human care workers? If so, what would become of care and care work?

Although this book focuses on Japan, the questions it asks and hopes to answer are critical for many other higher income countries that are contending with growing populations of older people but do not seem to have enough caregivers to look after them. Japan may appear to be a special case since it is facing such a serious care crisis. The statistics seem to paint an extraordinary picture. By 2050, the proportion of people over sixty-five years of age is forecast to grow to nearly 40 percent of the overall population, with 514,000 people over one hundred years of age—nearly ten times the number in 2016. In 2000, there were about four adults of working age for every person over sixty-five; by 2050, there will be near parity. By the same year, almost one in ten of the population—nine million people—is expected to be living with dementia. To cope with the level of care that will be needed, Japan’s government expects that by 2040, one in ten adults of working age will be employed as a care worker, up from around one in 160 in 2000, not counting the many people providing informal care to older family members and friends. In 2012, annual social benefit spending for older adults was at an all-time high—¥74.1 trillion ($741 billion), representing 21 percent of national income. By 2040, it is forecast to hit ¥190 trillion ($1.9 trillion).2

Japan is, however, not alone in this predicament. In Eu rope, it is estimated that one-third of the population will be over sixty-five years of age by 2060, leading to a doubling of care needs for older adults compared with the level in 2012. In the United States, the figure is expected to be slightly lower, with around onequarter of the population over sixty-five by 2060, although a sense of crisis is even more immediate due to the absence of state assistance for eldercare.3 Many European Union countries as well as the United Kingdom expect significant and growing shortages of care staff in the near future. This is why policymakers and nursing home administrators across Eu rope and North Amer ica are looking to Japan for possible technological solutions to their caring crisis.

In attempts to preempt some of the vast social and economic transformations that these predictions seem to imply, some in Japan and other aging countries have been imagining alternative futures. Over the past twenty years, one such vision has increasingly materialized among government technocrats, research managers, and corporations. It is a future populated by robots that care, and it has driven Japan to pioneer a new kind of techno–welfare state increasingly focused on high-tech systems and networked digital devices. In this technologycentered reimagining of care, machines with names like Hug, HAL, and Pepper are intended to supplement or replace the work of human caregivers while also assisting older people to look after themselves, breaking down the tasks of care into linear strings of simple, repeatable physical actions and speech that can be digitally reproduced by computational algorithms and performed by robots.

Japan is an ideal case study in helping us explore the fantasy of robots solving the significant social and demographic challenges that confront aging postindustrial societies. The idea of robots coming to the rescue taps into a rich invented tradition of Japan as “robot kingdom” which has been cultivated over decades, with relentless promotion of robots in popu lar culture and across state, media, and industry. Yet despite considerable domestic and international interest in eye-catching Japa nese robots, actual knowledge about what kinds of technologies are being developed, how, and for what purposes remains scant. Many news stories portray an exoticized version of Japan that fails to capture the complex real ity of how care robots are developed and used, while many academic studies of robots are conducted by those with significant stakes in the success of the industry.

This book explores the world’s single largest project to date aimed at developing and implementing care robots, launched by the Japa nese government, as a lens through which to view this attempt to transform the future of care. It examines the differences between how the roboticization of care is imagined, how it is proceeding, and what this process looks like from the perspective of an eldercare facility and care workers expected to use robots. In doing so, it grapples with a number of questions: What do robots mean for the future of care? Will robots decimate human employment in the care sector, and would this in fact be a desirable outcome, given the often-negative reputation of caring jobs? What is the interface between the engineers and technocrats who design and promote robots, the workers who use them, and the care home residents whose lives they are ostensibly designed to improve? How do robots contribute to transformations of care labor and practices, what it means to care, and how those doing this work understand good care?

I will argue that despite considerable hype, lofty expectations, and substantial investment, robots alone cannot yet deliver on the promise of solving care crises in Japan or elsewhere. Efforts to develop and implement them instead call attention to what might be lost in the roboticization of care, while also revealing alternative approaches that go beyond technological fixes.

Caring for Capitalism

I first became interested in Japa nese robots in 2007 during my master’s degree at Oxford University. The Japa nese government had just released Innovation 25, an optimistic vision statement that imagined everyday life in Japan in the year 2025—a society full of robots and other high-tech gadgetry. An ambitious new research project aiming to develop a robot version of a human child (CB2) had also been launched, and other Japa nese robots were garnering international media exposure on a regular basis. It seemed as if the futuristic “robot society” depicted by the Japa nese government was just around the corner. My enthusiasm was not shared by my adviser, an anthropology professor, who counselled me not to be distracted by the hype and fanfare of robots that were rarely used in daily life. But by the time I began my PhD in 2014, academic interest in robots was continuing to build. The relatively new field of human-robot interaction studies was expanding rapidly, and scholars across the social sciences showed more interest than ever in the subject. Japan was a key center for the development of interactive and humanoid robots, and the government had just initiated the largest ever care robot development and implementation project. If care robots had not entered everyday life quite yet, they seemed poised to do so.

In Japan, state and industry backers of care robots imagine them as helpful companions, looking after elderly parents and even young children at home, and enabling working-aged members of their family, particularly women, to keep their jobs and pursue econom ically productive lives without having to spend time and effort providing care. These technocrats aim to promote the development and use of a range of what they call personal care robots, to be employed mainly in care institutions but also increasingly in private homes, to help with demanding or time-consuming care tasks. Some of these devices are aimed at physical care, including machines that can help lift older people unable to get up by themselves, assist with mobility and exercise, monitor their physical activity and detect falls, feed them, and help them take a bath or use the toilet. Others are aimed at engaging older people socially and emotionally in order to manage, reduce, and even prevent cognitive decline, provide companionship and therapy for lonely older people and their hard-pressed caregivers, make those with challenging behav ior due to dementia-related conditions easier for care staff to manage, and reduce the number of caregivers required for day-to-day care.

In promoting high-tech robotic solutions to the seemingly technical problems of care, such as the transfer of older people from bed to wheelchair which contributes to widespread back pain among Japa nese caregivers, government and industry supporters also hope to improve poor employee hiring and retention rates. In this way, they expect to be able to capitalize on peripheral elements of the labor force by encouraging older or less physically able workers into the formal care sector. At the same time, they aim to support informal familial care at home and aid the “independence” of the increasing proportion of older people who live alone, thereby mitigating the ever-growing demand for institutionalization.4 Some believe that introducing care robots to do many of the tasks currently performed by human caregivers can reduce the burden of care on families, alleviate labor shortages, reduce the need for politically problematic migrant care labor from other parts of Asia, and increase productivity in the sector, thereby cutting spiraling care costs and revitalizing the economy. All this while reducing loneliness, preventing elder abuse, and improving standards of well-being and care for older people who require it—although these latter aims tend to be presented as, at best, an afterthought. Care robots are intended to showcase Japanese innovation and technology and to create a massive new high-tech export industry for Japan, supplying an international market that will continue to grow rapidly for decades in tandem with the aging populations of wealthy countries. The imagined benefits of care robots are seemingly endless.

The reason for the care crisis in Japan seems straightforward: there are too many older people who need care and not enough younger people to provide it. Yet, this simple statement obscures layers of political, economic, and sociocultural complexity encompassing ideologies and politics of neoliberalism and globalization, gender and family relations, and intergenerational ethics. If this is a crisis of care at a particular historical moment of demographic extremes, it also seems to be a broader crisis of capitalism. Capitalism requires workers; workers have to be reproduced—not only biologically but also socially: looked after, cared for, brought up, and socialized through countless interactions with family, friends, and other caregivers throughout their lives, most of which is done informally and in the home—unpaid, out of love, duty, or other reasons unrelated to money (Folbre 2001). Without this reproductive labor, capitalism could not exist: as Joan Tronto notes, “No state can function without citizens who are produced and reproduced through care” (2013, 26). Care work, including eldercare work, can be understood as reproductive labor in the sense that care reproduces society and social values, maintaining social cohesion and intergenerational reciprocity. Reproductive labor historically has been undervalued or not valued at all in economic terms; care labor has until relatively recently been taken for granted.

Nancy Fraser has argued that the crises of care seen across many postindustrial societies today originate from this “contradiction” of capitalism that “tends to destabilize the very processes of social reproduction on which it relies” (2016, 100), while Anna Tsing (2015) argues that the translation of noncapitalist areas of value (including, I would suggest, unpaid caring) into capitalist systems is in fact an essential aspect of how capitalism works, which, like Fraser, she sees as unsustainable in its current form. This process only seems contradictory because of the rhetoric of rationalization used to describe markets and economies, which tends to ignore noncapitalist elements such as care that are among its vital inputs. Crises of care occur as the tacit economic need for unpaid care labor conflicts with the competing drive for maximal employment in the formal labor force. Capitalist models that largely ignore care labor therefore start to look increasingly precarious when reproduction rates fall and large sections of the population pass retirement age.

Whereas most Western countries have turned to the near-term solution of immigration from lower income countries to provide a fresh supply of low-paid care workers, the situation in Japan has been complicated—uniquely among higher income countries—by relatively low levels of immigration, for sociocultural and political reasons that will be examined later. Nevertheless, amid growing international recognition that “ free” familial care is actually paid for by the individual and societal economic opportunity costs of lower household income and fewer employees in the workforce, the Japa nese government has been pushing eldercare from mainly informal and unpaid provision into the paid sector in hopes of freeing up family carers to participate in the formal economy. In the process, it has exposed the substantial economic costs of trying to bring informal unpaid care labor into the formal capitalist economic system through public financing on a national scale. Yet, this formalization of labor is also creating new markets. The world of care, long hidden in plain sight, has now become a crucial area of commodification and “value creation”—a new market frontier ripe for innovative disruption, with older people reconceptualized as a source of economic growth and rejuvenation rather than a burden on national resources. Sociologist Ito Peng (2018) calls this the care economy, arguing that care has become “a key driver of the new ser vice sector economic growth and expansion” across almost all high- and middle-income countries.5

The development of care robots represents an attempt to square the apparent contradiction of capitalism in Japan while continuing to grow the economy: to digitally and mechanically reproduce and replace large swathes of human care, substituting capital for labor and so acting as a kind of bridge between productive and reproductive labor. Use of robots seems the logical extension of efforts to rationalize human work across all sectors and particularly those such as care work that are highly labor intensive by engineering a replacement that is entirely commodified—creating what robotics scholars Noel Sharkey and Amanda Sharkey (2012) have described as akin to an eldercare factory.

The aim of developing care robots is to make eldercare sustainable within the context of Japan’s export- driven economy—providing more efficient care services domestically while at the same time globalizing robot care by standard-