Care-led innovation
The case of elderly care in France and Japan
The objective of the project is to develop a concept of innovation led by “care”, in taking as a case study long-term care for the elderly.
The increase in human longevity and the aging of the population constitute a major challenge for our societies, which refers to forms of solidarity between generations, the heart of our social pact (Guillemard & Moscova, 2017). One of the key issues concerns care for the elderly, who face a loss of autonomy and forms of vulnerability, especially since inequalities (according to gender, regions, professions, income, etc.) in terms of disability-free life expectancy are significant and persistent (Robine et al., 2020).
Long-term care, a privileged area for the application of technologies
In this context, the issue of long-term care has become a privileged area for the application of technologies, in the spirit of promoting a “silver economy” (Yoshikawa, 2020). As such, Japan is often cited as an example with the use of personal robotics in specialized institutions or at home, which seems to be more accepted than elsewhere (Wright, 2020; Kodate et al., 2020). This trend can be observed in other geographical areas, for example in France, with the development of a market for geolocation devices intended for so-called “Alzheimer’s patients” (Morey, 2020). In general, the potential contribution of several technologies (notably robotics, artificial intelligence, information and communication technologies [ICT]) should be recognized: they seem to be able to partly solve problems of autonomy and vulnerability, whether it concerns communication, mobility or cognitive abilities.
If this contribution is recognized as a possible response to problems related to loss of autonomy, it is also characterized by certain limitations, which have been well identified, for example, by anthropologists who have analyzed the use of robots in Japanese institutions for dependent elderly people (Wright, 2019). Our hypothesis is that this is not a one-off problem, but a fundamental impasse related to the way in which social needs and technological responses are articulated. This is in line with the dominant paradigm of innovation, marked by a Schumpeterian perspective, which emphasizes the idea that every societal problem has technological solutions. Conversely, our conviction as SHS researchers is that there is an urgent need to reconnect social and technological dynamics, by proposing a concept and practices of innovation that make well-being (and not competitiveness) the ultimate criterion for innovation (Lechevalier, 2019). Our proposal is that care-led innovation is one possible response.
The concept of care, the heart of our analysis
By focusing on the issue of eldercare and by analyzing specific technologies (robotics, information and communication technologies, medical devices, etc.) that deal with specific problems that may lead to a partial or total loss of autonomy (mobility, cognitive impairments, isolation, etc.), we adopt an embodied approach to innovation. Our proposal is to put the concept of care (Molinier et al., 2009; Damamme et al., 2017) at the heart of the analysis. It should enable us to rethink the concept of individual autonomy without opposing technology and well-being. Faced with this general question, the mobilization of French and Japanese fieldwork seems relevant to us, in view of the commonalities between these countries (for example, from the points of view of longevity dynamics or the innovation paradigm) but also of their differences (social definition of ages of life, social contract between generations, family dynamics, forms of social protection, role of the State, types of technologies mobilized, etc.). The crisis generated by COVID-19 also deserves a specific analysis insofar as it revealed, sometimes brutally, tensions and implicit values or choices (Giraud et al., 2020; Kimura et al., 2020).
In the existing literature, the analysis of technological innovations in the field of eldercare has made significant progress in recent years in trying to better integrate the point of view of users, whether they are carers or helpers (Kodate et al., 2020; Obayashi et al., 2020). However, it is clear that this consideration is still imperfect, particularly from the point of view of well-being analysis, and that it is still very much marked by the perspective of the acceptability of technologies, which is quite limited from the viewpoint of wellbeing (Wright, 2020). For their part, despite rare exceptions (Morey, 2020; Allouche et al., 2015), care-centred approaches tend to put the human being at the heart of the analysis, setting aside what is technological.
Our goal is to bridge the gap between these two approaches by proposing a concept of care-led innovation and by focusing on the relationship between humans and machines. Care approaches also allow to better take into account gender and migration issues, which is all the more important as the mobilization of personal robotics in Japan is presented as a way to limit the use of migration (Hirata, 2011).
Several innovative elements emerging from our project
1) The objectives of our project are innovative, in that they aim to bring together two scientific literatures, the socio-economics of innovation and technology and the studies of care, which are very rarely mobilized jointly, with a few exceptions (Morey, 2020; Allouche et al. 2015).
2) From a methodological point of view, our multidisciplinary approach should allow us to renew the questioning and the answers provided. In a first step, it is a collaboration between social sciences researchers with different disciplinary approach. Our aim is to extend our perspective into two directions: a) to promote collaboration between social sciences and engineering and sciences (e.g. robotics, information and communication technologies); b) to promote collaboration between researchers and the stakeholders of eldercare and technologies made for eldercare (e.g. associations, care centers, living lab, private companies, public institution in charge of welfare, etc.)
3) Finally, the reference to Japan on these questions is quite common, but is most often based, in France, on second-hand sources. This project does not aim to draw normative lessons from the Japanese experience but rather proposes a real research collaboration between French and Japanese researchers, who are associated with the project.
