The funding will be used in a study to advance the evidence base for non-pharmacological interventions in memory care settings, with the goal of finding effective ways to support mental health and wellness in older adults with mild to moderate cognitive impairment.

Robots for Connection

Beltran and Gryglewicz are evaluating the preliminary effectiveness and feasibility of the PARO therapeutic robot — in this case, a soft, fluffy baby harp seal — to improve mood, behavior and social interactions. While studies have shown that non-pharmacological interventions, like pet therapy, have positive effects, access to animals in healthcare settings is limited due to allergies, hygiene and cost. Therapeutic robots could replicate the benefits of pet therapy without those limitations.

CHPS obtained its first PARO robot, nicknamed Sully the Seal, in 2023.

Social work faculty have already used Sully to support domestic violence victims during debriefing sessions and to provide companionship and interactive stimulation for neurodiverse adults. Beltran, a former nursing home social worker specializing in end-of-life care, saw an opportunity to bring Sully to older adults in long-term care settings to improve social engagement, foster connection and reduce loneliness.

The PARO robot is already in use in over 30 countries, including in hospitals, long-term care and behavioral health settings. The FDA recognizes it as a Class II medical device. Clinical studies have shown that the robot reduces cortisol levels and improves mood. Equipped with voice and vocal tone recognition, heart rate monitoring, and light and touch sensors, its behaviors are designed to elicit nurturing responses from users, which have been associated with physiological and psychological benefits.

CHPS will acquire a second PARO robotic seal for use in the study.

“Many older adults in long-term care have few opportunities for consistent, meaningful connections,” Beltran says. “Social engagement robots like PARO offer a simple way to create moments of interaction in settings where social connection doesn’t always happen naturally.”

An Alternative Method of Care

Memory care settings often heavily rely on medication to manage behavioral and psychological symptoms of dementia. Still, these approaches can have limited effectiveness, carry side effects and may not be appropriate for all residents. Beltran and Gryglewicz’s research will address critical gaps in research by developing and testing a structured intervention that combines guided group sessions and one-on-one interactions using PARO robots.

“Our intervention is not only innovative but also offers therapeutic benefits for enhancing the quality of life for residents,” Gryglewicz says.

Human-animal bonds are linked to healthy aging and an improved quality of life, including decreased blood pressure, cholesterol levels, triglyceride levels, feelings of loneliness, anxiety and symptoms of PTSD, according to the American Humane Society. Yet many older adults in memory care are unable to manage the responsibilities of pet ownership.

Robotic companions like PARO may be an alternative to a “living” house pet, with the ability to “sense” its environment and provide comfort to human companions.

How the Study Will Be Conducted

The Â鶹ӳ»­´«Ă˝ study will take place at two Central Florida memory care facilities, where 50 older adults with cognitive impairment or dementia will participate in both group and individual sessions with the robotic seals.

Master’s in social work students will lead group sessions, guiding participants through nurturing interactions, such as petting and talking to PARO. Nursing staff at the memory care facilities will help track behavioral and emotional responses before, during and after the sessions.

“For residents who may struggle with verbal communication, Sully can become a shared point of engagement, triggering smiles, memories or moments of interaction that might not otherwise occur,” Beltran says.

A Surprising Showcase

This past summer, Beltran showcased Sully at Orlando Health’s Second Annual Mental Health Conference, where she shared her experience using the robotic seal to enhance clinical impact. Social work professionals from around the state were able to experience Sully’s nurturing mannerisms in real time.

As Beltran presented, conference attendees heard soft squeals and subtle movements from a table in the back corner of the room. It was Sully, ready for attention before the seal was even introduced to the stage.

Sully purred as he was passed around from attendee to attendee, whining when he wasn’t petted.

“When I first introduce Sully, many social work practitioners expect that clients won’t connect with it or are skeptical that a robotic animal could be meaningful,” Beltran says. “The feedback I hear most often is surprise at how quickly Sully sparks real warmth, comfort and engagement.”

Future Efforts

Looking ahead, Beltran and Gryglewicz plan to expand the college’s robotic “zoo” within the next year to include other robotic animals like cats, dogs and birds.

“The goal of our research is to facilitate meaningful connections with these robotic companions, enhancing socialization and emotional well-being for individuals with limited social interactions and capabilities,” Gryglewicz says. “We plan to scale this intervention for widespread dissemination in healthcare settings in the future.”

The effort is modeled after the Zero Suicide Initiative, a national program to reduce suicide deaths, which have risen dramatically in recent years. Rates of suicide have increased by more than 25 percent across the U.S. since 1999, according to the Centers for Disease Control and Prevention. In Florida, the rate of increase is more than 10 percent.

“How do we improve safety measures and practices? And how do we use outcome measures to track what we’re doing to improve suicide care?”

The program also addresses a need raised by the region’s annual Community Health Needs Assessment, which consistently finds access to mental-health treatment is lacking across Central Florida.

The Â鶹ӳ»­´«Ă˝-AdventHealth collaboration will focus on patients who come into the emergency rooms at AdventHealth Kissimmee and AdventHealth Orlando exhibiting signs of suicidal thoughts or behaviors. Currently, those patients might be held in the ER for up to 12 hours waiting for a spot to become available in a psychiatric facility. Or they might be discharged back into the community, only to return to the ER in the following weeks.

If a patient shows warning signs for suicide, social workers will call and check in with them to monitor suicide risk, provide psychosocial education and support, and to make linkages to community supports on a regular basis for up to 90 days.

“The idea is to establish a relationship with the patient, so if the patient goes into an acute crisis, they have a point person who has a psychiatric background and clinical training in suicide prevention,” says Robert Geissler, director of emergency services at AdventHealth Kissimmee. “That point person can connect them with appropriate resources, rather than having them go back to the ER.”

In addition to the social-worker support, the program involves training ER staff and chaplains to recognize and treat patients who may be dealing with suicidal thoughts or feelings.

Kim Gryglewicz, associate professor of social work and interim director of the , is leading the research effort in conjunction with the AdventHealth Research Institute.

“From a research perspective, we’re trying to answer two major questions: How do we improve safety measures and practices? And how do we use outcome measures to track what we’re doing to improve suicide care?” Gryglewicz says. “We will be working to implement best practices in the ED setting using a comprehensive strategy for screening, suicide risk assessment and safety planning, and then tracking what happens post-discharge, with the ultimate goal of preventing suicides and attempts from happening.”

In the long term, the same practices and procedures would be implemented at other sites throughout Central Florida, then statewide and nationally with other AdventHealth sites, Gryglewicz added.

Available data on young people shows similar support services allowed 80 percent to be discharged from follow-up care no longer at risk for suicide, with the remaining 20 percent needing follow-up care.

Gryglewicz expects that researchers might find similar benefits among adult patients after the 90-day program. She hopes to have preliminary data after about six months.