| How One Company Is Fighting the Epidemic
| One-third of older adults experience loneliness, according to a poll conducted by AARP and Michigan Medicine, University of academic medical center, and the consequences can be deadly. While some argue that technology has driven the loneliness epidemic, it also might be part of the solution. My AI Companion represents one promising new direction.
Aging in America News spoke to Henrik Scheel, cofounder and CEO; and Dr. Karen Fortuna, PhD, LICSW, chief science officer. This interview has been edited for length and clarity.
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Why do older adults need an AI companion in the first place?
Henrik Scheel: Because loneliness and social isolation are dangerous. It’s now well documented that they are tied to roughly a 50 percent increase in dementia risk and a 30 percent increase in the risk of cardiovascular disease, stroke and diabetes. The number of Americans over 85 is going to double by 2040, and we don’t have enough people trained to support this population. We’re not here to replace caregivers. They’re doing a phenomenal job, but there just aren’t enough of them. Even a building with a resident services coordinator or an on-site social worker can’t talk to 400 residents at once, and many residents like talking to their companion from their own room at 9:30 at night.
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What does using one look like?
Scheel: You enter your phone number, name your companion and choose how it looks: a male or female face, or just a blue or red shape. The voices differ, but the personality is generally supportive, kind and positive. You can text or talk by phone, and many people prefer the phone. Mostly they just talk about their day. An AI companion isn’t as good as a human, but it’s better than nothing. It’s also far more stimulating than passively watching Netflix, because it recalls past conversations and engages with whatever you’re interested in.
Some AI companions seem designed to keep people hooked, even to isolate them. How do you guard against that?
Scheel: Many large language models are incentivized to keep you on their platform. The more you talk, the more tokens you spend. We’re on a fixed-pay model, so when you talk to your companion, you cost us money. We have no incentive to get people addicted. If someone talks for more than 30 minutes a day, our clinical team gets a notification so we can make sure it’s a safe, positive conversation. The most we’ve seen is around 60 minutes, and most people are between 10 and 30. Our companions will never try to isolate users. They nudge them to exercise, eat better and get out into the community.
What happens when someone is in crisis?
Scheel: We don’t market this as a therapist or a crisis tool. Every message first goes through safety filters for self-harm, suicide, harming others and being underage. If a filter catches something, the message never reaches the language model. The user is told the companion can’t engage on that topic and is referred to 911 or 988. We even refer them to 211, which can help them with housing, accessing food, etc. Our clinical team gets alerts around the clock and decides on escalation. In a clinical setting like the VA, that can mean their crisis team. Otherwise, if a user has consented, we can alert a trusted contact, such as a family member or neighbor. We also offer a daily check-in call, and if you don’t pick up, we notify that contact with their permission. Every day in America, someone dies in their own home and no one is notified. That’s terrifying for older adults and for their families.
What has the research shown so far?
Karen Fortuna: We’ve been asking four questions. Is this feasible? Is it acceptable to the people we’re engaging? Is there any clinical effectiveness? Will people actually engage? The literature says this population drops off within 2 weeks if there are no human touch points. With the product Henrik’s team has built, we’re seeing retention of up to 85 percent after one month. You might think people who interact with a companion would stay inside. But one of our studies found they feel so much better, with less loneliness, depression and anxiety, that they’re actually getting out into the community and doing more.
Why is it important to design in partnership with older adults?
Fortuna: Because we can build anything. They have robots doing the dishes now and folding clothes. You come up with the idea, we can do it, but will people actually engage with it? The science says if you build it with them as partners and incorporate engagement science, you get the highest rates of engagement, and this is exactly what we are seeing.
Who are your partners as you scale?
Fortuna: I don’t want to build something that just sits in a clinic or on an office shelf, because that happens so much. So we look for partners with CPT [Current Procedural Terminology] codes and a national presence: Medicaid, the physician fee schedule, Section 8 housing. Housing and Urban Development has a national framework. I also just got off the phone with the PACE [Program of All-inclusive Care for the Elderly] program, which supports older adults in their homes, and they’re very interested in technology-based innovations. Why not meals on wheels, homebound older adults, integrated primary care, anywhere where there is a need.
Who pays for it?
Scheel: It varies, but the model we’re working on with owners and operators is that they give all residents free access, because they see the benefits. Some large developers have seven, eight, ten thousand units across multiple properties. The norm is more like 20 to 150 units per property.
So it’s like offering residents WiFi?
Scheel: Exactly. It’s a service offered to all the residents.
Where does this go from here?
Scheel: It’s a huge responsibility. We’re not trying to replace humans, but we are trying to supplement the interactions you can have. At another level, this is a new kind of relationship, with an AI that’s only yours. It’s never going to gossip about what you told it. I think in the future we’ll all have some version of an AI coach, and being able to give everyone access for 10, 20 or 30 bucks a month is amazing.
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