How Do Older Adults Perceive Technology and Robots? A Participatory Study in a Care Center in Poland

Abstract

One of the key areas of application for social robots is healthcare, particularly for the elderly. To better address user needs, a study involving the humanoid robot NAO was conducted at the Municipal Care Center in Krakow, Poland, with the participation of 29 older adults. This participatory design study explored their attitudes toward robots and technology both before and after interacting with the robot. It also identified the most desirable applications of social robots that could simplify everyday life for the elderly.

1. Introduction

We present here a participatory design study aimed at exploring how social robots can support and enhance the daily lives of elderly individuals. As the global population ages, there is a growing need to develop innovative solutions that promote the well-being, independence, and social engagement of older adults. Social robots, which are designed to interact with people in a socially appropriate manner, have shown the potential to provide companionship, assistance with daily tasks, and support for physical and cognitive activities. We adopt a participatory design approach that involves elderly participants in the development and refinement of robotic solutions, ensuring that their needs, preferences, and expectations are thoroughly understood and integrated into the design process.

Elderly care is facing significant challenges worldwide due to rapidly changing demographics and a shortage of caregiving resources. According to the World Health Organization [1], by 2030, one in six people worldwide will be aged 60 years or older. The number of individuals aged 60 and above will grow from 1 billion in 2020 to 1.4 billion. By 2050, this demographic is expected to double, reaching 2.1 billion. Furthermore, the population of those aged 80 years and older is projected to triple, increasing to 426 million between 2020 and 2050. As life expectancy increases and birth rates decline, many countries are experiencing a substantial increase in the proportion of older adults within their populations. This demographic shift is creating an unprecedented demand for healthcare and social support services, placing immense pressure on existing elderly care systems. The growing number of older adults, many of whom live with chronic illnesses or disabilities, requires more specialized care, but the availability of trained caregivers is not keeping pace. The shortage of professional caregivers and healthcare workers is a problem exacerbated by low wages, high job demands, and the emotional and physical strain associated with caregiving roles (especially for family members, who have traditionally been primary caregivers). As a result, the elderly are at risk of experiencing insufficient support, social isolation, and a decline in overall quality of life. Addressing these challenges requires innovative solutions, including the use of technology, community-based programs, and policies that support and incentivize caregiving professions.

Companion robots, which can emotionally engage with older adults and provide the continuous monitoring and assessment of healthcare needs, have been proposed to support those seniors who may lack human caregivers [2]. For instance, socially assistive robots (SARs) are advanced technological platforms equipped with audio, visual, and movement functionalities. These robots are designed to foster positive and efficient interactions with human users. Their main goal is to provide assistance and support, ultimately enhancing the user’s quality of life through improvements in areas such as motivation, rehabilitation, and education [3].

SARs are physical entities that occupy space in the real world, as opposed to existing solely on a screen. They are capable of interacting socially with humans through audio and/or closed captioning, depending on their design [4]. It is essential to understand that SARs serve as both platforms for and forms of intervention. They can learn from and socially engage with individuals, offering interventions akin to mobile apps, such as skills training and health monitoring. By utilizing multiple sensory [5] inputs—typically including sound, sight, and touch—SARs can deliver content or interactions through various modalities tailored to user preferences or physical abilities [6]. With these diverse capabilities, SARs have the potential to merge traditional apps and telehealth supports with an interactive social companion, creating a more engaging and responsive experience for users.

With the increasing development and anticipated use of robotic technology, determining how and to what extent older adults accept and respond to socially assistive robots (SARs) is crucial for their successful implementation. Human–robot interaction (HRI) is a relatively new interdisciplinary field of research; therefore, there is a lack of consensus on strategies for measuring individual acceptance and subsequent use of robots [7]. Additionally, there are multiple dimensions of HRI, further complicating assessment and evaluation strategies [8].

The aim of this study was to explore the perception and attitude of elderly individuals toward social robots before and after interacting with a robot, incorporating elements of participatory design. The authors were particularly interested in how older users perceive and evaluate the robot’s communication skills, as well as how their attitudes toward social robots evolve through interaction.

This study addresses a critical research gap by

• Investigating a previously unexplored group—Polish seniors—who have not been the focus of similar studies.
• Examining older adults with special needs—those residing and receiving treatment in a daycare center—within their everyday healthcare environment.
• Employing a participatory design methodology that enables seniors to actively contribute to the development of reminder messages delivered by a robot to encourage medication adherence. This approach ensures that the messages are tailored to their needs and preferences, making them more effective and user-centered.

The target group included elderly individuals staying in a daycare center for the elderly in Krakow, Poland. The study examined their attitudes towards technology, particularly social robots, in the context of assistance with daily activities, such as medication reminders. Additionally, the research validated the perception of social robots as potential tools for supporting caregivers in simple communication tasks.

To address these aspects, the following research questions were posed:

• Can a medication reminder robot be a successful tool for older adults?
• Is the participatory design approach suitable for this specific participant group?
• What are elderly individuals’ attitudes towards technology and social robots?
• How do they perceive the use of social robots in their daily lives?

By exploring these questions, the study contributes to filling the identified research gap and provides new insights into the role of social robots in elderly care.

The paper is structured as follows: Section 2 presents the existing state of the art of elderly–robot interaction. Section 3 provides a detailed description of the study settings, participants, procedure, NAO robots used, and the analytical approach adopted to evaluate the interaction. It begins by outlining the research environment and the characteristics of the elderly participants, followed by a step-by-step explanation of the procedure implemented during the participatory design sessions. Next, the specifications of the NAO robots employed in the study are discussed, along with the measures used to analyze qualitative data. In Section 4, we first present the findings from a pre-test survey to understand participants’ initial perceptions of the robots before engaging in interaction. We then describe the outcomes of the participatory design activities, which, while differing from the initial expectations, provided valuable insights into user preferences and robot functionalities. Subsequently, the results explore participants’ impressions of the robot during the interaction sessions, highlighting key aspects of engagement and acceptance. Finally, we present post-interaction reflections, capturing shifts in attitudes and perceptions after direct experience with the robot. Section 5 interprets these findings in light of existing research, identifies the practical implications for designing socially assistive robots for elderly care, and addresses unexpected observations that emerged during the study. In Section 6, we summarize the main contributions and provide recommendations for integrating user-centered design in similar contexts. Lastly, Section 7 acknowledges the constraints of the current study and proposes avenues for future research to expand on the insights gained, particularly in exploring long-term interaction effects and diverse elderly populations.

2. Related Works

2.1. Robots and Elderly

The role of assistive and social robots in addressing physical limitations, enhancing companionship, and supporting mental well-being has been explored across various studies. Ref. [3] defines socially assistive robotics (SAR) as a field combining assistance and social interaction to support users without physical contact. Their taxonomy highlights key user populations, such as older adults and individuals with cognitive impairments, while outlining tasks like emotional support and interaction through speech and gestures [3]. This definition aligns with the expectations of our participants, who emphasized the need for both physical assistance and engagement through mental and social activities.

2.1.1. Social Robots for Comfort and Aid

Social robots are increasingly studied in healthcare for their potential to provide support and assistance. Although evidence shows favorable outcomes (for example, in the two studies [9,10] and the meta-review provided by [11], the majority of findings were positive, highlighting the multimodal capabilities of robots such as NAO, Paper or Paro and their significant potential as a SAR), the challenges remain, including improving functionality, robustness, and understanding user acceptability and perceptions [12].

Social robots offer distinct advantages over other assistive technologies, such as voice assistants and smart homes, particularly in enhancing elderly care and personal support. Unlike voice assistants, which are primarily task-oriented [13,14], social robots provide personalized, dynamic interactions, using both verbal and non-verbal communication (e.g., gestures, facial expressions) to foster emotional engagement and social companionship. Their ability to recognize and respond to emotions allows them to offer empathy, combating loneliness and supporting mental well-being. In addition, social robots often feature mobility, enabling them to assist with physical tasks, like grabbing objects from the floor [15], and performing autonomous actions, unlike stationary devices in smart homes. Robots can also adapt to users’ needs over time, offering a level of interaction and personalization that voice assistants and smart homes cannot replicate. This makes social robots particularly valuable in providing comprehensive, interactive care that combines emotional, cognitive, and physical support.

Some existing tools, such as the Technology Acceptance Model [16,17] and the Unified Theory of Acceptance and Use of Technology [18], are designed to recognize elderly attitudes toward technology. Several studies specifically address robotic companionship for older adults. Ref. [19] explored the feasibility of social robots in various life situations, demonstrating their effectiveness during activities such as dining and watching TV but highlighting limitations during sleeping or breaks. Similarly, ref. [20] found that robots with a high social presence improved perceived enjoyment and acceptance among older adults, showcasing their ability to alleviate loneliness. These findings reflect the views of participants in our study, who envisioned robots as companions capable of reducing isolation and encouraging mental stimulation.

2.1.2. Robots and Social Contexts

The effectiveness of robotic interactions is influenced by user familiarity and social expectations. Ref. [21] studied proxemic preferences in human–robot interactions, showing that users with prior experience were more comfortable with robots performing tasks in close proximity. Their findings also emphasized the role of social expectations in shaping user evaluations of robotic behaviors [21]. This corresponds to our study, where participants noted that robots assisting with mobility or daily chores required familiarity and clear behavioral expectations to be perceived positively.

Robots have also been evaluated as tools to reduce loneliness and enhance social engagement. In a comparative study, residents in care environments interacting with robots like Paro reported significant decreases in loneliness compared to periods without robotic or live animal interactions [22]. Paro not only facilitated conversations but also prompted greater social involvement among residents. An interesting approach to introducing SARs is the use of familiar designs, such as a doll-shaped robot. This is the case with the Hyodol robot, which was utilized in the studies conducted in Korea [23,24,25], suggesting its successful use in elderly care. Moreover, ref. [26] explored the ethical dimensions of robotic care, emphasizing that while robots can expand capabilities for older adults, they cannot fully replicate the richness of human relationships. This highlights a recurring theme in our study: robots were seen as valuable companions, but participants recognized their inability to replace human interaction entirely.

2.1.3. Robot as a Physical Assistant

Physical assistance remains a key expectation for assistive robots, particularly for individuals with physical impairments. Research in this area addresses various challenges, such as impedance learning for human-guided robots operating in unknown environments [27]. As [21] highlights, robots designed for domestic tasks must balance both functional and social expectations. Additionally, Ref. [20] emphasizes that a robot’s social presence significantly impacts user satisfaction with task execution. In our study, participants expressed a strong need for robotic assistance in daily activities such as cleaning, cooking, and mobility but also noted limitations in precision and effectiveness for more complex tasks. Our focus is on leveraging existing robotic systems to identify design requirements tailored to the needs of the elderly.

2.1.4. Speaking Robot

Finally, communication remains a challenge in human–robot interactions, particularly among users with sensory impairments. Ref. [26] and the findings presented in the references highlight that hearing difficulties and cognitive barriers can impact comprehension of robotic commands, leading to decreased comfort and usability. These findings align with observations in our study, where hearing impairments required repeated instructions and diminished participants’ overall experiences with the robot.

In conclusion, previous research underscores the potential of social and assistive robots to support physical, emotional, and social needs, particularly among older adults and individuals with impairments. However, studies consistently highlight critical limitations, including communication barriers, ethical considerations, and the importance of aligning robotic design with user expectations to ensure usability, acceptance, and meaningful engagement.

2.2. Participatory Design in Our Approach

Existing approaches to designing assistive robots for older adults often adopt a top-down or patriarchal approach, where designers and developers determine the functionalities and features of the robots without adequately involving the end users in the design process. This traditional model risks creating technologies that are misaligned with the actual needs, preferences, and abilities of older adults. Such an approach can result in robots that are difficult to use, fail to provide meaningful support, or are perceived as intrusive or patronizing. To address these issues, a shift toward participatory design is necessary.

A participatory design approach, as described by [28], emphasizes the importance of involving multiple stakeholders—elderly individuals, caregivers, medical professionals, and psychologists—in the development of social robots for elder care. By employing methods such as card sorting, storyboarding, and interviews, the study highlighted the value of capturing diverse perspectives to tailor robots to users’ specific needs and expectations. This aligns with findings from [20,21], which emphasize the significance of user-centered and socially inclusive design to enhance the acceptance and usability of assistive robots. Similarly, our research supports this participatory approach, as participants expressed a desire for robots to provide physical assistance (e.g., mobility support, daily tasks), alleviate loneliness, and promote mental engagement. Both our results and the participatory design framework underscore the necessity of holistic, stakeholder-driven strategies in designing robots that address not only functional but also social and emotional aspects of elder care.

Ref. [29] describe the benefits of using a participatory design approach while conducting studies with the elderly: participatory design methods actively involve older adults throughout the design and development process, ensuring that their voices are heard and their perspectives shape the final product. By incorporating multiple techniques, such as surveys, interviews, and design exercises, participatory design workshops can effectively capture the nuanced requirements of elderly users, accounting for age-related changes in motor, sensory, and cognitive abilities. This collaborative approach not only enhances the usability and relevance of assistive robots but also fosters a sense of ownership and acceptance among older adults, making the technology more likely to be embraced and successfully integrated into their lives.

While some researchers highlight the prevalence of a top-down, designer-driven approach in assistive robot development, others, like [30], point to a bottom-up approach focused on technological features, indicating that there are mixed perspectives in the literature on how design processes in this field are typically structured. According to [30], the current design of healthcare robots often follows a bottom-up approach, starting with technological features and mapping them to potential applications. While this method can lead to incremental improvements, it often results in low-impact functionalities, such as reminders or games, which other devices could better handle. Additionally, this approach isolates the robot from broader technological systems, limiting its integration into smart environments. To address these issues, a co-design approach should be adopted early on, considering both technological and user needs to create more effective and integrated solutions. According to [29], the participatory design with the elderly has to address the following issues, which we pursued in our study:

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Assistive robots as a potential support for older adults with everyday activities in their homes. In our study, the focus was on improving the experience of daily activity (medication intake).

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Participatory design methods are valuable tools to engage older adults in the robot design process, from conception to implementation. During our research, we engaged the elderly with an already existing robot (NAO); however, the programmable device can be continuously improved, adjusting its functions to the needs of users.

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Participatory design workshops may be most effective as they incorporate multiple methods (e.g., survey, interview, and design exercises) to elicit the perspectives of older adults. In our procedure, we decided to additionally interview participants, allowing them to express their insights before and after interacting with a robot.

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Age-related changes in motor, sensory, and cognitive capabilities must be considered in the instantiation of participatory design methods to maximize their effectiveness. The results of our study point out the need to align the robots’ functionalities with the real struggles of older users, such as hearing problems or motor difficulties.

3. Study Design

3.1. Setting

The study was conducted at the Municipal Care Center for the Elderly, Chronically Disabled, and Dependent Persons (MCO) in Krakow, Poland. Ethical approval for this study was obtained from the Research Ethics Committee at the Faculty of Philosophy, Jagiellonian University (approval code: 221.0042.16_2024).

3.2. Participants

Twenty-nine elderly people (M: 10, F: 19; 65–90 years) participated in this study. All the participants displayed varying degrees of dependence and were residing in the MCO facility. The participation was voluntary; many participants were motivated by the opportunity to interact with a robot. All participants gave their informed consent.

The sample size (N = 29) was determined based on standards commonly used in qualitative research on human–robot interaction (HRI) and previous studies on technology acceptance among older adults (e.g., [20,21]). Qualitative studies in the field of HRI often employ relatively small samples, as their primary goal is to explore user experiences, attitudes, and subjective evaluations rather than to generalize findings to the entire population [3].

Additionally, the sample size of 29 participants was a compromise between the organizational feasibility of conducting the study in a care facility and the need to capture a diverse range of opinions. Similar sample sizes have been used in previous studies on the acceptance of social robots among older adults [19]. As our group consisted of actively treated patients at an elderly care facility, we faced constraints both in terms of available time and the maximum feasible group size. While this study was not quantitative, its findings can serve as a foundation for future research with larger participant groups, incorporating statistical testing.

Finally, recent discussions suggest that qualitative sample sizes should be tailored to extract the maximum amount of insight from the data [31]. In our preliminary analysis, we observed repeated themes in the responses, indicating that data saturation was reached at 29 participants. Although a larger sample might have uncovered more individual deviations, our study did not aim for a completely individualized analysis.

To ensure the appropriateness of the participant selection and the reliability of the findings, participants were required to meet specific inclusion and exclusion criteria. The inclusion criteria included being 65 years of age or older, residing in a care facility, having no severe cognitive impairments as verified through interviews with facility staff, having the ability to communicate verbally in their native language, and providing informed consent to participate in the study.

Participants were excluded if they had significant hearing impairments that would prevent interaction with the robot, as assessed by facility staff, or if they exhibited advanced dementia or other neurological disorders that could affect their ability to consciously evaluate interactions. However, a lack of prior experience with technology was not considered an exclusion criterion, as the study aimed to explore perceptions of robots among individuals with varying levels of technological familiarity.

3.3. NAO Robot

An NAO6 robot, which is a 58 cm tall humanoid robot developed by Softbank Robotics, was used in this study. It features 25 degrees of freedom, allowing for complex movement and gesticulation. The robot is equipped with two 2D cameras for shape and face detection, microphones, tactile sensors, and two speakers.

The selection of the NAO robot for this study was based on several key factors. First and foremost, NAO is a compact humanoid robot (58 cm), making it less intimidating for users compared to larger robots like Pepper. Additionally, its ability to engage in conversation, recognize speech, and perform gestures facilitates social interaction, which was a crucial aspect of this study. Unlike Paro, which primarily serves a therapeutic function and stimulates tactile interactions, NAO enables actual dialogue, allowing for an analysis of how older adults perceive conversational robots. Furthermore, NAO was a pragmatic choice—its programmable functions allow for the easy adaptation of behaviors to meet the study’s needs. Due to its widespread use in human–robot interaction (HRI) research, NAO provides a basis for comparing findings with previous studies on the acceptance of social robots among older adults [20,21]. Additionally, NAO is used in other studies conducted within our research group, enabling a broader understanding of how different age groups perceive this robot.

3.4. Procedure

A single session, lasting approximately one hour, was conducted for each participant. Each session was recorded using both video and audio equipment.

Each session was structured as follows. After consent was given, the researcher conducted a pre-test in the form of an interview. The questions aimed to gather baseline data on the participants’ views and experiences with technology and were intended to provide a comprehensive understanding of the participants’ initial perceptions and attitudes towards technology and social robots, which would be critical in analyzing any changes in these perceptions after the interaction phase of the study. The list of questions is provided in Appendix A.

In the next step, the participants engaged in an interactive session where the NAO robot issued medication reminders. These reminders varied in pitch, volume, speed, and command type (three predefined commands). After the initial interaction, participants provided feedback on the reminders, indicating their preferences for the most useful and pleasant notifications. Real-time adjustments to the robot’s settings were made based on this feedback, followed by a reassessment by the participants, in line with the participatory design principles outlined by [28].

After participants interacted with the NAO robot, another interview was conducted where the participants were asked a final set of questions regarding their overall experience, comfort levels, and perceptions of the potential benefits and the challenges of using robots in elderly care.

3.5. Analysis

Participant feedback was transcribed using the Cockatoo program (https://www.cockatoo.com) and analyzed to identify common themes regarding the usability and acceptability of the NAO robot. Responses were thematically coded, focusing on the participants’ overall impressions, comfort levels, and suggestions for improvement.

4. Results

We conducted a qualitative analysis of the interaction sessions with respect to the following four aspects:

• Pre-test: conducted in the form of an interview with the study participant to determine their general approach to technology, its use in daily life, and previous exposure to robots.
• The participants’ impressions during the interaction with the robot: general impressions about the robot, comments on its appearance and behavior.
• Reports from the participants in the participatory design phase: selection of the best version of the message for reminding about medication intake: the participant converses with NAO, with the researcher moderating the conversation in the case of problems or doubts.
• Participants’ impressions after interacting with the robot: Focusing on the potential use of robots in daily life as assistance for the elderly.

Below, we present details of each of these four aspects of analysis. All the participants’ comments were in Polish, but the English translations by the authors are presented here.

4.1. Results of the Pre-Test

The pre-test analysis explored participants’ previous experiences with technology and robots, their attitudes toward them, and their expectations of robots’ appearance, behavior, and utility. Several recurring themes emerged from the responses:

4.1.1. Technology as a Facilitator of Daily Life

All participants recognized the significant role of technology in their lives, primarily as a tool to facilitate communication and daily tasks. For instance, P.1 highlighted technology’s role in making appointments, while P.16 used it for entertainment and communication. The majority saw technology as a positive influence, improving their quality of life by offering convenience and accessibility. P.14 described it as “a kind of progress and convenience”, particularly emphasizing the efficiency gained in daily activities.

The elderly recognized the impact of technology on their everyday life:

• P.2: “In a situation where I wouldn’t have access to this (technology)—there was a time when it didn’t exist, I remember those times, I’m old enough—it was still possible to live. But now, I simply can’t imagine not having a phone, or TV, or similar conveniences. It’s a positive development”. However, his positive attitude has its limits: “Positive, as long as machines don’t make machines”.
• P.7: “I was discouraged from using new technology due to my trembling hands, so I opted for the simplest available tools”.
• P.10 believes that technology has a positive impact on our lives, and as it evolves, it becomes “even more so”. People have become so accustomed to the presence of technology that its absence feels like a misfortune.

4.1.2. Limited Direct Experience with Robots

Most participants had little to no direct experience with robots. P.1, P.2, P.4, P.5, P.8, and others had only seen robots on television or in films, which heavily influenced their perceptions. Despite this limited exposure, they were generally open to the idea of interacting with robots, although some expressed reservations or discomfort. For example, P.12 mentioned a slight discomfort due to uncertainty about artificial intelligence’s impact on human life.

Some quotes about the participants’ previous experiences with robots:

• P.1: “I have never had any experience with robots. I imagine robots as they are shown on TV, moving in a specific `robotic’ way”.
• P.3: “I know robots only from movies. But I don’t have a negative attitude because this is the way technology is progressing. We will expect it sooner or later”.
• P.13: “My previous experience with robots was more of a technical curiosity; I saw one on display, and while it fascinated the younger generation, I just observed”. Before interacting with the robot, the participant expressed a sense of respect for the technology, saying, “I wouldn’t press every button right away”. He reflected on the generational difference in approaching technology: “What young people dive into immediately, I would need some time to think about what to do. After all, I was raised on the multiplication table. A calculator was the pinnacle of technology”.

4.1.3. Visual and Behavioral Expectations of Robots

Participants often imagined robots with human-like characteristics, influenced by media portrayals. Out of 29 participants, 17 had perceptions of what a robot looks like based on television. This represents approximately 59% of the participants. P.10 envisioned a robot with limbs and the ability to speak simple sentences, while P.13 described robots as a ‘technical curiosity’. The visual expectation of robots varied from humanoid figures (P.16) to more mechanical forms (P.5), often reflecting the participants’ familiarity with specific robot types, like P.6’s reference to NAO. However, the concept of a robot’s appearance was generally associated with functional design rather than aesthetics, emphasizing practicality over form.

Participants commented on their perception of robots’ appearance and behavior:

• P.1: “I imagine the robot mostly white so that it is visible in the dark, with blue reflective eyes and lights to avoid getting lost”.
• P.4: “I imagine it as a large machine. Maybe something like a humanoid shape, but still clearly a robot”.
• P.15: “The robot would be just slightly larger than a table, with some robotic arm instead of a hand, and it would move on wheels”.
• P.16: “A robot should have the stature of a man, wearing glasses, intellectual-looking, similar to a human, but not a monster”.

4.1.4. Robots as Assistive Tools in Daily Life

A common theme was the expectation that robots could assist with daily tasks, particularly for those with physical limitations or elderly individuals. P.3, P.5, and P.8, among others, mentioned robots as aids for carrying heavy objects or performing household chores, such as window washing or medicine reminders. The concept of a robot as a companion, particularly for the elderly or isolated individuals, was also prevalent. P.2 and P.9 discussed robots as potential companions to alleviate loneliness, capable of simple conversational exchanges or even helping with cognitive tasks, like reminding them to take medication.

Possible applications for social robots viewed by the elderly were as follows:

• P.8: “Without a phone, it’s like missing a hand, and the TV is a window to the world. A robot could help with carrying things”.
• P.12: “A robot reminding me to take my medications could be very helpful, especially for people with memory issues”.
• P.13: “Robots should replace humans in many areas, like medicine or heavy industry, where they are most needed”.

One participant reflected on their situation, stating, “As someone who is active, and from there illnesses, strokes and all of a sudden it shut down and I’m alone …you know, it is not going to replace a human being, but for example you can talk to it, right? Like a robotic companion”. This role of a robotic companion was seen as particularly valuable for those who are isolated, offering them someone to talk to or perform services, even if it cannot fully replace human interaction.

4.1.5. Cautious Optimism Toward Robotics and AI

While the participants were generally positive about the potential of robots, there was an underlying cautiousness regarding the integration of artificial intelligence into daily life. P.2 expressed a favorable view “as long as machines don’t make machines”, reflecting a broader concern about the autonomy of AI. Similarly, P.10 was uncertain whether a robot would adequately understand and meet her needs (“I don’t know if such artificial intelligence would know what I would want, for example, whether I need to go to the bathroom and wash my hands, prepare a meal, or make the bed”), pointing to a potential gap in trust between users and AI systems.

Some participants expressed concerns regarding the presence of robots:

• P.2: “I think at first I would feel awkward because it is not a human being, but I’m positive about new things, so I would probably accept it”.
• P.14: “I wouldn’t feel too comfortable around a robot, maybe due to fear or the emotion of encountering something new”.
• P.10: “In the presence of a robot, I would feel rather ‘average,’ not overly comfortable”.

4.1.6. Comfort and Adaptation to Robot Interaction

The level of comfort participants anticipated feeling during interactions with robots varied. Some, like P.5 and P.7, anticipated minimal discomfort, believing they could easily adapt to the presence of a robot. Others, like P.11 and P.15, were more hesitant, citing a lack of experience or uncertainty about how to interact with a robot. P.14 suggested that with gradual exposure, even older adults could become accustomed to robots, though initial interactions might be challenging.

The analysis revealed that while participants are generally receptive to the idea of incorporating robots into their lives, their expectations and comfort levels are shaped by their limited exposure to robotics, the influence of media portrayals, and their existing reliance on technology for daily tasks. The prevailing attitude is one of cautious optimism, with participants recognizing the potential benefits of robots, particularly as assistive tools, while also expressing concerns about AI’s autonomy and their ability to adapt to new forms of technology.

4.2. Participatory Design

As mentioned in the Related Works section above, participatory design methods are promising tools to engage older adults in the robot design process. In our study, the participatory design phase took the form of participants listening to various versions of a reminder message delivered by a robot and selecting the best version or proposing an alternative. The analysis focused on several key aspects: the clarity of the robot’s speech, preferences regarding the robot’s voice and tone, areas where the robot’s communication could be improved, and the most problematic aspects identified by the participants.

4.2.1. Clarity of the Robot’s Speech

A predominant theme in the feedback was the clarity of the robot’s speech. Most participants emphasized the importance of clear articulation and understandable phrasing. Many participants found certain versions of the robot’s speech to be difficult to understand, which hindered the effectiveness of the reminder message. Some participants (13 out of 29, approx. 45%) who struggled with understanding the robot’s message often suggested slowing down the pace of speech and enunciating words more clearly.

4.2.2. Preferences Regarding the Robot’s Voice and Tone

The participants expressed different preferences regarding the voice and tone of the robot. However, 13 out of 29 participants preferred a voice that was calm, neutral, and slightly lower-pitched, as they found it more soothing and authoritative, which they believed would be more effective in delivering medication reminders. Five participants expressed a preference for a higher-pitched voice. The rest of the participants did not find the distinction between high- and low-pitch voices significant.

• P.10: “The robot shouldn’t speak too quietly, but speaking too loudly would be shrill”.
• P.27: When the robot asked if it should speak differently, the participant suggested that it should speak a bit more softly, with a gentle tone. This reflects a preference for more balanced communication.

Two participants indicated the need for a more upbeat and friendly robot tone, suggesting that it could make the interaction feel more personal and less like an obligation.

• P.23: “The robot is to have a warm, relaxed voice, without giving any orders, just a nice, friendly voice that sounds clear”.

4.2.3. Most Problematic Aspects

The most problematic aspect of this part was that the respondents had trouble grasping the actual purpose of the study (i.e., jointly determining with the robot which version of the medication reminder message was best or proposing their own improved version). Some participants did not seem to understand why the robot was repeating the same message (which highlights the problems with understanding the robot’s speech, as well as speech changes that involved different pitch or speed). Some seemed to attribute their problems understanding the purpose of the study to the robot’s behavior/attributes.

• P.1: After completing the participatory design phase of the study, the subject countered that she had no questions for the robot and commented on its behavior “as if it had dementia”, because it kept repeating itself.

When the message was repeated, the participants became irritated, as the purpose of the robot’s behavior was not clear to them. Some respondents perceived the repetition as an attempt by the robot to undermine their self-reliance.

• NAO: “Today I’m only able to remind someone about the medication.” P.1: “But you know, I don’t have such a bad memory yet, I remember, and I’m asking you for these medicines and a glass of water”.
• P.3: Frustrated by the repeated message, the respondent believes the robot is repeating itself and brings it to his attention, ignoring the robot’s explanations.
• P.16: She seems annoyed by the robot’s reminders (despite the robot’s and the researcher’s explanations), noting that she has already taken her morning medication, but sums up the messages as “excellent”. She emphasizes that despite her age, she has no problem remembering her medications.

The sense of undermining their self-reliance was by far the biggest problem in conducting this part; despite assurances from the robot and the researchers that the purpose of the study was to repeat the message several times, some of the participants did not fully understand what the purpose of the participatory design phase was. Avoiding negative emotions in the participants is a challenge for future similar research.

4.3. Participants’ Impressions During the Interaction with NAO

This section presents the insights gathered from the participants during their interactions with NAO that were not directly connected to the participatory design phase. This analysis revealed various perceptions and reactions to NAO’s behavior and appearance, thereby providing insights into how elderly users perceive humanoid robots, with a particular focus on NAO’s physical characteristics and communication style. For instance, P.1 commented, “I saw it on TV, and I thought its eyes should be glowing”, reflecting a tendency to expect human-like features in NAO. P.1 further noted, “I don’t know if you’ll be helpful, because you’re lying down right now”, indicating that NAO’s posture affected their perception of its utility. Similarly, P.2 remarked, “Why do you shake when you walk? I hope you don’t make noise while I’m sleeping”, expressing concerns about NAO’s movements affecting their comfort.

4.3.1. Reactions to NAO’s Behavior

The participants often struggled to understand the purpose of the study, which influenced their opinions about the robot’s capabilities. Despite this confusion, they remained interested in the robot and generally evaluated it positively, appreciating its potential usefulness in everyday tasks and interactions. P.3 voiced frustration about the repeated messages and pointed this out to the robot, ignoring its explanations. This behavior indicates a lack of understanding of the study’s purpose, which was a recurring issue among several participants (at least 25% of the participants). This highlights frustration with NAO’s communication. Conversely, P.4 was curious and engaged, asking, “Show me what you can do”, reflecting a desire to explore NAO’s capabilities. P.7 remarked, “I feel strange about this—I don’t quite see how this could be helpful in a patient’s home. However, reminding about taking medications in the evening while watching TV could be useful”.

4.3.2. Communication Clarity and Preferences

The clarity and volume of NAO’s speech were recurring concerns. P.2 commented, “It’s important for me to hear you clearly; if you’re too quiet or too fast, it’s hard to understand”, emphasizing the need for clear and appropriately paced communication. P.2 also noted, “The voice change was significant because some voices sound threatening while others sound friendly”, pointing out how voice modulation impacts their perception of NAO. However, P.7 expressed a preference for the robot having a higher-pitched voice but evaluated the most recent voice samples positively as well. She highlighted the importance of the speaker’s direction, stating, “When the speaker was facing me, it was the best”. P.7 also noted that the change in the robot’s voice did not impact her perception of the clarity or effectiveness of the message. This indicates that the ease of understanding the message, particularly for older adults, may hold greater importance than other communicative aspects, such as voice tone. However, it is important to consider the mentioned methodological challenges, such as the frequent lack of understanding of the study’s purpose.

4.3.3. Technical Issues and Understanding

Technical issues significantly affected participants’ interactions with NAO. More than 50% of the participants reported difficulties in understanding the robot’s speech. The cases of P.14, P.26, and P.29 may be indicative of limitations commonly observed in this age group of participants, namely progressive hearing difficulties.

• P.14: “It could be a bit louder because I’m slightly hard of hearing”.
• P.26: “Please speak louder because I’m deaf”.
• P.29: “My friend, I don’t understand you. You need to speak not just louder, but more clearly; there’s something in your device that isn’t precise enough, and that’s why I can’t understand”.

P.22 also experienced technical issues: this participant mentioned that the robot was speaking a bit too fast and thanked it when it slowed down. There were ongoing issues with understanding NAO’s speech, as the participant frequently asked the researcher to repeat what the robot had said. NAO’s speech was perceived as unclear and too rapid. During the participatory design session, moderation by the researcher was essential to facilitate communication and ensure the participants’ engagement.

4.3.4. Emotional Reactions and Engagement

Participants’ emotional responses ranged from positive to negative. P.6 was enthusiastic, saying, “I’m delighted, and I even forgot what I wanted to ask you”, and praised NAO’s appearance with, “You have beautiful eyes. Your arms, your legs. You have everything in working order, your joints, not like mine, old …”. After the interaction, the participant noted that people with various health conditions might struggle with taking their medications. According to her, a simple alarm or a note is often insufficient. She added, “But a dear little doll like this could be really helpful”. In contrast, P.11 showed confusion and skepticism, saying, “I didn’t expect this kind of robot”, and questioning NAO’s responses with, “I’m not sure if what you said is what I wanted to hear”.

Moreover, the results showed some differences in perceptions of the robot depending on prior technological experience. Those who had been exposed to modern technologies (e.g., smartphones, tablets) showed more openness to interacting with the robot and were more likely to view it as a potentially useful assistant (e.g., P.2, P.10). In contrast, participants who had not previously interacted with similar devices were more likely to approach the robot with caution, jokingly pointing out its limitations (e.g., P.13). Age also had an impact—younger people in the study group (e.g., about 65 years old) were more likely to accept the robot as a tool for mental activation, while older participants (over 80 years old) were more likely to expect practical support in daily tasks.

4.3.5. Practical Expectations and Requests

Participants had specific expectations for NAO’s functionality. For instance, P.7 stated that she would expect the robot to be understanding if she didn’t know how to use a phone. She would be comfortable in the company of the robot and could find a use for it in her home, such as a reminder for taking medication, which indicates a desire for practical assistance. P.13 asked if it would be possible to program the robot to remind someone about specific medications, for example, taking one in the morning and another in the evening. This participant saw particular value in this for people who live alone. P.29 also focused on practical concerns, asking NAO about her medical concerns and referring to her own issues. This reflects a need for NAO to provide tangible support in daily activities.

However, the strongest expectation was the importance of physical support. For instance, one participant shared, “I have hands, I have some arms movements that I can no longer do …I can’t cope …I can’t clean the window, I can’t do it. Well, the kind of robot that cleans windows would probably come in handy then”.

Beyond physical assistance, there was an expectation for robots to act as proactive aides, promoting engagement in mental and social activities. One participant imagined a robot that would encourage them to stay active, saying, “So it would say: «Read something, relax, solve a crossword puzzle …sometimes it is so mindless to sit»”.

4.3.6. Positive Reinforcement and Interaction

Several participants showed positive reinforcement and appreciation. P.17 expressed gratitude, saying, “Finally, I get to see a robot in person”, and appreciated NAO’s efforts. P.28 also expressed amazement, noting, “It’s amazing; technology is advancing, and you’re [NAO] doing great”, reflecting a positive view of NAO’s capabilities and advancements in technology.

4.3.7. Perception of NAO’s Physical Appearance

Participants had varied perceptions of NAO’s physical appearance. P.6 was positive about the experience: “I am delighted that at the end of my life, I had the chance to meet a robot that talks to me. I am deeply moved and really like its appearance”. Some participants (e.g., P.8, P.10, P.14, P.23) expressed their surprise over the small size of the robot, which indicates their assumptions of the taller robot. P.28 was impressed that the robot can stand up on its own after a fall, and she checked to ensure that it did not need any help. As one of the few participants (along with P.29), she also considered the robot’s gender identity, noting that, based on its design, it looked like “she”. Some participants associated the robot with different entities such as Transformers or koala bears.

4.3.8. Adaptation and Learning

Participants demonstrated adaptability and learning in their interactions. P.26 showed proactive behavior, saying, “I’ll move the paper away from the robot’s feet [so it doesn’t trip over this]”, indicating an active role in ensuring NAO’s functionality. P.29 displayed a learning attitude, remarking, “It’s my first time talking to an electronic device, and I’m grateful for the opportunity to learn,” showing a positive and adaptive approach to interacting with NAO. This participant was one of the few that recognized the ability to benefit from the robot’s assistance also requires effort and work on the part of the person.

4.3.9. Summary of Impressions During Interaction

Participants’ impressions of NAO reflected a complex interplay of anthropomorphization, communication clarity, practical expectations, and emotional engagement. Technical issues, communication clarity, and NAO’s physical appearance significantly influenced participants’ experiences. The findings highlight the need to address technical and communicative aspects to enhance user interactions with robots like NAO and improve overall user satisfaction.

4.4. Insights After the Interaction with Nao

4.4.1. Perceptions of the Robot’s Potential Applications

Participants expressed a range of views regarding the potential uses of the NAO robot, particularly in assisting elderly individuals. The most frequently mentioned (45%) application was medication reminders (however, it is possible that it was influenced by the study procedure). Several participants saw this as a significant benefit, emphasizing how such a feature could support those with memory issues or those living alone.

• P.1: “The robot could be very useful for people with dementia. It is ideal for assistance”.
• P.2: “A robot could remind lonely people to take their medication, and also serve as a reminder if a spouse forgets”.
• P.5: “A robot that reminds you to take your medication is a wonderful thing, especially for our old age conditions”.
• P.5: “So [the robot] would say: «Read something, relax, solve a crossword puzzle…sometimes it is so mindless to sit»”.

Participants also suggested other possible uses for the robot, such as helping with household tasks and providing companionship.

• P.1: “It could assist with tasks like turning off lights or checking if the gas is off. It would help in keeping track of things”.
• P.3: “Credit to those who create these robots, as they can replace many tasks and help us. Whether it’s bringing something, carrying something, lifting, or providing mobility support for people. Bring, fetch, clean up”.
• P.18: “The robot could help with picking up something from the floor or provide companionship, especially useful if you’re recovering from surgery”.

Interestingly, while some participants saw robots as a potential replacement for humans in remote or challenging environments, such as space or deserts, they also recognized the limitations of robots in certain contexts. As one participant noted, “a good cook the best robot can’t replace”, highlighting that while robots may be invaluable in some areas, they cannot fully substitute human skills in others.

4.4.2. Impressions of the Robot’s Appearance

The robot’s appearance received mixed feedback. Some participants were surprised by its small size, which did not align with their expectations of a robot. This reaction was linked to their perceptions of the robot’s potential capabilities.

• P.3: After the interaction, he noted that the robot’s size must depend on its purpose (e.g., a larger robot for polishing floors, but a small one is sufficient for sitting on a table and having a conversation).
• P.4: The robot’s appearance matched the participant’s expectations, except for its size; she had expected a larger robot.
• P.10: The participant added at the end that she had expected the robot to be a “giant, but it’s so tiny”—expressing surprise at its small size. “When it came in, I thought, «Where’s the robot?». And there it was, hidden, so as not to scare anyone”.
• P.14: “I expected a bigger robot, but it was fine”.
• P.28: Although the participant initially imagined the robot as something similar to a computer, she ended up liking it.

4.4.3. Reactions to the Robot’s Behavior

Participants had varied reactions to the robot’s behavior, with some finding it impressive and others less convinced of its utility. The robot’s ability to communicate and perform tasks like reminding users about medications was generally seen as beneficial, though there were concerns about its current limitations.

• P.4: “I felt a bit awkward at first, but if I had more contact with the robot, I would feel more comfortable. It could be a universal helper”.
• P.15: “The robot seems to have intelligence in how it interacts and asks questions. If I had memory problems, I would find it helpful”.

However, some participants noted that while the robot showed potential, its current functionality seemed limited.

• P.2: “The robot’s capabilities seem limited. If it could physically hand over medications, it would be more useful”.
• P.7: “I feel strange because I don’t quite see how this could be helpful in a patient’s home. However, reminding about taking medication in the evening while watching TV could be useful”.

4.4.4. Overall Impression and Future Outlook

Overall, all of the participants described the experience with the NAO robot positively, recognizing its potential to assist with medication reminders and offer companionship. They also acknowledged that while the robot’s current capabilities might be limited, there is significant room for development.

• P.12: “The robot has great potential and could be very helpful for elderly people. It’s a nice piece of technology”.
• P.21: “The robot is a good prototype but still in the development. If it is well-developed, it will remind me about the medications, maybe even bring them to me, and be able to choose the right ones [it could be useful]”.

In summary, while opinions varied, there was a general consensus that the NAO robot holds promise for supporting elderly individuals, particularly through medication reminders and companionship. Participants appreciated the robot’s friendly demeanor and acknowledged its potential, despite some concerns about its current limitations and size.

Some quotes regarding possible applications after interacting with NAO are as follows:

• P.1: “The robot could be very useful for people with dementia. It is ideal for assistance”.
• P.8 had different visual expectations of NAO, anticipating a larger robot. She expressed pleasant surprise during the interaction with the robot, commenting, “The technology is beautiful”.
• P.15 felt comfortable during the interaction with the robot and saw its potential usefulness, especially for people with memory loss. He considered the robot’s behavior and questioning to be a form of intelligence. After the interaction, he felt more at ease with the robot. While he acknowledged that robots could be helpful in daily life, he felt that, in his current situation without memory issues, the robot might even be somewhat unnecessary.
• P.19: “The robot’s reminders can be overwhelming at times. I see its potential for helping with memory, but other uses are unclear to me”.

This analysis reflects a balanced view of the robot’s current functionality and future potential as perceived by the participants.

5. Discussion

In our study, the robot used was NAO, which is widely applied across various fields, even though it is not specifically designed for healthcare purposes (though its use in this domain is not excluded). While we did not fully adhere to the recommendations of [30], we feel that utilizing existing robots enables a rapid and efficient deployment of well-validated technology across different contexts. Moreover, such an approach offers the potential to adapt these robots to conditions that are comfortable and suitable for older adults.

Our findings resonate with prior research highlighting the role of assistive and social robots in addressing physical challenges, fostering companionship, and promoting mental well-being. The framework of socially assistive robotics (SAR) [3], which integrates assistance and social interaction without physical contact, aligns closely with the expectations expressed by our participants. These expectations reflect previously identified priorities for SAR, such as supporting older adults and individuals with cognitive impairments through tasks like emotional support and interaction via speech and gestures. This alignment underscores the need to develop robots that not only provide practical assistance but also facilitate meaningful social and emotional engagement.

The participants of the study appreciated the potential of the robot in terms of medication reminders. This is in line with previous studies that have shown that social robots such as NAO or Pepper can effectively support the management of medical therapy in older people through voice reminders and interactive functions. Both our study and previous studies, such as the study by [11,12], indicate that robots such as NAO and Pepper effectively support older people in managing their therapy through voice reminders and interactive functions. Other studies emphasize that these functions are well received by users, especially in the context of older people with memory problems.

Our study also confirms the results of the work of [9], who described the use of NAO in a medication management system (MMS). The robot not only reminded about medications but also documented their intake and recognized medications using barcodes or visual identification. Such functions are particularly helpful for older people with cognitive problems. In the study by [9], the NAO robot was integrated with electronic health record (EHR) systems, which allowed remote monitoring by physicians. Although our study did not analyze this advanced integration, a review of the literature on NAO (2010–2020) showed that the robot was often used in the care of older people, including those suffering from mild cognitive impairment or dementia. Functions such as social interaction and cognitive stimulation were considered valuable [10], which is consistent with the results of our study. Participants in our study drew attention to their own cognitive limitations (such as hearing problems and progressive memory problems) or indicated other ailments in which making it easier to take medications with the use of a robot could be useful (e.g., dementia).

The concept of robotic companionship for older adults emerged strongly in our study, with participants frequently referring to robots as “companions” designed to reduce loneliness. This aligns with findings from prior research. For instance, Ref. [19] demonstrated the feasibility of social robots in daily activities such as dining and watching TV while noting limitations in contexts like sleeping or breaks. Similarly, ref. [20] found that robots with a high social presence enhanced perceived enjoyment and acceptance, effectively alleviating loneliness among older adults. Studies conducted in Korea further support this potential, reporting significant reductions in depression scores among lonely older adults who engaged with robots [23,24,25]. Together, these findings underscore the promise of robotic companions in fostering connection and mental stimulation for older populations.

Our work also included an analysis of the robot’s tone of voice and speaking rate, and participants were asked to select the clearest and most understandable statements. However, we found that many participants had difficulty making these choices, suggesting that they were not always able to effectively evaluate the best and most understandable statements. This shows that the chosen participatory design paradigm could not be the best suited for these groups, not because of the lack of proper tools—the topic was engaging and the context familiar for the given participants, as [29] suggested—but rather due to the technical shortcomings that should be addressed in future studies. Although participants enjoyed talking to the robot and were engaged in the interactions, they were also frustrated when they had to repeat certain statements or when the robot did not understand them the first time, which caused some discomfort in communication. A meta-analysis conducted by [32] indicated that older adults often face difficulties understanding robot speech, which can impact their level of engagement. Among the reported challenges affecting the effectiveness of social robots in this context were participants’ struggles to communicate effectively with the robot and convey necessary information, which corresponds to our findings, where the participants were often frustrated when the robot did not understand them or they could not process the robot’s speech.

In fact, the use of companion robots raised more concerns about the potential loss of human care among providers than among recipients [33]. Nevertheless, our findings, despite concerns about potentially maladaptive interactions, are more in line with previous studies, which have shown that the use of companion robots in elderly care has a humanizing effect [34,35]. While professionals may be preferred in some cases, companion robots can be introduced as a caregiving solution since they can play important friendship roles, assist users in completing daily tasks, and/or enhance the sense of autonomy and self-control [36]. However, the results of our study are based on a relatively short-term interaction with NAO, and while preliminary findings indicate that the robot can provide emotional engagement and social interaction that may reduce loneliness, further research is needed to assess the long-term effects.

Overall, our findings are consistent with previous robot studies that have shown short-term benefits in terms of reduced agitation, depression, loneliness, and nonadherence to medication [32,37,38,39]. It is worth noting that, similar to the findings in [39], one of the most significant advantages of using SAR in daily life, as highlighted by participants in our study, is the potential for robots to assist with everyday physical tasks. Although NAO is not a robot designed to help with tasks such as lifting heavy objects, the recurring preference for utilizing robots in this way is remarkable and should be considered in the design of future SAR models.

6. Conclusions

This study aimed to explore the needs and expectations of individuals over 65 regarding the use of social and assistive robots, as well as the facilitators and barriers to their integration in everyday life. The findings reveal that older adults generally have a positive attitude toward robots, with the humanoid NAO robot showing promise as a complementary tool to support home care services, particularly for those living alone.

6.1. Key Findings

6.1.1. Medication Reminder Robot

Medication reminder robots can be helpful in the daily lives of elderly individuals, but their effectiveness depends on a good understanding of the purpose of medication reminders (ensuring the user does not feel that their autonomy—remembering to take medications and actually taking them—is undermined) and on maintaining the overall perception that the robot is an assistant meant to help, rather than replace, the elderly person.

6.1.2. Diverse Expectations

Participants expressed a range of expectations from robots, particularly as physical support systems. Robots were envisioned as tools to assist with tasks that participants could no longer perform due to health limitations, such as fetching items, preparing meals, or aiding in personal care tasks like washing or mobility assistance.

6.1.3. Companionship and Loneliness

Many participants highlighted the potential of robots to alleviate loneliness. Robots were frequently perceived as companions capable of providing emotional support and mental stimulation, reflecting the participants’ desire for more meaningful interactions.

6.1.4. Recurring Themes

Two central roles for robots emerged across participant responses:

• Companion: A robot as a source of emotional connection and interaction.
• Assistant: A robot as a helper for managing daily activities.

These roles underline the dual purpose participants envisioned for robots in enhancing their quality of life.

6.1.5. Processing Verbal Cues

Participants were often so focused on understanding the robot’s verbal instructions that they provided limited real-time feedback on its behavior. Most behavioral observations and reflections were shared post-interaction, indicating the need for a period of reflection to form opinions. Moreover, hearing difficulties emerged as a significant barrier, affecting participants’ ability to comprehend the robot’s speech. Issues such as frequent requests for repetition and discomfort with communication highlighted the importance of addressing sensory impairments in robot design.

6.2. Implications for Design

These findings underscore critical considerations for the development and implementation of social and assistive robots:

• Accessibility: Robots must account for sensory impairments, such as hearing loss, to ensure effective communication and user comfort. An example of expanding existing solutions with additional functions is the use of Pepper’s tablet, which could be used to display text corresponding to what the robot is saying. This could lead to better speech comprehension, especially for people with hearing impairments. Attempts have already been made to use social robots for children with hearing impairments [40].
• Dual Functionality: Future designs should integrate both physical assistance and emotional companionship to meet the multifaceted needs of older adults. There are robots that have physical support functions, such as Gita [41], a followbot designed to follow the user and carry certain loads, like a backpack. This is an example of socially silent machines [42]. However, it is worth considering the support provided by robots that could combine social functions with physical assistance.
• User-Centered Reflection: Allowing time for participants to process and reflect on their interactions may provide deeper insights into user experiences and preferences.

By addressing these challenges, robots can better fulfill their potential as accessible and effective companions and assistants, enhancing the independence and well-being of older adults.

To conclude, the study reveals diverse and nuanced expectations from robots, particularly among individuals who face physical limitations or experience loneliness. Participants strongly desire robots to serve as physical support systems, assisting with tasks they can no longer perform due to health issues. This sentiment was echoed by others who envisioned robots helping with daily activities such as fetching items, preparing meals, or even assisting with personal care, like washing or helping with mobility in the bathroom. The study also highlighted the potential of robots to alleviate loneliness, especially among older adults.

7. Limitations and Future Works

We acknowledge the limitations of this study and recommend further research. Recent evidence [43] indicates that companion robots may not work in all cultures and may not be suitable for everyone.

One limitation of this study is that the participant group consisted solely of individuals from Poland. While this aligns with the study’s methodological approach, which focused on a specific target group, we acknowledge that findings may not be directly generalizable to other cultural contexts. However, as this was an exploratory study, future research will aim to expand the participant pool to include individuals from different countries, allowing for cross-cultural comparisons and a broader understanding of the phenomena under investigation.

Moreover, as we must distinguish between (subjective) loneliness and (objective) social isolation, future research should include more detailed assessment and attention to social isolation.

In addition, the script should be more aligned with the older participants’ needs—one of the main downfalls of the study was that the messages presented to the participants were not sufficiently distinct, making it difficult for them to differentiate between them. It may have been helpful if the robot had explicitly stated each time, “Message 1: …, Message 2: …”. This approach could have made it easier for participants to remember or confirm which message was being referenced. Additionally, ensuring that the messages do not end with a question could prevent participants from feeling compelled to respond to them automatically. Moreover, many participants did not fully grasp the concept of participatory design, particularly in the form we proposed. Instead of treating the task as an evaluation of the statements, participants often interpreted the reminders in a personal context. This confusion highlights a potential gap in the design of the study, where the expectations for participants’ roles and responses were not sufficiently clear. Future work should involve a more detailed explanation of the concept of participatory design to ensure that participants understand their task, which is to evaluate statements rather than engage with them on a personal level. Additionally, exploring alternative ways to frame the reminders to minimize personal interpretation may be beneficial.

Moreover, nearly all participants reported issues with understanding the NAO robot’s speech, either directly (by asking the robot or the researchers to repeat the question) or indirectly (by answering different questions, not responding at all, or commenting on the robot’s speech). These communication barriers may stem from several underlying factors. Age-related hearing loss or hearing impairments due to illness could have significantly affected participants’ ability to understand the robot. In future research, it would also be beneficial to plan to better account for individual differences by including assessments of hearing ability and cognitive function as part of participant screening. This would allow for a more nuanced analysis of how such factors might influence the effectiveness of robot-mediated communication. Additionally, the unfamiliarity with the robot’s speech patterns, which may differ from human speech in rhythm, tone, or clarity, could have further contributed to these difficulties. The NAO robot’s speaker volume might also have been insufficient, especially in cases where participants had hearing challenges, leading to a lack of clear audio transmission.

These technical and auditory challenges suggest that before involving senior participants in future studies with the robot, several measures should be taken. These could include conducting preliminary hearing assessments, adjusting the robot’s speech patterns to be more human-like, ensuring the speaker volume is adequate, and perhaps even incorporating visual aids to complement the robot’s speech. Addressing these issues will be crucial for ensuring that participants can fully engage with the robot and accurately complete the tasks they are assigned.

The study results also revealed a discrepancy between participants’ expectations and the actual capabilities of NAO, which is primarily a conversational robot. Several approaches should be considered to bridge this gap in future research.

First, it would be beneficial to test robots with more advanced physical capabilities that can actually perform the tasks participants mentioned, such as mobility assistance or simple household chores. Notable examples include the Japanese Robear [44], designed to lift people and assist with bed positioning, wich currently being tested in Japanese nursing homes, and Gary [45], which can carry objects, provide physical support to patients, and monitor their condition.

Second, an important direction for future research could be the use of hybrid robots that combine conversational abilities with physical support functions.

Third, providing participants with more detailed information about the robot’s capabilities before the study begins could help set more realistic expectations.

Additionally, research on better aligning robotic functionalities with the needs of older adults could benefit from their active participation in the design process of socially assistive robot (SAR) features.

It is also important to note that the absence of a control group limits our ability to definitively attribute the effects of interaction to the presence of NAO. However, this study was designed as a qualitative exploration incorporating participatory design, focusing on gathering in-depth insights rather than making direct comparisons. Given this methodological approach, the lack of a control group is not an inherent limitation but rather a deliberate choice aligned with the study’s objectives.

Nevertheless, future research could extend this approach by incorporating a comparative group in which participants interact with alternative technologies, such as:

• A human caregiver (to compare social interactions with a robot versus a human),
• A smartphone or smart speaker (to assess whether participants prefer humanoid robots over more abstract voice-based systems),
• A different robot (e.g., Paro or Pepper) (to examine whether NAO’s humanoid form influences the perception of functionality and usability).

Such comparisons would allow for a more precise analysis of the effects associated with different forms of interaction, potentially clarifying discrepancies between participants’ expectations and NAO’s actual functionality. Additionally, incorporating technology adoption models such as the Technology Acceptance Model (TAM) or the Unified Theory of Acceptance and Use of Technology (UTAUT) [16,17,18] would be beneficial.

Finally, building on the amendments mentioned above, the most critical recommendation for future research is to explore the potential impact of companion robots on reducing workload and burnout among healthcare workers, which is the primary motivation for introducing social robots into healthcare. It is important to provide training and support to older adults and their caregivers on how to use robots effectively. This will help ensure that robots are used in a way that meets the needs of older adults and their caregivers. Several studies conducted in Korea showed that public health social workers who managed the Hyodol care system also highlighted the positive impact of Hyodol in providing companionship, care, and emotional support, especially in situations where clients felt isolated or lacked regular family interactions [23].

Future research should therefore include longitudinal studies to assess the long-term effects of social robots like NAO on loneliness and emotional well-being. Additionally, incorporating caregiver perspectives would provide valuable insights into the practical impact of robots on both users and their caregivers. Lastly, comparing social robots with other assistive technologies, such as voice assistants and smart home devices, is essential to understand their relative effectiveness in alleviating loneliness and identifying the most suitable solutions.