Long-term care residents and staff perspectives on PARO using video-reflexive ethnography (VRE)

Residents with dementia in long-term care (LTC) often experience social isolation, loneliness, and distress. Socially assistive robots such as PARO, have been introduced to support psychosocial well-being, yet prior studies have typically examined resident or staff perspectives separately, limiting understanding of how such technologies function within everyday care practice.

This study examined the relational, practical, and organizational feasibility of using the social robot PARO in a special care unit by exploring both residents' experiences and staff reflections.

A qualitative ethnographic study was conducted in a Canadian LTC home. Residents living with dementia (n = 10) participated in group-based PARO sessions over 4 weeks. Video recordings, field notes, and conversational interviews captured residents' experiences. Care staff (n = 10) engaged in video-reflexive ethnographic (VRE) group sessions using selected video footage to prompt discussion of benefits, barriers and implementation considerations. Data were analyzed using reflexive thematic analysis informed by person-centered care.

Feasibility emerged as relational, practical, and organizational. PARO promoted engagement and nurturing behaviors when actively facilitated by staff, but successful use depended on workflow integration, supervision capacity, infection-control procedures, and institutional resource priorities. VRE enabled staff to collectively identify implementation tensions grounded in observed interactions, reframing feasibility as a context-dependent process negotiated within daily care practice.

The feasibility of social robots in dementia care depends on relational meaning, workflow integration, and organizational priorities. VRE is a valuable method for identifying implementation tensions early and supporting reflective, person-centered adoption of emerging technologies in LTC.