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HEALTH

Lacking health workers, Germany taps robots for elder care

The white-coloured humanoid "Garmi" does not look much different from a typical robot -- it stands on a platform with wheels and is equipped with a black screen on which two blue circles acting as eyes are attached.

Published: 19 March 2023 10:29 CET
Lacking health workers, Germany taps robots for elder care
The artificial hand of the Garmi robot is seen in front of the robot in the laboratory of the Research Center Geriatronics of the Technical University Munich. Photo: Christof STACHE/AFP.

But retired German doctor Guenter Steinebach, 78, said: “For me, this robot is a dream.”

Not only is Garmi able to perform diagnostics on patients, it can also provide care and treatment for them. Or at least, that is the plan.

Garmi is a product of a new sector called geriatronics, a discipline that taps advanced technologies like robotics, IT and 3D technology for geriatrics, gerontology and nursing.

About a dozen scientists built Garmi with the help of medical practitioners like Steinebach at the Munich Institute of Robotics and Machine Intelligence.

Part of the Technical University of Munich, the institute based its unit specialising in geriatronics in Garmisch-Partenkirchen, a ski resort that is home to one of the highest proportion of elderly people in Germany.

Europe’s most populous country is itself one of the world’s most rapidly ageing societies.

With the number of people needing care growing quickly and an estimated 670,000 carer posts to go unfilled in Germany by 2050, the researchers are racing to conceive robots that can take over some of the tasks carried out today by nurses, carers and doctors.

“We have ATMs where we can get cash today. We can imagine that one day, based on the same model, people can come to get their medical examination in a kind of technology hub,” said Abdeldjallil Naceri, 43, the lead scientist of the lab.

Doctors could then evaluate the results of the robot’s diagnostics from a distance, something that could be particularly valuable for people living in remote communities.

Alternatively the machine could offer a more personalised service at home or in a care home — by serving meals, opening a bottle of water, calling for help in case of a fall or organising a video call with family and friends.

‘We must get there’

In the Garmisch laboratory, Steinebach sat down at a table equipped with three screens and a joystick as he got ready to test the robot’s progress.

At the other end of the room, a researcher designated as a test model took his spot in front of Garmi, which poses a stethoscope on his chest — an action directed by Steinebach from afar via the joystick.Medical data immediately appear on the doctor’s screen.

“Imagine if I had had that in my old practice,” Steinebach said, while moving the joystick.

Besides the retired doctor, other medical practitioners also visit the lab regularly to offer their ideas and feedback on the robot.

“It’s like a three-year-old child. We have to teach it everything,” Naceri said.

It’s anyone’s guess when Garmi might be ready on a commercial scale. But Naceri is convinced that “we must get there, the statistics are clear that it is urgent”.

“From 2030, we must be able to integrate this kind of technology in our society.”

Question of trust

And if it is indeed deployed one day, residents of the Sankt Vinzenz retirement home in Garmisch, a partner of the project, will likely see Garmi whizzing down the corridors.

Just thinking about it made Mrs Rohrer, a 74-year-old resident at the home, smile.

“There are things that a robot can do, for example, serve a drink or bring meals,” she said as Eva Pioskowik, the director of the home, did her nails.

Pioskowik, who battles with staffing shortages on a daily basis, said she did not expect the robot to take the place of health workers.

“But it could allow our staff to spend a bit more time with the residents,” she said.

For Naceri’s team, one of the major challenges is not technological, medical or financial.

Rather, it remains to be seen if most patients will accept the robot.

“They need to trust the robot,” he said. “They need to be able to use it like we use a smartphone today.”

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HEALTH

Should you take vitamin D supplements in Germany?

With the mornings and evenings getting darker, many people may be wondering if taking a vitamin D supplement is recommended in Germany. Here's what to know.

Published: 13 September 2024 13:12 CEST
Should you take vitamin D supplements in Germany?

Vitamin D is a vital nutrient for overall health and well-being, and most people are aware that it can be absorbed via sunlight. 

But as long-time residents in Germany know all too well, sunlight is often hard to come by in the autumn and winter months. In December, there’s only a few hours of daylight per day, typically when most people are at work (and it often isn’t even sunny).

This makes it much harder to get enough vitamin D. A deficiency in vitamin D can lead to several health problems in the long run. Muscle weakness and cramps, fatigue and depression are among the symptoms of not getting enough of this vitamin. 

How do I get the most vitamin D in Germany?

It mostly involves getting outside in the warmer months. Germany’s disease control agency, the Robert Koch Institute (RKI), says that vitamin D production happens from March to October and this is when the body builds up reserves for the winter. 

“During this time, the body is not only able to cover its acute needs, but also to build up vitamin D reserves in fat and muscle tissue for the winter months,” says the RKI.

READ ALSO: Your guide to getting through the German winter

The RKI adds that to counteract low vitamin D levels all year round in Germany, current recommendations suggest “exposing your face, hands and arms to the sun uncovered and without sun protection two to three times a week between March and October”.

However experts add that sun protection measures, like wearing sunscreen, must be taken when spending longer periods of time in the sun.

Meanwhile, the German Nutrition Society (Deutsche Gesellschaft für Ernährung or DGE) states: “It is recommended to expose the body to the sun for a total of around five to 25 minutes per day with face, hands and large parts of arms and legs uncovered.”

A number of foods provide some vitamin D. It’s mainly found in fatty fish, roe and fish liver, but red meat, egg yolks and liver are other sources.

Vitamin D is also added to some foods in Germany, such as some milk or vegan milk drinks, yoghurt and other snacks. The nutritional label on food packaging will let people know how much vitamin D they are consuming. 

Although eating foods rich in vitamin D is generally recommended in moderation as part of a varied diet, the DGE says the main focus should be on the body’s own production of vitamin D through exposing skin to sunlight.

READ ALSO: Essential phrases and customs to survive the German winter

What about supplements?

Another way to improve your vitamin D status is to take supplements. 

The German Nutrition Society recommends going down this route if an improvement in vitamin D status cannot be achieved through other routes like getting out and about in the sunlight. 

But be aware that experts also say that taking larger doses over a long period of time can be harmful. 

Pictured are Vitamin D capsules.

Pictured are Vitamin D capsules. Photo by Michele Blackwell on Unsplash

During the height of the Covid pandemic in 2021, the Federal Institute for Risk Assessment (BfR) warned of the health risks of taking vitamin D supplements without taking to a medical professional first. 

“Higher doses should only be taken under medical supervision and taking the individual vitamin D status into account,” the institute said.

“Anyone who wants to take vitamin D on their own should only use supplements with a daily dose of up to 20 micrograms (800 international units),” said the BfR. “With this amount, health impairments are not to be expected.”

According to the BfR, regular daily intake of vitamin D via high-dose preparations – for reasons other than medical reasons – increases the risk of health damage such as the formation of kidney stones or kidney calcification. There have also been cases of acute kidney failure as a result of uncontrolled self-administration of vitamin D preparations, experts said. 

There are a number of people deemed to be more at risk of a vitamin D deficiency.

From the BfR’s point of view, a general vitamin D intake of the upper limit of 20 micrograms per day should only be considered for nursing home residents and other risk groups. 

“This is because vitamin D is produced in the skin under the influence of sunlight. However, many older people hardly exercise outdoors,” the BfR said. Vitamin D production also decreases significantly with age.

READ ALSO: 8 tips for enjoying the cold like a true German

The risk groups for an inadequate vitamin D supply also include people who rarely or never spend time outdoors or who – for cultural or religious reasons – only go outside with their bodies completely covered. Some people who suffer from chronic gastrointestinal, liver or kidney diseases or who take medication that impairs vitamin D metabolism are also more at risk. 

If you suspect that you’re not getting enough vitamin D, go to your GP. They can test for various deficiencies, but bear in mind that these tests are not usually covered by statutory health insurance. 

Even if you don’t test, GPs will be able to advise you on whether you should take a supplement in winter – or all year round – depending on your individual case. 

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