Transforming Setbacks into Stepping Stones for Growth

Study Overview

Ikigai, a Japanese term, roughly translates to “that which most makes one’s life seem worth living” [1], “meaning in life” [2], or “reason for living” [3]. Having ikigai has been associated with numerous health benefits among older adults, such as reduced risk of developing depression [4], dementia [4], disability [4,5] and cardiovascular disease [6,7]. Furthermore, it is associated with lowered all-cause mortality [6,8,9]. Ikigai is essential for older adults to lead fulfilling and independent lives [10] and is associated with increased mental well-being and life satisfaction [4].

Emerging technologies with artificial intelligence may be able to support and even expand people’s experience of ikigai by providing activity suggestions and opportunities for people to connect with others. Several recent review papers suggest that for older adults, social robots might be particularly appropriate for providing social, cognitive, and behavioral interventions through home use, as they show positive effects on the physical, social, and mental health of older adults [11–14]. However, it is important to understand who to design for—both in terms of who might receive the most benefit from the technology and who might be most accepting of it.

In this paper, we explored (1) how Japanese older adults define and experience ikigai and (2) how a home robot meant to promote ikigai is perceived by older adults. We achieved these 2 aims by conducting 20 in-depth interviews with older adults, collecting 50 survey responses from older adults, and conducting 10 interviews with family caregivers. We focus on older adults because ikigai often declines in old age [9,15], as individuals experience changes in social roles [16] and autonomy, caused by factors such as retirement [17], reduced social interaction [18], and declining physical health [19].

As some ambiguity exists over how to translate the conceptual essence of “ikigai” to a Western audience, we start by using a mixed methods approach to consider how ikigai maps to other concepts in the well-being literature (eg, eudaimonic well-being [EWB], hedonic well-being [HWB], meaning, and vitality), analyze older adults’ sources of ikigai along with their sources of concern, and consider how ikigai relates to satisfaction with social roles (work and family) and discretionary activities (leisure and friendships).

In addition, we analyze how an “ikigai” robot—showcased to participants via video—is viewed by older adults and might further be developed to support their ikigai. Previous studies with older adults in the United States have suggested that robots may be beneficial in helping older adults maintain and enhance their ikigai [20]. In addition, feedback obtained via interviews with ikigai experts, both academic scholars and those running ikigai centers in Japan, has been largely positive about the idea of using robots cross-culturally to support ikigai [21]. Therefore, this paper presents the next step in answering if and how robots might support Japanese older adults’ ikigai. This also entails exploring which older adults may be most open to having QT, a humanoid desktop robot, as an “ikigai” robot in their homes. Our study advances the human-robot interaction and social robotics fields by (1) contributing to knowledge about robot design for meaning and purpose in life, an area little represented in the field and (2) contributing additional knowledge about the individual characteristics that are associated with home robot acceptance.

There are several reasons why we studied ikigai, instead of only studying the perception and design of QT for this application. First, owing to differences in the definition of the term ikigai in literature, we needed a better understanding of exactly what we would be designing the robot to do and which of the existing ikigai scales to use to measure changes in ikigai. Second, as there is a large body of research on using robots to support HWB (eg, decreasing loneliness and increasing positive affect) in the United States, we needed to determine whether this existing body of literature might be directly applicable to the development of this robot. Third, the goal of our larger research project is to design such a robot for cross-cultural deployment between the United States and Japan, where the word “ikigai” is not understood by those in the United States. Thus, we needed to clarify how best to translate this term for the US population during testing. Therefore, we explored 4 main research questions (RQs):

• RQ1—What are older adults’ self-reported primary sources of ikigai, and how do these relate to eudaimonic and hedonic sources of well-being?
• RQ2—How does ikigai correlate with scales of well-being common in the Western well-being literature, such as scales of meaning and purpose, positive affect, social support, and related concepts such as satisfaction with social roles and discretionary activities?
• RQ3—How do older adults envision a social home robot supporting their ikigai and overall well-being?
• RQ4—Are there certain characteristics of older adults that lead to more positive perceptions or acceptance of a social robot for supporting ikigai and well-being?

What Is Ikigai?

The Japanese term, ikigai, consists of 2 Japanese (Kanji) characters: “iki (生き),” which means life, and “gai (甲斐),” which means value or worth. Therefore, broadly speaking, ikigai means that which makes one’s life seem worth living [22]. However, it also refers to a range of additional concepts including purpose and meaning of life; self-actualization [23]; psychological well-being [24]; or at a smaller scope, the joy a person finds in living day to day [25]. In fact, there are still considerable differences in definitions of ikigai, as found in a systematic review [26].

Despite the diversity and broadness in the interpretation of the concept, what seems to be accepted across different interpretations is that ikigai is individual to everyone, and ikigai is a familiar concept deeply rooted in the daily lives of Japanese people. Miyako Kamiya—who is often described as the mother of ikigai research—suggested a distinction to address 2 aspects of ikigai—“ikigai-kan,” meaning the feeling of ikigai, and “ikigai tai-sho,” meaning the object or the source of ikigai [23]. It is also described as having 3 “levels”—first person (personal; eg, hobbies), second person (interpersonal; eg, family), and third person (community; eg, volunteering) [27]. In Japan, the concept of ikigai is pervasive to the extent that many individuals possess an abstract idea of what it is without thinking about it [25].

Issues arise as the concept garners broad international interest, including the publication of several popular English-language books and efforts by Japanese scholars and practitioners of ikigai to make the concept and related practices more available to a non-Japanese audience [25,28–30]. When translating ikigai as a concept from Japan to international audiences, it is clear that ikigai is not the same as HWB or subjective well-being (SWB; defined as positive affect, negative affect, and life satisfaction [31,32]). However, whether it is largely equivalent to EWB [24,33] or comprises aspects of both EWB and HWB [6,34,35] has been a point of divergence among some researchers. This is an important distinction, as it facilitates the understanding, adaptation, and comparison of decades of accumulated ikigai studies in Japan with well-being studies in the West.

What Is Well-Being?

There are 2 different but complementary aspects of well-being [36,37]. The first, HWB, is typically measured by 3 constructs: positive affect, negative affect, and life satisfaction [38]. In this way, it is synonymous with SWB. The word happiness is often used interchangeably with both HWB and SWB. Of the 3 constructs, life satisfaction results from a cognitive appraisal of one’s life as a whole, whereas positive and negative affect are affective components of HWB. It has been shown that positive affect is responsible for 75% of the variation in HWB [36].

In contrast, EWB is often defined by what it is not (ie, not mere affect, pleasure, or happiness) [39]. It encompasses many important aspects of one’s experiences, including meaning in life, vitality, personal growth, spiritual transcendence, accomplishment, engagement, and self-acceptance. However, most scholars agree that if a single construct is to be associated with EWB, it is meaning. In fact, meaning has been found to capture 70% of the variance in EWB and is often used as its proxy [36].

Researchers now define “meaning” as referencing 3 different dimensions—coherence, purpose, and significance [33]. Meaning as coherence refers to one’s cognitive ability to make sense of the experiences one has in life. Meaning as purpose is future oriented, providing a sense of direction, and it refers to one’s goals and aims in life. Meaning as significance is an evaluation that life or one’s life is significant—that one has a “life worth living.” This assessment involves taking into account our past, present, and future. It can also overlap with many of the EWB concepts mentioned previously, as to come to the decision that one has a life that is significant and worthwhile, consideration might be given to one’s accomplishments, goals, vitality, and so on. HWB, similar to these EWB concepts, can even become a part of one’s meaning (significance) if it is assessed as part of what makes one’s life worth living. Though these may lead some individuals to feel they have meaning, they are still conceptually separate, distinguished as a “source of meaning rather than a part of meaning” [33].

Ikigai Scales

Japan experienced a “Renaissance of ikigai research [26]” in the 2000s, especially regarding older adults’ ikigai, owing to its relevance to social concerns about the rapid aging of the population [2]. Therefore, various ikigai models and scales to conceptualize and measure ikigai were developed during the period. Although early Japanese researchers adopted and modified the scales made in the West to quantify ikigai, including the Philadelphia Geriatric Center, Morale scale [40], and Purpose in Life test [41], new scales were developed for the Japanese concept specifically including: the K-1 scale by Kondo and Kamada [42], the ikigai model by Hasegawa et al [2], and the ikigai-9 scale by Imai [43].

The K-1 scale measures older adults’ ikigai using 16 items across four categories: (1) self-realization and motivation, (2) sense of fulfillment in life, (3) motivation to live, and (4) sense of existence [42]. The ikigai-9 is a 9-item scale developed with Japanese older adults aged >60 years, designed as a tool to measure their sense of ikigai across three different aspects: (1) optimistic and positive emotions toward life (eg, “I often feel that I am happy”), (2) active and positive attitudes toward one’s future (eg, “I would like to learn something new or start something”), and (3) acknowledgment of the meaning of one’s existence (eg, “I believe that I have some impact on someone”) [28,43]. The reliability of both scales has been validated with Japanese populations [43,44] (and international populations for the kigai-9 [28]), and they have been used as valid tools to investigate older adults’ ikigai [20,28,45].

Ikigai Interventions

Previous studies have examined the effects of various interventions on older adults’ ikigai. For example, Ohashi and Katsura [46] designed a behavior program to enhance older adults’ ikigai, a series of participatory workshops focusing on themes including improving relationship skills and reflecting on their life and goals. Using the K-1 scale [42] as a validation tool and 32 female older adults as their study participants, the authors reported the program’s effectiveness in increasing the sense of ikigai for older adults. Similarly, using a combination of self-evaluation scales, including the K-1, Shitakura and Murayama [47] suggested the success of using a program consisting of goal-oriented activities (eg, exercise sessions) with older adults to maintain and improve their self-reported physical health and sense of ikigai. Iwahara et al [48] used the Japanese version of the Philadelphia Geriatric Center morale scale [49] to suggest the positive effect of their intervention (ie, college students spending a couple of days doing various activities with older adults) on the ikigai of older adults living alone.

Ikigai and Health

Health is often discussed as inseparable from ikigai and frequently cited as an indicator that correlates with a high sense of ikigai for older adults [2] or as a precondition or a means to support older adults’ pursuit of activities [27]. The Japanese government discusses the promotion of ikigai and health together, encouraging and supporting national-level and municipal-level projects to improve older adults’ health and ikigai—for example, senior citizen’s club, national senior sports festival event called “Nen-rin pics,” and exercise programs conducted at local ikigai centers [50]. One of the aims of such promotion of health and ikigai for older adults through national policy is to improve the health expectancy of older adults, which leads to the prevention of care needs and therefore the reduction of costs for older adults’ care at the national level, which is a pressing societal issue for the aging society [50]. On the basis of a survey-based study to investigate regional differences in ikigai, Hasegawa et al [51] suggest a strong positive correlation between older adults’ sense of ikigai and their self-rated level of health, for older adults in both rural and suburban areas. Shirai et al [35] also found that subjective assessments of health (but not number of hospitalizations) contributed to having ikigai; however, it did not influence how much ikigai one had. Similarly, studies such as those by Okamoto [52] and Harada et al [53] report a strong correlation between sports and exercise and a high sense of ikigai in older adults.

In contrast, for those with declining health, maintaining or increasing social ties, both strong and weak, is associated with a protective effect against the decline in ikigai that often occurs in old age [19]. Other research indicates that physical decline does not directly lead to loss of ikigai but rather that overlaps in “frail” categories do—that is, having issues with ≥2 of the following health indicators: physical health, cognitive health, or social health [54]. In addition, causative modeling has found involvement in social activities to be predictive of ikigai, whereas physical functioning was not [55]. Studies have also suggested that the benefits of health to ikigai are, at least partially, a consequence of participation in the leisure activities they allow [56].

Social Robots for Older Adults’ Well-Being

As aging has become a prominent challenge in many parts of the world, robot designers and researchers have explored the potential of social robots to support older adults’ well-being and quality of life [57,58]. For instance, it is possible for social robots to enhance older adults’ well-being by enabling fun, engagement, and calming interactions [59]. Social robots might also enhance social bonds and self-reflection [20]. Furthermore, robots can increase older individuals’ perceived emotional support and social connection for a better quality of life [12]. These robots might resemble a pet, such as AIBO or Paro [12], or be more humanlike, such as the telenoid [59]. For example, Paro, a baby seal–like robot, was shown to stimulate engagement by older adults when applied in a multisensory behavior therapy session in a nursing home [60]; when used in a public space in the nursing home for voluntary interactions, it acted as a social mediator between the participants and other people [61].

Among the many countries that have robots, Japan is prominent in the variety and public pervasiveness of social robot designs and applications for everyday consumer use [62]. Many such robots are developed to support the health and well-being of older adults, including the previously mentioned Paro [12]. Another example of a social robot for well-being developed and studied in Japan is Kabochan Nodding Communication ROBO [63], a humanoid robot developed as an intervention for older Japanese women living alone; it was found to improve cognitive abilities that could be helpful for other aspects of well-being.

As the concept of ikigai has broad personal and societal significance in Japan and people in Japan are likely to be aware of the potential social and health applications of robots, we were particularly interested in exploring perceptions about the potential use of robots to support ikigai among Japanese older adults.

However, despite the high interest in robotic technology, social barriers to designing and implementing social robots for older adults cannot be ignored. Older adults tend to distance themselves from being the prospective robot user because they believe users are lonely, needing care and companionship [64]. In a study conducted with older adults in the United States, older adult participants framed robots designed specifically for older adults as not being for them, despite an otherwise positive view about such robots in general [65]. Older adults more generally tend to avoid situating themselves in relation to aging-related technologies, owing to the associated negative aging stigma [66]. For example, older adults will avoid using personal call alarms to prevent serious injury unless they live alone or are very old [67]. Therefore, there may be resistance among some older adults to using robots, even if they see their benefits.