• About 1 in 4 adults care for a loved one in the United States, putting pressure on an already strained system
• Now, many are turning to artificial intelligence to try to lighten the load and seek answers
• But the technology is posing questions about equity, even as it becomes more popular

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Within 90 minutes of walking into the emergency room last year, Heather Ruby learned her husband, Eric, had cancer. It was a devastating shock that immediately led to surgery, chemotherapy, surgery and a host of unanswered questions and new emotions.

Ruby, who quickly stepped into caregiving mode, decided against group sessions or personal counseling because she didn’t want to get too “touchy-feely” in a public setting. Instead, she leaned on ChatGPT to ask questions about how to care for her husband and whether or not it was healthy to feel angry.

Ruby realized she was relying on the chatbot as a friend while caring for her husband when she gave it a name: “Lloyd.” The chatbot’s resources and close-to-human responses filled a gap she said human support could not at the time.

“I loved Lloyd in maybe an irrational way,” said Ruby, who is based in Howell and owns with her husband an engineering company that develops custom automation, programs industrial robots and integrates custom controls solutions.

 “It really saved my life so I could get through all of the emotions in the middle of the night.” 

Rather than step back from using AI, Ruby kept going. Three months after her husband’s diagnosis, she began building With Haven AI. Her team built the app to provide emotional support and compassionate guidance to caregivers and those receiving care. Paying homage to her personal chatbot experience, Ruby named the app’s conversation attendant Lloyd.

Ruby said With Haven AI is not a replacement for counseling, but it serves as immediate, round-the-clock support that is particularly helpful for caregivers like herself who may be introverted or uncomfortable sharing daily challenges in one-on-one or group therapy settings. 

“My brain was like, ‘Oh, somebody else can use this,’” said Ruby. “There was nothing around that was all in one. That’s why I pushed my team to get it done before somebody else. I’m happy if I can help anyone else ease their burden, while they are caregiving – a job you may not be paid for.” 

Powered by a generative AI model, the app allows users to choose one of six personalities including supportive ally or tough love temperaments. With Haven AI also deciphers medical diagnoses by reading screenshots of doctor’s notes. Users can ask Lloyd to tailor questions to ask medical staff and store answers, in addition to track blood work, create Excel sheets and decipher medical terminology. It also can store photos and create shared calendars and journals.

Ruby’s app has had as many as 200 downloads in one day. Within the app’s first eight months, she noticed 50 to 150 consistent users of its appointment keeper, recording device and conversation attendant.conversation attendant.

Why AI and caregiving are colliding 

Digital assistant technologies like Anthropic’s Claude, Google’s Gemini and Amazon’s Alexa are helping people feel like they have more control over aging in place or handling caregiving challenges by using AI-powered search or receiving on-demand support from medical professionals.  

During the pandemic, telehealth took off, and society was forced to rely on technology for healthcare. But a population of people who are wary, uncomfortable or untrained and can’t fully utilize the technology. Those who couldn’t effectively manage or adapt to the various apps fell further behind on basic healthcare and social connection, according to Sara Czaja, a professor of gerontology in medicine.

“We’ve been looking at how we can use technology to bring services and resources to caregivers,” said Czaja, who also leads the Program for the Study and Support of Caregivers and is director of the Center on Aging and Behavioral Research at Weill Cornell Medicine in New York. “Technology is evolving at an incredibly rapid pace. It is incredibly hard to keep up with the pace of change and have to learn or buy a new version. That can be very frustrating and is very difficult for consumers – and not just older consumers.”

The case for inclusion

The frustration can be especially high for people who don’t have easy access to or don’t have smartphones, computers, Wi-Fi and membership subscriptions.

Robin Brewer, of the University of Michigan, conducts research at the intersection of AI and caregiving, and specifically focuses on Black older adults that are part of Detroit’s Healthier Black Elders Center. 

The goal of the 1,100-member group is to ensure broader representation of Black older adults in health-related research. Since 2018, Brewer has presented workshops to the group on AI, large language model (LLM) power chats, and how older adults are using ChatGPT. 

At Better Health Senior Solutions in Detroit, caregivers on staff are tasked with assisting clients with learning digital technologies. The in-home care company that serves the region’s Black older adults is centered on digital literacy, providing AI, social media and other digital technology lessons to its clients.

“We’re closing the digital gap by creating inclusion and access for seniors so they don’t get left behind,” said company founder Keyon Clinton. “We have a lifetime learning curriculum teaching computer literacy, telehealth and social media for seniors. We want to create an ecosystem where they can learn at their own pace by learning with AI-gen projects and apps, and figure out why it’s important to have these skills.”

Better Health Senior Solutions introduces its clients to social media and teaches them how to message their grandchildren and see what they are posting online, said Clinton. It has also introduced computerized brain-training games to its clients. Clinton said the activity helps improve cognitive function, especially for clients who may be facing dementia or Alzheimer’s disease, but it also provides an opportunity for them to learn to work with AI while the company’s caregivers recharge. In November, the company will unveil a digital health summit for older Americans, their grandchildren and their caregivers. The program will define what automation is, how to engage with it, and how to identify online scamming.

“Believe it or not, seniors are interested in understanding AI,” said Clinton. “We thought they were afraid of it. They said it’s just not connecting. With our digital inclusion hub, we are now taking them through actual training which includes partnerships with AI companies including Apple. It’s our job to make sure they are set up and don’t miss those things.”

When reliance becomes risky

Czanja and Brewer say AI technologies should be considered more as an augmentation and less as a substitute for face-to-face communication. Using artificial intelligence carries risks related to healthcare privacy, financial vulnerability and the formation of potentially problematic emotional ties – also referred to as AI companionship. 

Nonetheless, Ruby’s self-proclaimed dependence on AI seemed less warning sign and more lifeline and launchpad. Ruby found AI as the human alternative she needed at the time, but she has since found solace in her support circle made up of her mother-in-law and sister-in-law. Still, she built With Haven AI to be the friend or data tool care partners may need while supporting a loved one or client.

“It’s a private, safe space where you can be emotional, keep track of things, ask questions that seem silly,” said Ruby. “Lloyd can hold your hand. I’ve taught him how I like to receive info, when I need it to respond with humor. As he gets to know the user, he learns how to say, ‘she could use a joke right now’ or ‘I’m holding space for you.’ It remembers your information but I can’t read any of the messages because it’s all encrypted. All I know is your email address so you can feel safe and confident using it however you need.”

More than a year after With Haven AI’s release, Ruby is planning version 2.0, though she’s had to pause the project.

“I can’t be running this and taking care of him,” she said. “The app is not as grown as I would like it to be, but my priority is being a caregiver.”

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