From Hands-On to High-Tech: How Dutch Care Workers Navigate Digitalization and Robotization

Whether we embrace it or not, digital technologies and AI are here to stay, and they are fundamentally changing the human world of labour. As new technologies revolutionize the healthcare landscape, these changes are reshaping the lives and work of care workers. In this blog, Sreerekha Sathi shares insights from her research, which explores important questions about how digital technologies are reshaping care work in the Netherlands specifically: how these innovations are affecting care workers and how care homes are adapting to digital solutions and AI-assisted robotics. What specific forms of AI-assisted robotics are currently being utilized in Dutch care homes and how can we evaluate the benefits, challenges and risks associated with their implementation?

Digitalization, robotization and the care worker

The Dutch healthcare sector faces increasing inequality in access to care, staff shortages, increasing workloads and a high percentage of aging populations. Around two thousand government-funded care homes serve the elderly, those with dementia, disabilities and other care needs.

Like other countries in Europe, the Netherlands has been experimenting with digitization and robotization in health care. Over the past two decades, AI-assisted digital tools and Socially Assistive Robots (SARS) have become more common in surgeries, patient monitoring, consultations, diagnostics, rehabilitation, telemedicine, cognitive and emotional care, especially in the post-pandemic period (Getson, C., & Nejat, G. 2021, Kang et al. 2023). Beyond Europe, countries like China and Japan lead these developments, with Sweden and the Netherlands close behind.

The use of digital solutions and AI-assisted robotics have moved beyond the experimental phase into early adoption. Current discussion focuses on opportunities for collaboration between private companies, academic institutions and healthcare providers. This pilot study involved conversations with few care workers in the care homes, innovation managers, company officials and academic scholars in the Netherlands.

Conversations with care workers show that most technologies in use are still relatively simple – medication dispensers, sensor systems and communication tablets – selected for their affordability and ease. Once prescribed, digital care tools like Compaan, Freestyle Libre, MelioTherm, Medido, Sansara or Mono Medical are introduced to clients by neighbourhood digital teams, usually via smartphone apps connected through WIFI as part of online digital care.

The introduction of robots is slowly gaining ground. Many universities, including Erasmus University, are collaborating with private companies on new projects in robotization and digitalization in health care. Some of the robots which are popular in use currently in Europe include TinyBots (Tessa), Zorabots (NAO), Pepper, Paro and other robotic pets, and SARA, which supports dementia patients. Some care workers believe that the robots promote social contact and enhance patients’ independence, while others appreciate that robots taking over peripheral tasks can make their own work easier.

Care workers are required to learn and engage with new technologies, which directly affect their everyday lives. Although they are relatively well paid by normal standards, their workload and stress often exceed what their pay reflects. Larger, well-funded care homes have support staff who assist care workers for indirect or non-medical support at lower pay. When new technologies are introduced without sufficient involvement and inputs from the workers, they can lead to more burden on workers in terms of time and labour costs. For them, new technologies are often ‘thrown over the fence’, with insufficient training or involvement of care workers in design or decision-making, leading to frustration, resistance and underuse even when the tools are effective. They argue, ‘we don’t need fancy tools – just the right tools used in the right way.’

Many workers feel that if a robot can take on physical tasks, the workers can give clients more time and attention. When the purpose of a tool is clearly explained, and workers remain present in critical moments, clients and families are more accepting of new technology.

Gender and labour in new technologies

Feminist Science and Technology Studies (FSTS) has long shown how technologies carry gendered biases. Feminist histories of computing have highlighted women’s contribution to the invention and introduction of computers and software (Browne, Stephen & McInerney, 2023). A relevant question to explore today is would new technologies using AI assisted robotics replicate the same biases. Although new technologies are often presented as objective, they are built upon datasets and assumptions that can reproduce biases and stereotypes, based on the foundations of the feeds and accesses in-built into it (1). Robots, for instance, often reflect the idealized gendered traits. Nurse robots are designed with feminine or childlike features – extroverted and friendly – versus ‘techno-police’ styled introvert security robots as stoic and masculine.

Care work remains a heavily gendered profession, though more men are joining the field. While some men care workers face occasional client push back, they are increasingly welcomed amid shortages. Many care workers worry about being replaced by robots, yet most agree that emotional presence of caregivers – especially in elderly and dementia care – remains essential and robots may support but cannot substitute the human connection that defines good care work.

Further, workers also stress that technology must be context-sensitive: its success depends on the socio-economic profile of the area, staff availability and the lived preferences of the people receiving care. They advocate for flexible, context-based implementation rather than top-down standardization of new machines. Core to the debates on digitalization and robotization in care are ethical issues often narrowly framed as privacy concerns but extending to autonomy, emotional dignity and growing surveillance and inequality.

Insights into the future

The study observe that many attempts to introduce digital technologies or robotics in care homes stall in the pilot phase, often disliked or abandoned by care professionals or clients. Care workers need time and training to trust these devices, especially regarding the risks and uncertainties involved. They emphasize early involvement through co-design as essential for building trust, transparency and accountability. For sustainable implementation, the focus should shift from what is ‘new’ to what is ‘useful’.

Future debates will likely centre around prioritizing digitization in health care versus SARs in physical care. Persistent challenges include time constraints to software failures (Huisman & Kort 2019). As efforts to create ‘smart homes’ and support independent living continue (Allaban, Wang & Padir 2020), environmental sustainability and climate resilience must become priorities.

Another important step for exploration is to critically analyze the growing corporatization and monopolization in digitization and robotization (Zuboff, 2019; Hao, 2025). Rather than leaving healthcare innovations to monopolies or private capital, public or community-based state welfare support must retain agency in how digital and robotic tools are implemented. Finally, pushing back from military robotics towards socially beneficial technologies – such as health care or waste management – needs to be prioritized.

As a work in progress, this research is significant for understanding the social impacts of digitalization and robotization. In the next step of this study, these conversations will further bring together care workers, academics and innovative managers between the global south and the global north to foster dialogue about how these changes are reshaping the healthcare economy, care homes and the future of care workers.

 

End Note:

1. A focus on changing forms of labour, along with the concerns around gender stereotypes and gendered knowledges attributed to social robots, is important for further exploration in the fields of AI-assisted occupations. The introduction of new machines involves the invisible human labour behind them, which is mostly the ‘ghost workers’ from the global south, whether with data work, coding or mining. What is inherent to existing social contexts, including gender, class, and racial stereotypes, are already heavily compromising the digital world.

Acknowledgements: This research was supported by a small grant from Erasmus Trustfonds for 2024-2025, I embarked on this short study to explore these questions. Although the grant period concluded in June 2025, the research continues. I would like to thank Ms. Julia van Stenis for her invaluable support in making this study possible.

 

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About the author:

Sreerekha Sathi works on issues of gender, political economy, and critical development studies. Her current research explores the intersections of gender, care, and labour with digitalization, AI, and the future of work, and engages with critical debates in decolonial thought. She is a member of the editorial board of Development and Change.

 

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