Socially assistive robots (SARs) are being deployed in elderly care facilities to augment caregiver capacity and support residents’ social and emotional well-being. In this systematic review of 24 empirical studies published between 2019 and 2024 (Scopus, SpringerLink, ACM Digital Library, PubMed, Bentham Science), we examined how SARs integrate within digital care ecosystems, their impact on social interaction and loneliness, and the barriers to implementation . Our main findings indicate that most SARs continue to operate as standalone companions; however, those integrated with IoT platforms, electronic health records, and telehealth services enable real-time monitoring, adaptive interventions, and streamlined care coordination. Personalized interactions—driven by facial recognition and emotion-sensitive responses—consistently reduce loneliness, enhance emotional engagement, and strengthen peer and family connections, and telepresence-enabled SARs proved especially valuable during periods of enforced isolation such as the COVID-19 pandemic. Key obstacles include high acquisition and maintenance costs, inadequate interoperability with existing digital infrastructures, ethical concerns around privacy and emotional dependency, and technological limitations in navigating complex care environments. Resistance among both staff and residents underscores the necessity for robust training programs, clear ethical frameworks, and phased adoption strategies. Future research should investigate long-term psychosocial and health outcomes of SAR deployment across diverse cultural and clinical contexts; conduct cost–benefit analyses to inform procurement and scalability decisions; develop standardized protocols for ethical data handling and user consent; explore design optimizations for enhanced mobility and autonomy in complex care settings; evaluate caregiver–robot collaborative workflows; and pilot longitudinal trials assessing sustained user engagement and adaptive learning capabilities of SARs.

Keywords: Socially Assistive Robots, Elderly Care, Digital Ecosystems, Systematic Review.