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The Future of Tech -- Mismatched with the Logistics of Home Care

Caregiving is hot – but practicality is not.  The letters to the editor in today’s WSJ print edition were on point following Ezekiel Emanuel’s May 3 article about the Independence at Home program. The article described care in the home provided for an 87-year-old diabetic, post-stroke, oxygen dependent woman receiving six hours of daily home care, supposedly more than she would receive in a nursing home. One doctor observed: “What happens at the seventh hour when she needs help in transferring, falls from her wheelchair or when her blood sugars go out of control?” What happens indeed? And the next letter: "The backbone of home care remains 'Low-paid, low-skill home service workers who cook, clean, bathe and help clients around their home.' And the process for overseeing this industry of workers who help the neediest elderly – actually it’s not much of a process at all. And the distinction in the media between private duty non-medical home care, home health care, geriatric care management, or hospice care in the home?  Not much. 


Family caregiving: yes it’s researched, but tech solutions are, at best, awkward. You might have read the AARP/Parks Caregiving Innovation Frontiers report that sized the Caregiving market opportunity at $279 billion (yes, that's billion with a B). Its pages noted a plethora of product brands – but alas, no online directory was provided to follow-up or pursue these. And perhaps you slogged through the 171-page Atlas of Caregiving Pilot Project report that studied the 'family caregiving crisis.' This is a study that paid 14 families in the Bay area to participate, using many cool tools used to collect data about the daily caregiving experience. Are you familiar with the $1690 Empatica E4 that monitors physiological signs in real time, or the Narrative Clip wearable camera (out of stock), SmartThings Motion Sensors ($39 each), or the Netatmo Weather Station ($179) to track the home environment?  All this to conclude that the family caregiving crisis is significant and that up next, the world "needs to learn from thousands, even millions, of caregiving families." 


Who knows the definition of "technological caregiving?" In a study to be published May 12, family caregivers were studied by Northwestern researchers for ways to detect odd online behavior.  Following focus groups with 20 families, communication researchers at Northwestern recently noted that: "Technological caregiving is a new form of work," Professor Piper [the lead researcher] said. "We hear about the physical, financial and social stress of caregiving, but no one ever talks about the burden caregivers feel to keep people active online, which we feel is a fundamental part of participating in society...They detailed four main ways caregivers currently help people with cognitive impairments use the Internet -- "guiding, stimulating, connecting, and protecting," with guidelines about how to improve those dynamics."


Pendulums are swinging – but which way? Will there be smarter, more useful applications of tech for care in the home and tech for the home care profession? Or just more tech? New age home care has caught the imagination of entrepreneurs this past year – including those folks entering from other industries. VCs have funded several – and they’re in the market with a tablet app here, a background check there, "talent acquisition" for workers that can be hired at a one-hour minimums, and there is growing pressure for price transparency.  Do these changes foretell a new home care industry that works well, operates efficiently and serves clients well, or at least better than the crisis level reached in old industry?  More interesting, will the new age home care companies influence the long-time home care players? This has already happened with the partnership between Comfort Keepers and grandPad. Are partnerships forthcoming between long-time home care companies and tech providers? What about the home health workforce, the constrained supply and structure of the industry, visiting nurse providers, or the services of senior housing operators in the community?   How will the inevitable supply crunch, consolidation, quality management and day-to-day monitoring, combined with growth in the aging population play out?