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Watching the home care industry slowly (or quickly) morph

Some industries remain the same for 30 years – and then POW!  Think back to travel agencies, bank branches, bookstores, hardware stores.  Each of these ultimately were traumatized into consolidation and transformation by new entrants. Smaller players in every segment went out of business.  The consumer was willing and eager to change. Online promotion of new capabilities helped them see what the existing players could not. Consider that in 2011, there were a very few indicators of the utility of tech-enabled home care. Naysayers about home care’s future in those days included some of the most entrenched.

The home care industry is at an inflection point.   Fast forward to now – even the healthcare industry is watching digital health startups and new remotely-delivered consultations nibbling at their feet. Change is both driven and hampered by reimbursement changes, rising insurance and delivery costs and ever-louder consumer frustration about both. The home care industry is in transition today because of a longer-lived population, worker scarcity, low wages -- and the potential of retiring franchise owners.

Does all the new entrant buzz matter? For visibility and sustained media attention, yes. Even if the best at buzz may not be the biggest, may not provide the best service or even offer the most capabilities. The startups with the greatest PR skills are getting giant capital infusions and fawning attention from news media. But all home care is hyper-local and despite fame and apparent fortune, these firms only operate in a few locations. And so it is the more traditional agencies and franchise owners who are wondering what the PR means – to them.  We must remember that...

...The majority of older consumers cannot pay what senior housing wants to charge. Periodically (media) mention crops up about the absence of senior housing choices for the middle class. Of course, the senior housing industry must know the $156K median net worth of those aged 75+. But no matter, the senior 'living' industry is a real estate business, and developers continue to search for what the aging consumer with money really wants -- or desperately needs. Meanwhile, older adults will remain at home and need some or a lot of home care, much of it still with high worker turnover, all of it provided locally. 

Home care providers now must rethink their use of technology.  Maybe they don’t feel they need that portal about care status just yet.  Maybe that smartphone application isn’t required, at least in their particular practice, though it soon will be. Maybe family members prefer phone calls, face-to-face interviews of prospective caregivers, direct contact with franchise owners/operators.  Or maybe the tech-centric types will be pleased to be offered online marketplaces, video interviews, and daily status updates through their own smartphones. In the end, home care is a service business. And as we know by now, all service businesses that are still in existence have a noticeable underpinning of technology – and sometimes, as with Uber, a transportation service business can consist of just the tech -- no cars, no car maintenance, no garage.  As with Uber and Lyft, that's when partnerships matter. 


Predictably speaking, the home care industry has the potential to morph in other directions besides the utilization of technology improving the holistic homebound care experience. 

When more clinical procedures similar to doctor homebound visits from Medicare’s “IAH {Independence at Home}" initiative become part of care service offerings, home care will become more of a "hybrid care" offering cafeteria-style care options to ailing homebound patients. 

Thank you for sharing your resourceful article with us on our Home Care and Healthcare Advocacy group on LinkedIn! 

Thanks Laurie....treasure trove of information as always.

If only it could morph a little faster.

Thank you for sharing this article.  In my business I set up a whatsapp group to share information both ways - family and carers.


Then there are also those like me who shudder at living in places [like AL or SNFs] that feed us non organic and unsafe food choices and have to shove medications in us to satisfy government oversight. No thank you!!

I have been around the industry long enough to wish it also had ISP's or Individual Service Plans for those whose needs and disability warranted one. I see too many sitting in their rooms watching TV or sleeping because there is nothing they want to do going on, and no one to care if they joined in or not. A friend and I wrote a program to help places implement ISP's. It can be found on my website www.loveyourlongevity.com.

I have been a nurse since 1984 and most of that has been in home care. The hardest problem I find is there are so many adult children trying to get their parent/parents on Medicaid by hiding their monies and tendering them penniless so they can "get rid" of them . In return the child/children get everything and the clients get nursing home.


Spot on!

The hype is definitely fast and furious, and the reality of implementations is not as quick.  That said, the direction is set and there is good movement in that direction.  Much better than only a few years ago.  The high tech / high touch model allows the home care industry to provide more for less while gaining more customers, and greatly mitigating the industry's Number One challenge:  labor -- shortages, quality, attrition, retention, costs, laws ...  With the right technology, the care recipient and their family and friends don't compromise -- they simply pay less, and get more!  In the end, we must find better ways to care, when someone can't be there!


Thanks for the article. It was very informative. As a provider of adult day center services, I sincerely acknowledge the importance of home care services for frail older adults living in the community. At its best, home and community based services are collaborative with all service providers doing what they do best (we offer clinical oversight, socialization, personal care assistance, and nutrition for one all inclusive price). At this time a great disparity exists in availability of support for those with the financial means to purchase from a smorgasbord of services and those who need services but must depend upon government or family subsidy in order to avail themselves of the most basic service. I look forward with great anticipation to the day when all services are made available to all frail elders, regardless of assets and income.

Good article, but I'm the end it's focus on the basics that families need: reliable, stable, predictable, compassionate care and skills, with trusted, loving relationships. This will never change.

 Agree with Barbara. And then we have family who do not visit their elderly parents/parent. Easier to call occassionally. Grandchildren who send text messages to me - my husband & l live with Mum after Dad passed away. Text messages! Tell Nan we send our love. We don't have time to chat. too busy. How do you explain the reasoning behind text instead of call? To promise to help around the house, but assume being 'old Mum will forget'. Isolating from family gatherings because of possible interruptions taking her to the bathroom. Last excuse was ' we love her but can't smoke around her'. Last Mothers Day was so painful. A quick ph call before going to the restaurant for lunch. Mum is too polite and gentle to express how hurt she was being left out. Her eyes said how she felt. So my husband and I order flowers on different occasions from my brothers sisters and grandchildren. The joy it gives her being remembered by her family is worth the deception. She keeps every card. 
There are so many Aged Care Departments, Advocacy Groups. Lists look impressive but are useless. Too many chiefs and redirection of contacts to try and get support for homecare Carers. Caregivers need real people to talk to. Can't see app helping us..

Laurie, seems there is still no app for Caring (with a Capital "C").

I have been a medical caretaker since 1984 and the greater part of that has been in home care. The most difficult issue I find is there are such a large number of grown-up youngsters attempting to get their parent/guardians on Medicaid by concealing their monies and offering them poverty stricken so they can "get free" of them . Consequently the tyke/youngsters get everything and the customers get nursing home.