Tech-enabled home care isn’t really there – yet.  Okay, there are smart phone apps that reveal a caregiver has arrived. There are back-office offerings like CareTree or ClearCare – in a way, these are the ERP (enterprise resource planning) systems for home care agencies.  And then there are the new entrants, scooping up more money, presumably planning to take over the home care universe with…apps. So what is the device of choice for these folks?  A portal or app that can be accessed through a smartphone or perhaps an iPad.   These are big leaps forward from the no-transparency, telephone-only days of yore, true. But what if there was a multi-purpose device in the home that could enhance the quality of life of the care recipient – and also assist with information flow between the participants, including professional caregiver, agency management, family members?  

Who expects that most seniors will move to assisted living? Not that many. Our clues: # 1) one of the long-time thought leader consultants in senior housing, Ryan Frederick, is now involved in multi-generational housing development.  Or Clue # 2) Occupancy is unchanged in senior housing – still at 89% for the past three years. And don’t you just love the phrase 'inventory has outpaced absorption'? Or the next big challenge for senior housing – serving the middle class? And the profile of the resident in assisted living?  Clue # 3) The typical resident is an 87-year-old woman who remains for an average of 22 months.   Clue # 4) The net worth for folks aged 75+, presumably the feeder group for assisted living, inclusive of home equity, is $155,714.

Finding new findings is slowing down in these last days of August.  First we learn that older people are happier. Whew. And we also learn that seniors don’t seem to take to digital health tools, according to a JAMA-published National Health and Aging Trends Study, a project out of the school of public health at Johns Hopkins University. “Notably, the seniors in the NHATS were willing to get on a computer to respond to this annual, in-home, computer-assisted, longitudinal nationally representative survey of community-dwelling Medicare beneficiaries 65 years and older.” Okay – hence it must be valid.  Says study author Dr. Levine: "Little is known about how this population actually uses technology." Well, actually quite a bit is known -- and published during the study years of 2011 – 2014.  For one, consider the 2011 Linkage survey of individuals age 65-100.  Then there are the numerous surveys from Pew, for example, this one from 2014 on older adults and technology adoption.  Or from Nielsen.  

Nursing home avoidance – the home care wave fits the profile.  So we know that tech-enabled home care has received several infusions of cash lately.  Whether this is an anomaly -- once new-age firms realize that home care consists of difficult and backbreaking labor – or signals a trend, remains to be seen.  The apparent bloom of the home care business opportunity appears to be the inverse of the business gloom in senior housing, as noted in these Chapter 11 filings. These businesses are failing at the same time as nursing home bed capacity is anticipated to become constrained.   As AARP has endlessly repeated, 90% of older adults want to remain in their own homes. Or maybe it is 87%.  But regardless of intent, most will stay because they can’t afford anything else.  

In June, Parks Associates observed low utilization of caregiver apps.  Their research published at the time showed "27% of current caregivers and 41% of future caregivers are very interested in a connected health app featuring medication lists with reminder functions."  Parsing that a bit, caregivers today are not big users of apps to help them with caregiving, but perhaps today’s millennials (future caregivers) will be more interested.  The graphic associated with the press release reaffirmed any doubts about the viability of the PERS industry -- topping the chart -- panic button, tracking and fall detection. Okay – so if current caregivers were to use apps more productively, what might they use? And will the most likely use end up with families who have engaged home care workers?  These imponderables aside, the information from the five noted here was drawn from the websites or public press material:

Is the home care franchising world doomed by tech-enabled home care? First clue: Google’s $46.6 million investment in June in Care.com (child, elder and pet care to housekeeping). Then the Honor jaw-dropping investment of $42 million in Series B. The home health industry is a "fragmented" system that Honor aims to fix, according to its new investor and the Business Insider article: There are an estimated 2.5 million home care workers out there, and about 12,400 home health agencies managing them all.  According to "Thrive VC Kareem Zaki, he told Business Insider that it was important that Honor owns the whole system." And per Seth’s vision for the platform, he said: “It'll be like a car: There's a lot of complex technology going on behind the scenes, but driving the car is easy enough for anyone to do."