MedCity Influencers, Health IT

A look at the caregiving economy and matching demand with supply

Between 2014 and 2024, the Bureau of Labor Statistics projects the first and third largest occupational jumps to be Personal Care Aides and Home Health Aides.

Rarely do we have an opportunity to align the desires of patients, payers, and providers. In the instance of providing care for older adults in the home, we are afforded this opportunity. Nearly 90% of our loved ones want to “age in place” and live at home as long as possible. According to the US Department of Housing and Urban Development, living at home later in life yields cost savings not only for families, but also for government and health systems. Aging in place also provides the benefits of improved physical and emotional health.

Innovating caregiving has the potential to provide the biggest immediate impact on reducing systematic healthcare spending and enhancing individual quality of life. Caregivers are our first line of defense against poor medication adherence, mobility difficulties, dehydration, malnutrition, and acute changes in health.
One Caregiver’s Experience
Caregiving is something that I never thought of myself as doing, professionally or personally, but it is precisely what I was doing. In my early 20s, I dedicated six years of my career to operating a boutique lifestyle concierge business. We mostly served women in their 70s to 90s. The strain on families and employees coordinating care was daunting and at least half of my time was spent supporting the family members of clients and employees. Understanding this as a bigger problem than my little concierge service, I shifted my focus to enhancing and designing technologies to serve families caring for loved ones.
As a granddaughter to four rural Colorado residents, the role of caregiver has taken on a new meaning. Each of my grandparents has very different health experiences. As their priorities and goals change, I am learning that the dignity of risk is important, especially to my grandfathers. We all want to support our loved one’s desire to stay at home, yet we are in a struggle over their well-being and experience (sometimes immense) guilt for not being able to do more.
Caring as a Family
40 million individuals are providing care for loved ones in the United States. Familial caregivers often provide unsustainable sacrifices, both personally and professionally. Professional employees that provide care for loved ones cost employers an estimated $13 billion, annually. By 2020, over 100 million Americans will need assistance of some kind, yet we will only have an increase in 5 million additional informal caregivers.
The typical profile for an informal or familial American caregiver is a female in her late 40s to early 50s. According to Lori Bitter, 50+ marketplace expert, Boomers are happy to accommodate care for loved ones, however; the loss of 28% of their nest egg during the recession has compressed their care capacity and forced more Boomers to remain in the workforce. Through her research for the book The Grandparent Economy, Lori observed a growing trend in Boomers reaching out to younger family members to help with grandma, regardless of family socioeconomic status.
Millennials in Caregiving
Millennials account for 25% of familial caregivers. Generation X accounts for another 25%. In many families, Millennial and Gen X caregivers also double as tech support. Our digital understanding, coupled with our appreciation for quality of life, will help our families leapfrog less than dignifying tech-heavy offerings for our grandparents and parents. We will demand better products and services for our loved ones because we know what is possible in markets targeting our demographics and we want the same for our family. Many young entrepreneurs are taking this a step farther and we are rolling up their sleeves to building the services that we want for our loved ones and for ourselves.
Three companies with Millennial and Generation X founders are building the on-demand home care marketplace. HomeHero, Hometeam, and Honor have raised a combined total of $86.5 million in seed funding to B round investments. Hometeam recently received $5 million from Kaiser Permanente Ventures, bringing their B round up to $32.5 million. Many payers and providers see the value in serving older adults in the homes, focusing specifically on direct care providers.
Growing Market
Jeff Makowka, director of market innovation at AARP, has been working with aging marketplace stakeholders, entrepreneurs, and investors. Helping to manage daily essential activities that eat into the cregiver’s time and building trusting, personalized relationships with care recipients will enhance the offerings of companies entering the space. Jeff believes that the first round of technology solutions for the caregiver marketplace will apply best practices from adjacent markets. Applied lessons from traditional technologies will act as an accelerator to the caregiver market where first mover advantage may be more important than in other scenarios.  AARP’s Caregiving Innovation Frontiers highlights areas ripe for innovation within the caregiver marketplace.
Another major impact affecting care is the increasing gap of professional caregivers. Between 2014 and 2024, the Bureau of Labor Statistics projects the first and third largest occupational jumps to be Personal Care Aides and Home Health Aides. These additional 800,000 aides will total over 3.5 million workers by 2024, and are currently earning wages of just over $20,000. This doesn’t take into account high levels of caregiver burnout and turnover, let alone proposed minimum wage adjustments, making caregiving jobs less attractive. As unemployment rates rise, I wonder if these caregivers will prefer to continue in their line of work or transition to a less demanding role within another industry, while making the same wage.
Innovations in Care
Tools to reduce the burden of care for both familial and professional caregivers will have a massive impact on the success of aging in place. Free mobile apps providing care coordination, education, and medication adherence tools will make a big impact on preventing hospital admissions and enable transparent care. Wearable companies targeting those wishing to maintain independence are also putting pressure on competitors to blend design and function.
Overall, I am optimistic that intergenerational caregiving and the ingenuity of American entrepreneurship will overcome these massive gaps in care. Increased longevity has the potential to be the greatest asset to our society. To enjoy this time with our loved ones and reduce the burden of care, we must listen to patient, payer, and provider desires and learn how to provide exceptional care in the home.

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