Today I took part in an interesting panel at Bloomberg HQ in NYC put on by their HR department that was exploring the topic of working family caregivers. There wasn't enough time to talk about all the innovations available for family caregivers so I promised to write a blog post listing out some of the many links and resources we've come across at Aging2.0. It's only a flavor of all of the interesting projects going on, and on the other hand, rather lengthy, as I didn't have enough time to make it short!
The topic of working caregivers is increasingly relevant, given that 70% of the 40m+ family caregivers in the US work full or part time. This has become a topic of interest for Bloomberg, and this was reflected by the fact that it was a sold out event and everyone in the room seemed engaged.
The other panelists were Matt Kudish, SVP of Caregiver Services at the Alzheimer’s Association, New York City Chapter, Brenda Clark from Bloomberg's HR department who had recent personal experience as a caregiver, Noreen Guanci, Founder and CEO of professional care manager LongTerm Solutions, and it was expertly moderated by Eileen Zenker, Director of Client Services from Humana’s Senior Bridge home care group. They brought a lot of personal and professional caregiving experience, while my role was to identify some of the emerging and relevant tech solutions that may resonate with the forward-thinking Bloomberg employees.
In a kick-off show of hands, it was surprising that only one third of the room was actively involved in caring for an aging parent, with the majority where there doing research ahead of time. This foresightedness is unusual, as the Alzheimer’s Association rep noted, but a good sign of the preparedness of the Bloomberg staff.
As the discussion continued, it was clear that merely starting the conversation was beneficial to people. Given that half of working caregivers are reluctant to tell their employers about their situation (which includes those that don’t even recognize themselves as caregivers), merely having a forum for conversation and people to share experiences will ensure this is a useful exercise.
The session was based on some case studies covering quite common scenarios (see at Annex). There follows a non-exhaustive list of resources available for those looking to provide care, with a focus on the startups we’re familiar with (those in our portfolio are indicated as such).
Starting the conversation ahead of time
Given that most people in the room were starting to plan ahead, rather than deal with a short term crisis, tools to help people plan and have conversations with some structure were recommended.
- Everplans* - a local NYC startup provides guidance (such as checklists) and secure / sharing of key documents. The idea here is that everyone should be making plans no matter how old they are.
- The Conversation Project provides a structured way to have a conversation about later life care, financial planning and end of life that many people avoid.
Creating a tech-enabled home that’s easier to ‘age in place’
We hear a lot about assisted living but fully 90% of older people will remain in the community - in their homes or that of a family member. We didn’t have time to get into this in much detail, but there is a huge amount of innovation happening right now in the smart home space. This New York Times article describes a number of the smart home technologies that can be adopted.
According to a a recent report by the Center for Aging Better in the UK, every £1 spent on home adaptation can generate £4 in savings by reducing demand on other public services – so we’ll increasingly see more interest by healthcare payors to support innovations that keep people living healthier, happier and more independently.
- Assessment services – The National Association of Home Builders (NAHB.org) has a set of resources to assess whether a home is suitable for aging in place.
- Reviews of aging-in-place technology: check out these resources for aging in place technologies: Tech Enhanced Life and Aging in Place Technology Watch. Also good work to frame the emerging space is being done at the Center for Technology and Aging.
- Robots are starting to provide support services – Jibo* is one of the first ‘social robots’, Catalia Health’s robot helps with behavior change in chronic diseases (impacting e.g. medication management) and Amazon’s Echo helps you order products.
- Smarter everyday objects: Check out Toto’s smart toilets and Eatwell’s beautifully designed smart tableware (no tech involved).
- Reminder Rosie* - speaking alarm clock
- Evermind* - monitoring activity via power usage
- Ally - an 'unobtrusive' home care solution (from UK, still in pilots)
Next generation clothing and accessories
This Time Magazine article about smart watches for seniors identifies quite a few new technologies specifically designed to combine modern wearable technologies and senior-focused services. Here are some other interesting clothing and accessories.
- “Next generation PERS”. While the ‘I’ve fallen and I can’t get up pendants’ generally work as directed, they’re often only good within a small area and are more often than not left on the nightstand. Lively’s* new PERS / watch is stylish and will work outside the house
- Withings - stylish blood pressure monitors
- Qardio- more stylish blood pressure monitors
- Smart diapers – Simavita is on the market while Sensassure, and NY-based Pixie Scientific are still in the testing phase.
- Stylish clothing that is also functional – Narrative Apparel*, Bathboxr
Improving communication and reducing isolation
Lonely people are 3.5 times more likely to enter residential care and are 3x more likely to suffer depression, and 14% more likely to suffer heart disease – so there’s no point in having a smart home to age in place if you don’t also ensure that the individual is not isolated.
‘It takes a village’ speaks to the benefits of local community - the concept of the village is as old as civilization and it is only very recently that we moved away from communal child rearing to the atomized family units we have today. Villages are in decline around the world, challenged by borderless globalization and technology, and nowhere more so than in America. A number of solutions are brining the concept of local community back which can help people live independently, while still being part of a community.
- Getting older adults online: Have the older adult take a course at local (NYC) tech lessons for seniors – e.g. OATS / SeniorPlanet
- Hybrid volunteer-run organizations: The Village movement, GrandeAides and Full Circle America.
- Breezie* & Gociety* - easy to use tablets and smartphones making communicating and engagement easier
Bringing services into the home
Increasingly those making new services to deliver on-demand convenience to millennials are realizing the bigger market is older people who often have the money to pay for services but struggle to get around town, know about the services and use what can be complex interfaces. A word of warning, many of these are only available in urban centers like New York and San Francisco, although the successful ones are scaling rapidly, fuelled by healthy amounts of VC cash.
- General errands and house services - Envoy, TaskRabbit, Handy.
- Shopping – Instacart, FreshDirect
- Meals – Blue Apron
- Local deliveries - Postmates
- Transportation - Uber, Lyft, Shuddle, LiftHero*
- Tech support – Geekatoo
- Bill payment – Silver-Bills.com (NY-based startup)
- Laundry & cleaning services - Rinse & Washio
Care and medical services
Beyond these services which are all about 'activities of daily living' there are a range of more specialized support services for in-home care. I would urge you to check out the services offered by the other panelists (listed below) who provide expert care planning services, and I added some additional tech-enabled services for caring:
- Panelist Matt Kudish shared numerous resources - all free of charge - offered by the Alzheimer's Association, for example they have a website that matches trained aides with families in the NY-metro area: www.TogetherWeCare.com.
- LongTerm Solutions - Panelist Noreen Guanci is the founder of this Boston-based elder care planning service that now has over 70 staff and helps employers and insurance companies provide elder care services to their employees and customers.
- Senior Bridge - Moderator Eileen Zenker runs Client Services for this care management and home care services by this successful local company that was recently purchased by Humana.
- Daily Caring – practical tips for family careivers
- CarePlanners – NY-based geriatric care management
- Non-medical home care platform: CareLinx*, Hometeam operate in NYC, other fast-growing companies out of the west coast include Honor and HomeHero.
- 24/7 care provided by remote caregivers: Gerijoy*
- Medication management - PillPack
- Housecalls by doctors: Heal
- Remote caregiver via avator - ID Avatars
Moving into a facility
Here’s one person’s journey about the conversation about moving into a facility, and how the things that they took for granted before have become more challenging. An important piece of this is to ensure that older person maintains control where possible.
- Online assessment tool – Roobrik*, allows family members to use a validated third party service to provide an easy to use assessment level. Starting with driving risk assessment they’re moving into choosing the right setting for care.
- Portal: Carescout has over 90K ALs, SNFs, HomeCare agencies with ratings and profiles. Caring.com and LeadingAge have resources for when and how to make the decision for transition to assisted living and how to start the search
- Market leaders A Place For Mom, Caring.com and startup Seniorly.com provide portals for finding communities, though the coverage of some of these can be limited to those who pay a referral fee.
This important topic was addressed at the end, in response to the obvious frustration and concern highlighted by one of the audience members. The importance of taking time for yourself was emphasized – it was noted that unfortunately the long-term carer often dies before the person they’re caring for. In fact, the rate of chronic disease in caregivers is twice the average of non-caregivers. A few resources to help deal:
- Non-medical home care provider HomeInstead provides this resource site: caregiverstress.com
- MakingCareEasier - Boston-based startup founded by an HBS team with tools and resources for family caregivers
- Dementia Adventure – this UK-based social enterprise arranges relaxing and expertly guided holidays for people with dementia and their family caregiver, providing some light relief for all concerned.
- The impact of music as a mood changer for older people and caregivers shouldn’t be underestimated. Music&Memory, a local NYC non-profit (am on the board) has done a terrific job creating programming that brings music on iPods to older people with dementia, resulting in a massive and significant improvement in mood. In a similar vein, LA-based startup SingFit* has an app that allows any of us to provide music therapy – which is enjoyable for all involved.
*Aging2.0 has equity in these companies
Thanks to Sarah Thomas and Janet Simpson Benvenuti from Circle of Life Partners (and author of Don't Give Up On Me!) for their valuable contributions to the ideas above. Feel free to let me know at stephen at aging2 dot com about other resources you think should be added the list to help ease the job of the working family caregiver, so we can make life easier for the millions of people doing this important but often under-appreciated role.
Annex: Case Studies (provided by Bloomberg)
Case Study #1: Providing Care for a Resistant Elder
My grandmother is in her late 80s and while she is still pretty spry for her age I am concerned for her wellbeing since she lives alone. She has recently been experiencing dizzy spells that cause her to faint. She has a life alert bracelet for these emergency situations, but I think she needs additional monitoring. How can I assess when it is time for her to move to assisted living? How can I help convince her to move, when she is adamant about staying in her house? How can I find the best assisted living centers in her area? What resources are available to help her “age in place” if she won’t move? How can I find permanent and back up care for her that could come to the house?
Case Study #2: Transitions for a Surviving Spouse
Mrs. J is an 83 year old woman who was alone after the death of her husband; who oversaw the household while he was alive. Physically healthy, Mrs. J is having difficulty managing the household without her husband's assistance. Her children, who live out of state are not able to help her on a regular basis. Is there a service that can help her manage bills, run errands, and help with meals?
Case Study #3: Managing Money
I think my Mom is showing early signs of dementia but it might just be typical aging. What should I be looking for? If she does have dementia, she will mostly likely need to be placed into assisted living but are worried about the expense. What type of monetary aid/insurance is available for seniors in assisted living, or those with large medical bills? How can I start planning for those expenses now so I can help out when the time comes?
Case Study 4: Future Elder Care Concern
My parents are completely healthy but in their lates sixties and early 70s so I am trying to plan for the future. They tell me that they really want to become a burden for their children and prefer to just stay at home instead of paying a lot of money for an assisted living facility. What should I be thinking about/doing now so I can prepare for that time?