Merrily Orsini's Thought Leadership

Are We Creating a Horror Scenario for Future Elder Care?

Scary folks are entering the elder care business

How are we protecting our elderly from the zombies who provide care?

After three calls yesterday from folks who are planning on starting a home care company, I am feeling really scared about the level of care that our nation’s older folks are going to get when they need it. In each case, the person had no health care or aging care experience, no business experience, and no idea of what a caring for the elderly business actually means. This inquiry from start-ups is not new, but it seems that lately the quality of those callers has degenerated. And, it certainly seems that they are coming with more frequency.

I know there have previously been concerns voiced over the franchising of elder care, but, the established franchises have checks and balances in place, and train and educate so the new owners have some guidelines to follow, and help on issues when they arise. However, there are now almost 90 franchises that serve the home care industry, and some of them new to the game are as bad as these independents of which I am now writing. No experience, no standards, no quality measures….only $$ is their eyes.

The independent individual who is just starting out and only reads that elder care is a good business for the future, really has no idea how hard it is to care for people. Plus, the caregiver shortage is everywhere. And, if you look at the demographics, that should be no surprise. We do sell a manual, a start-up manual, about how to start a good elder care business, and the items that are necessary to know prior to start-up, but these folks are not interested in spending any money to know what to do, they are only interested in making money without knowing what it is they are doing.

I like to cite my entering 1st grade as a great example of a nation unprepared for the boomers. It should have been no surprise that the children entering the first grade were going to overwhelm the system in 1953. After all, we were born in 1947 and, 6 years later we would be entering first grade. You cannot tell me that the hospital maternity wards were not bursting at the seams in 1946 and 1947. Logically, without a plague, we would all grow, age and be ready to start school.
The same is now happening with caring for our aging society. Back in the 90’s Ron Crouch (noted demographer) and I used to do workshops on envisioning the future out to 2020. We presented at the American Society on Aging, and around the Kentucky regions where we were both active. The information on the numbers who are aging has been no surprise, as well as the information on the decreasing numbers of those younger who could provide care.

And, what if we had chosen home schooling for our boomers? Instead of double shifts for 1st grade, we would have been in a no school zone. There simply would not have been enough teachers to go one on one. What makes us think that caring for people at home (one on one) as the population is bursting at the seams is going to be any different? In private duty, there are oftentimes more than one on one care needed. When I had my ElderCare Solutions business, we even had clients who needed two caregivers at once, 24/7/365. So, it took at least 5 caregivers to maintain that one person at home. Unusual, but not unheard of. More likely today it is one or two caregivers for each elderly person needing care.

So, home centered care is the model for the future, and, I think it is a good model, but it has to be done with some sense of reality and thought. The Future of Home Care Project that the AHHQI is undertaking is a great first step. Also, technology will have to play a great part in this care. We are just at the beginning if looking at ways to meet the care needs that are impending.
What scares me today is the people who are now starting these in-home care businesses and buying untested franchises, and running those businesses, with no idea of what they are doing, the nuances of care needs, and what is in the best interest of the client. Join Sam Smith from AXXESS and me at the American Society on Aging conference in March as we explore some of these issues in depth and look at the future of home care in America and what we (as a nation) are doing about it.