In the growing caregiving market, digital health can be an important tool in helping people take on this difficult role, experts say.
An analysis from The Holding Co., a company that works with caregiver technology startups, revealed that the home-based care and aging-in-place market was valued at $151 billion in 2021. The Holding Co. also found sales of products and services supporting aging in place have grown 13% annually since 2017.
Experts say these needs will only increase as the population ages. Currently, there are seven potential family caregivers per older adult, according to the Centers for Disease Control and Prevention. By 2030, there will be only four potential family caregivers per older adult, the CDC estimates.
“The vast majority of caregivers have no idea they’re in that role,” said Alexandra Drane, CEO and co-founder of ARCHANGELS, an engagement and resource platform for caregivers and healthcare organizations. “They are the linchpin for our society.”
Caregivers are a broad term to describe those providing supportive care for at-risk or elderly populations. The litany of tasks varies widely but can range from cooking, cleaning, bathing or administering medication.
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Caregiver stress, one of the metrics ARCHANGELS ranks, is surging. The platform company found 45% of young caregivers—aged 24 to 43—have had serious suicidal thoughts in the past 30 days. But the problem isn’t specific to younger caregivers. Of all caregivers scoring in the ‘high intensity’ stress category, 91% experienced adverse mental health symptoms.
Data from ARCHANGELS found the number two reason people have left or cannot join the workforce involves the demands of caregiving.
Digital health to the rescue?
Experts say digital health solutions can help aid the problems associated with caregiving.
The ARCHANGELS platform aims to provide resources to caregivers and providers, while others seek to better connect supply with demand. Platforms like MeetCaregivers, a Massachusetts-based company matching its network of nearly 10,000 potential caregivers, serve as a marketplace for families seeking to connect with caregivers. Florence Furaha, MeetCaregivers’s founder and CEO said this service allows for consistency in care for seniors and their families.
“We know that caregivers tend to jump job by job due to the fact that most of the time they don’t feel like the matching fits their needs,” Furaha said. “When we are doing the matching between the seniors and the caregivers, we want to have a better understanding of the caregiver skills, but also personality, hours they are looking to work [and] what type of salary or hourly wage they are looking for.”
While industry turnover and care consistency are two common problems, others remain. Many lower income families without large savings are unable to afford services. The monthly median cost of having an in-home caregiver in 2020 was $4,481, according to elderly-focused insurance company, Genworth.
Dr. Mattan Schuchman, an assistant professor of medicine specializing in geriatrics at Johns Hopkins University, said compensating caregivers is not a panacea. While increasing compensation would likely attract more formal caregivers, it results in additional out of pocket burden for families and individuals.
“I think the underlying problem for both informal and formal caregiving is that it's just really undervalued,” Schuchman said. “It's extremely hard work, and often is paid near minimum wage.”
Many caregiving services are not covered by Medicare, particularly for personal care or housekeeping. While Furaha admitted the majority of MeetCaregivers’ business derivers from private payers, she said the company is focused on growing relationships with companies that offer Medicare Advantage plans.
“It’s extremely hard work, and often is paid near minimum wage,” Schuchman said. “People can earn more money doing work that’s less labor intensive. We just don’t have enough people to staff the need for all the formal caregiving needs that we have.”
Schuchmann is skeptical digital health solutions can fundamentally solve the problem but admitted market solutions can better align supply with demand, while helping connect families and patients with resources. He said patients benefit from quality and consistent caregiving.
“I can’t quote this in a study, but it’s just been my observation that the quality of caregiving is one of the biggest determining factors on how well a person does with their health,” he said the lack of its inclusion in the Affordable Care Act shows it is undervalued.
Drane and other experts said the cost of care paired with caregiver sentiment can be often be traced back to the payment structures and compensation.
“These issues have always been there. The difference is the attention that’s being paid to them, because they can no longer be ignored. There are gaps in the labor force that are unignorable,” Drane said.
Interoperability
Jennifer Wolff, director of the Roger C. Lipitz Center for Integrated Health Care at Johns Hopkins Bloomberg School of Public Health, said the care delivery system is broken and dysfunctional for caregivers. While digital health is potentially a solution, poor interoperability between platforms further increases the burdens for caregivers, she said.
“For the people who have the most complex needs, the fragmentation of care is just tremendous,” Wolff said. “They may see ten different providers that are not in the same system, so family is often engaged in bridging communication between clinicians.”
A recent paper Wolff co-authored reveals how intelligently designing electronic health records with caregivers in mind could drive equity. She said allowing caregivers to sign onto an electronic health platform and interact with providers would have benefits.
Wolff said improvements could happen quickly as employers have begun to recognize the costs associated with caregiving. In addition to contributing to the tight labor market, caregivers present other challenges to their employers, most often in the form of lost productivity or increased absences.
“A lot of that is being on the phone with insurance companies trying to get bills paid or scheduling appointments with clinicians,” Wolff said.
While long-term, systemic change will be slow, Wolff is confident incremental problems can be addressed more quickly, while still yielding results. Existing digital health solutions, like shared health portal access, already exist. Once more patients know about these solutions, benefits will follow, she said.
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