The Business of Aging

Will The Changing Economy Bring Families Closer Together? What it Could Mean for Elder Care.

John Sumser is an expert when it comes to employment and recruiting topic. At our recent annual company meeting, John gave a superb keynote presentation where he touched upon how changing demographics and other societal trends are impacting everything from politics to marketing to recruiting - and the opportunities this is presenting. Fascinating stuff and I highly recommend John for any event you are planning. His presentation can be tailored to any company/industry. It's important stuff. 

Anyway, John's presentation got me thinking about elder care.

People say it takes a village to raise a child. This is debatable but when it comes to caring for elders, there is no question about it - it takes a village or at least a team of experienced and caring professionals. Especially when the elder has Alzheimer's.  But most of all, it takes a family. Unfortunately, within the last one hundred years of our society, increasing numbers of people have moved away from home. The number of long-distance caregivers in the U.S. who are caring for an older relative is about 7 million. Long-distance caregivers are generally defined as living more than one hour from the older adult needing assistance.

But a recent USA Today article titled For family, There's no Place Like Your Hometown  shows this trend is starting to reverse - and the economy is a major reasons why. In fact, geographic mobility is at the lowest levels since the government began keeping statistics in 1948 according to a recent study by Pew Research Center.

"People move for economic opportunity, and they stay put for family ties," says Paul Taylor, project director of Pew's Social & Demographic Trends Report. "But if you add it all up, you find ultimately family trumps money when people make decisions about where to live." 

Those who study migration trends say a combination of factors has led to the decrease in mobility, including an aging population (the prime ages for moving are 18-29); a rise in two-career couples, which complicates job moves; a murky employment outlook; fewer moves to traditionally high-growth areas; and the economic slump, whose roots began years before the word "recession" came into play.

My opinion is that this trend of decreased mobility will dramatically increase in the next 10 - 20 years - meaning I believe families will be brought closer together by either (1) children moving back to their parent's hometown or (2) parents moving to their child's hometown.  And the primary reason I believe this will happen is economics.

And the impacts this will have on companies providing products and services relating to the aging population is enormous.

According to Met Life,  the average cost of a private room at a nursing home in the USA is about $77,000. The average monthly "base" rate for an individual residing in an assisted living community is about $35,628 annually. If you have dementia and require additional support, this number can exceed $100,000 per year. And unless you have a long term insurance policy, this is all  private pay. What about in-home care? The average hourly rate for in-home care is about $20. If your needs increase to requiring a full-time live-in you can end up spending $200 per day or over $70,000 per year.

Now, how many families can afford these rates? 

Not many.

And even fewer with the recent real estate and stock market downturns.

As a result, children of aging parents requiring some level of care may be forced to live if not together, closer to their parents.

And this will impact how we market senior services.

Rating Nursing Homes - A New Tool

A USA Today article titled Feds Rate U.S. Nursing Homes  reveals that non-profit facilities fared better than for-profit ones, but that the overall quality of homes left a lot to be desired.

Nationally, 23 percent of the nursing homes rated achieved just a "one-star" ranking overall (out of five). The ratings site, Nursing Home Compare  is administered by the Centers for Medicare & Medicaid Services, part of the Department of Health and Human Services (HHS).  Nearly 16,000 nursing homes are included on the rankings site, which focuses on facilities that are certified to participate in Medicare or Medicaid. Both for-profit and non-profit homes are ranked.

The ratings are based on data from:   

- Health Inspections:  There are three types of inspections including (1) "Comprehensive" whereby the nursing home health inspection process looks at all major aspects of care in a nursing home (about 180 different items); (2) Onsite visits whereby trained inspectors visit each nursing home to check on the quality of care, inspect medical records, and talk with residents about their care; (3) Federal Quality Checks whereby federal surveyors check on the state surveyors’ work to make sure they are following the national process and that any differences between states stay within reasonable bounds. The limitations are that there are some differences in how different states carry out the inspection process and there are also differences in state licensing requirements.

- Staffing: The quality ratings look at the overall number of staff compared to the number of residents and how many of the staff are trained nurses. The limitations here are that staffing data is self-reported by the nursing home, not collected and reported by an independent agency. Also, staffing data are reported just once a year and reflect staffing over a 2 week period of time so it's a snapshot.

- Quality Measures: These measures show how well the nursing home helps people keep their ability to dress and eat, or how well the nursing home prevents and treats skin ulcers. Limitations are that again, the quality measures are self-reported by the nursing home. Also, the quality measures represent only a few of the many aspects of care that may be important to a family.  

When it comes to caregiving, it was not that surprising that non-profit facilities fared better than for-profit ones. We also see the same when it comes to for profit and not for profit hospice programs.  The theory is that for profit entities often times limit care in order to make a larger profit but this is not always  the case and believe me there are exceptions.

Anyway, in spite of the limitations of these rankings, they serve a very useful purpose as they give families and caregivers additional help in selecting appropriate nursing facilities for loved ones. I just wish there were more services like this for in-home care and assisted living which are much more popular today than nursing homes.

These ranking sites and the growing popularity of web 2.0 including blogs and social networking sites for caregivers and senior care suppliers are great for the industry because they can only raise the bar when it comes to care.

Geriatric Nursing – A Noble Profession in Need of Help

I received a very nice article from Kelly Kilpatrick, who writes on the subject of geriatrics.  I am posting it below. Kelly invites your feedback at kellykilpatrick24 at gmail dot com

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Geriatric nursing focuses specifically on aging and elderly patients who require a variety of different types of care.  In the United States, the aging population continues to get larger each and every year and geriatric nurses are needed all over the country to fill positions at various facilities.

Currently, there is a shortage of nurses in the US, which is being filled by people from various foreign countries, including India and the Philippines.   Nurses in the United States on average make great money, on average around $57,000 per year, according to the bureau of labor statistics, and geriatric nurses can expect to receive similar wages.

As of 2006, nursing facilities employed less than 10% of all nurse in the US, with nearly 60% working in hospitals, but this trend is expected to shift dramatically over the next decade, with nursing facilities for eldercare expected to take up to as much as 20% of the nurse for extended care.

Many long-term health care facilities are looking to employ geriatric nurse that are willing to adapt to the various demands of the aging population.  Dementia, cancer complications, and cardiovascular illnesses are just a few ailments geriatric nurses can expect to deal with on a daily basis.

Caring for our aging population is something that is on the minds of many as our parents and grandparents continue to age.  There will be many positions available in the coming years for those interested in a career in geriatric nursing.

By-line:
This post was contributed by Kelly Kilpatrick, who writes on the subject of geriatrics. She invites your feedback at kellykilpatrick24 at gmail dot com

Another Potetial "drug" in the Fight Against Alzheimer's - Vitamin B3

Another potetial "drug" in the fight against Alzheimer's is an over the counter vitamin - B3 (Nicotinamide). Researchers at the University of California have discovered that Nicotinamide lowers levels of a protein called phosphorylated tau that leads to the development of tangles associated with Alzheimer's disease.  In the study, researchers added Nicotinamide to the drinking water of mice with AD. They then tested the rodents short and long term memory and found that treated Alzheimer's mice performed at the same level as normal mice and untreated mice experienced memory loss. This suggests that people with Alzheimer's (even people without AD) may find their memory improves by taking Nicotinamide which can be found at more health food stores.

I also updated my previous blog posting that gives a nice overview of all currently approved FDA drugs and those in the pipeline for the treatment of Alzheimers. 

Differentiating Your Home Care Business

I sat in on a very informative webinar this morning sponsored by Corecubed, a marketing agency that helps owners of home care (private duty) companies with their marketing.

Our company SeniorCareMarketer.com and Corecubed have a lot in common in that we believe in leveraging "content" with a combination of traditional and Web 2.0 marketing/PR tactics to build visibility of your company and drive leads.

The speaker on the webinar, Merili Orsini, spoke a lot about the "spectrum of care options" for in-home care and the marketing strategy of marketing to "referral targets". Good stuff. Merili gave an excellent presentation - she knows what she is talking about.

The webinar got me thinking about in-home care and marketing.  The growth of in-home care agencies is staggering. Several prominent business publications have identified home care as one of the top franchising opportunity at the moment. Generally speaking, there are two types of in-home care companies - franchises and locally owned independent agencies. Some well known providers include:

• Aegin Place
• Always Best Care
• Caring Hearts
• Comforcare
• Comfort Keepers
• Home Care Assistance
• Home Health Mates
• Home helpers
• Home Instead
• Homewatch CareGivers
• LivHOME
• Right at Home
• Seniors Helping Seniors
• Synergy HomeCare
• Visiting Angels

As the primary caregiver for my mom I've had some experience (as a buyer of home care services) with in-home care - from hourly to full time live-ins.  In fact, while researching potential agencies for my mom, I've spoken with most of the companies listed above as well as a handful of independently owned firms.  I've had great experiences and I've had some horrible experiences (where what was promised was not even close to being delivered).

There are a lot of ways to effectively brand and market your home care agency which I'm not going to get into in this blog posting. But I do want to make two very important points that many home care agencies are not aware of or at least their marketing does not reflect it.

Point #1 - You May Be a Local Agency But Many of Your Customers (Buyers) Are Not

You are probably having great success with your local marketing activities from advertising (print/Yellow Pages, cable TV, radio, display), sponsorships, trades show exhibiting, direct marketing, etc.) but these campaigns are just that - local.  Many of your buyers (e.g., caregivers) are long-distance (e.g., live greater than 50 miles from the personal they are caring for) and they may not be seeing your campaigns. Consider these long distance caregiving facts:

• The number of long-distance caregivers in the U.S. who are caring for an older relative range are between 5 million and 7 million. Long-distance caregivers are generally defined as living more than one hour from the older adult needing assistance. - Source: National Alliance for Caregiving and AARP.
•  Caregivers live an average of 480 miles from the people for which they care. - Source: Long Distance Caregiver Project - Alzheimer's Association LA & Riverside, Los Angeles, CA.

As a result, regardless of the size of your business, you should be easily found online and dedicate a significant amount of resources to SEO, online marketing and of course make sure you have a great web site.   This is also why Corecubed's markeitng strategy of targeting referral targets is so important.  And why our product, SeniorCareMarketer is so valuable.

Point #2 - The Most Valuable Service You Can Provide During the Buying Process is Information, Guidance and Support - FOR FREE!

Think of this as sampling or a loss leader in marketing lingo. Most buyers of in home care services are not the actual people who need the service. The buyers are the children or other family members of the person needing in home care. And most of these people have no experience with elder care. Unlike child care where parents have plenty of time to prepare for their child's care needs (e.g., throughout pregnancy) elder care needs typically arise with no advanced notice. So the most valuable service you can provide these buyers is information, guidance and support. Yet, call any in-home care agency and most will connect you to a sales rep who lead right into a sales pitch about their firm. As competition heats up in this field, I would advise in-home care companies to hire or contract with geriatric case managers who can spend one or two hours providing free consultation with the prospect.  Sure, this will increase your selling/operational costs and you may even talk some people out of in-home care (if it is the right decision) but my hunch is your buyers will be grateful for the service and this in turn will reward you with increased business. And it makes for some great branding and marketing campaigns. And who knows, you may even be able to turn the new offering into a profitable consulting or resource and referral service.

Another Way the Aging of America Impacts Employers

A recent poll from LifeCare,  a provider of work-life employee benefits, reveals how the majority of single women who belong to the sandwich generation of caregivers (those caring for children and elders simultaneously) are most challenged by two issues: balancing the needs of their loved ones and coping with the overall stress of caregiving.  Don't bother with the hassle of doing a similar poll of men - trust me, the results will be the same.

When speaking to employers about how the aging workforce will impact them, most talk about attrition and the challenges of replacing the retiring boomers (although given the stock market performance, I think many boomers will extend their careers by a few years).

However, perhaps a greater threat to employers are the costs of dealing with employee stress due to caregiving.

Consider these facts:

• Family caregivers experiencing extreme stress have been shown to age prematurely. This level of stress can take as much as 10 years off a family caregiver's life. - Source: Arno, Peter S., Economic Value of Informal Caregiving.
• American businesses can lose as much as $34 billion each year due to employees need to care for loved ones 50 years of age and older. - Source: Metlife Mature Market Institutes.
• 44.4 million caregivers (or one out of every five households ) are involved in caregiving to persons aged 18 or over. - Source: National Alliance for Caregiving and AARP.

For these reasons, expect a surge in the popularity of workplace programs (employee benefits) that help employees not only cope with stress (Employee Assistance Programs) but also deal with the complexities of caring for aging loved ones (Work-Life Counseling, Resource and Referral Programs).

These are inexpensive employee benefits ($10 - $20 per employee per year) that deliver a huge value to both employees and employers.