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The U.S. Census Bureau reports there are 40 million Americans ages 65 or older, and nearly 10 million are at least 85 years old—the so-called “oldest old.” We are living longer, and increasingly Americans have long term care insurance or some other means of paying for care in their own homes.
“The senior care industry, just for senior home care, has grown more than 40 percent in the last five years,” said Julie Northcutt, CEO of Caregiverlist.com, which tracks the market. “Everything predicts care is going to continue to move to the home.”
She said there are almost 11,000 senior care agencies in the U.S., with 1,000 of them created in 2012 alone.
Cydney Kaplan, a former reality television producer who has a degree in therapeutic recreation, launched Independent Living Concierge in Los Angeles last summer. She rents out her services to high-end senior citizens for $60 an hour.
“I’m a Girl Friday, a rent-a-daughter, or a granny nanny for seniors and their families,” she said. “A lot of seniors have dignity issues, where they don’t want to be seen with a caregiver. They want to be seen with someone that’s a professional and looks like a member of the family.”
One of her clients is 92-year-old Dorothy Sabel, who lives in an assisted living facility. The spry retired real estate agent hired Kaplan to regularly take her shopping, see a movie, or go to the salon. “You have to go out once in a while,” Sabel said. “Cydney does that for me … she does more than my relatives do for me, because they’re so busy.”
Jack Fackrell also saw an opportunity. He was working in sales in the trucking business when he saw a neighbor in the senior care industry. He then co-founded Alta Home care, a full service caregiver company.
“A lot of the nation’s wealth is tied up in the seniors,” he said. Ten years later, Alta now has about 600 clients in California and Louisiana, where it just acquired a smaller company.
“This year we’ll do about $15 million (in revenues),” Fackrell said. He is hiring 15 to 20 people a week, but most applicants are rejected. “The hardest part is finding good people.”
This work can be challenging, and the pay averages $10 an hour. Fackrell said he has tried to make the business more professional. His head of human resources is a former Los Angeles County Deputy Sheriff whose job is to filter out those not right for this career.
New hires in an Alta training session learn things like how to remove colostomy bags. “Watch your facial expressions,” the nurse instructor told the class. “If you have this, ‘Oh my God, this is disgusting’ expression on your face, you’re going to make the patient feel very bad about themselves.”
Home care is not covered by Medicare, which is both good and bad. Good, because it’s not subject to federal budget realities, challenging because many people can’t pay for it.
“I have so many friends who absolutely wish they could afford this,” said 88-year-old LaRae Irvine, a client of Alta Home Care. Irvine used the company to hire Victoria Lomeli, a native of the Philippines, to make meals and provide other help. “I’d die if I didn’t have her,” Irvine said, laughing, “I couldn’t survive without her.”
As for Lomeli, the job provides her with flexibility, and she doesn’t have to lift Irvine. “Lifting is hard for me.” One reason Lomeli took a job with Alta rather than hire herself for cash under the table is because the company pays her social security and income taxes. “That’s what I wanted.” Alta also insures her in case she’s hurt on the job.
Nationally, 4,000 caregivers and certified nursing assistants are being hired monthly, according to Caregiverlist.com.
Alta Home Care received a private equity cash infusion in 2010 from Transition Capital Partners, and large public companies are looking to buy up some of these operations.
“It’s definitely become a very enticing industry for some of the larger corporations that have been centralized more on the Medicare side of the world,” Fackrell said. “They’re looking at the private duty side because we don’t get rate cuts.”
However, this job isn’t for everyone. Cydney Kaplan said when she first started putting together her “granny nanny business plan” she researched potential competition. She found a company doing something similar which had gone out of business. Kaplan called the owner to find out why. “He said, ‘I did it for the wrong reasons’.” He told her there was money to be made, “but he said, ‘Rich or poor, the seniors all had the same problems, and I found it incredibly depressing.’”
Her advice is that you need to like the people you’re serving to be successful. “I love the seniors, learning from them, being around them. I love their energy, even when they’re being cantankerous.” (She added with a laugh that it can be challenging when clients want to talk about their sexual exploits.)
“It’s not fashionable, it’s not glamorous,” said Jake Fackrell of his business, “but these are the people who built the country we have now, and I feel every day that when I go to work, I’m doing something to make someone else’s life better.”