Business Finds Innovative Tech Solution for Home Health Care

November 28, 2023

Neal Shah has experienced firsthand the stormy world of caring for family members with health crises. He couldn’t stop thinking that there must be a better way to help people with home care.

Much of the home care he found was expensive, inconvenient, and of uneven quality. It was difficult to find quality help for services such as companionship, cooking meals, and doing light housework.

“Not to offend anyone,” Shah says, “but the home care industry is really broken.”

So the former Wall Street hedge-fund manager made an abrupt career change by founding CareYaya, an online registry that offers a simple solution: Matching young adults pursuing careers in health care with clients, mostly seniors.

Shah has found a way to tap the creativity, ambition, and great interpersonal skills of talented college students and give them flexible, useful experience – all for a $15-$20 hourly wage that’s higher than what they could earn at most other home care companies or jobs in retail or food service.

The new home care model is a win-win for everyone. The seniors and/or their families pay the young adult caregiver directly, far less per hour than the typical $30 that other home care companies charge. The caregivers are eager to give the best home care possible because they are gaining experience relevant to their field. The seniors love bonding with young adults – in many cases developing relationships like a grandparent/grandchild.

IDEA ATTRACTS NATIONAL RECOGNITION

College students from universities throughout the Southeast – about 3,000 of them – have signed up to be CareYaya caregivers. The number grows every day, mostly by word of mouth among the students. The company has received national recognition from AARP, which named CareYaya as a top 10 tech innovator for seniors – the only home care company chosen among other winners that typically offered products such as hearing aids. The AARP AgeTech Collaborative program has offered CareYaya start-up support and other resources to scale the business nationwide.

Last spring, the company was also one of 5 winners of the first annual Health Equity Innovation Challenge sponsored by Atrium Health-Greater Charlotte North Area and other collaborating organizations. Each winning business received a $50,000 investment. CareYaya was also recently selected as top 10 out of 500+ technology startups across the South by Venture Atlanta and invited to present at its prestigious Venture Atlanta conference. The event is the biggest innovation and venture capital conference in the South, attracting 1000+ venture capital and angel investors.

For now, Shah is operating the registry at no profit, using funds from grants and angel investors to hire a few employees and to build out the online platform to meet the rapidly growing demand.

In fact, his business model doesn’t call for him to ever make money from the caregivers or seniors themselves. “We are not focused on profitability right now. We have ample support from grants and angel investors and are focused on running it in a low-cost and capital-efficient manner. Our hope is that if we grow it big enough, other businesses and institutions that have a stake in caregiving will help us make it sustainable, such as large corporations who want to help their employees manage family health care needs – or even the government through Medicare.”

HOME CARE CHALLENGES HIT HOME

Shah was managing a $250 million hedge fund in New York when he began to see how the challenges of caring for family members could strain even the most committed caregivers, including his own family.

“I actually started the business after I had a couple of personal care experiences involving my grandfather with dementia, and then caring for my wife through cancer,” Shah says. “And, you know, it’s a lot of stress. I tried to outsource the work to agencies and I found the cost was very high and then the experience – the quality level – was pretty low.”

With most home care agencies charging in the neighborhood of $30 an hour – yet often paying the caregiver only $12 – it’s easy to see why the traditional home care model doesn’t work for everyone, Shah said. “It’s very expensive for families, and then the caregiver is keeping less than half of what you’re paying. If a caregiver can get a job that pays more at Walmart or McDonald’s, many of them leave.” In addition, many companies require that a client commit to a minimum number of hours per day, even if that is more than the client really needs.

When Shah’s mother had to assume the responsibility of finding good care for her father, she quickly found that she was not satisfied with home care options and decided to do the care herself. She thought the arrangement would be temporary. But in too many cases, “That turns into years of doing it yourself,” Shah said. “She was already later in her career, and after my grandfather passed away, she had difficulty in going back to the workforce.”

Even from a distance, Shah could see the psychological and physical strain on the family. Then Shah unexpectedly became a fulltime caregiver himself when his wife was diagnosed with an aggressive form of cancer. She endured long stints of chemotherapy and multiple surgeries and was even in a medically induced coma for a month.

“It was basically three years of hell,” Shah said. “Ultimately, we had a successful outcome and she has now been in remission for a couple of years.” Although doctors had told them their chances of conceiving a child were near zero, his wife miraculously had a child not long afterward. They now have a healthy 2-year-old daughter.

BURNOUT INSPIRES NEW CAREGIVING MODEL

Despite the happy outcome, Shah was left in a haggard state.

“I’ve been in so many hospitals and seen so many other people going through this stuff that could use the help. Family caregivers burning out. People driving themselves to chemo. I couldn’t believe it. I mean, how many elders are going through cancer treatment and they’re driving themselves to chemo, getting the infusion, and driving themselves back?”

During his wife’s illness, Shah and his wife moved back home to Raleigh to get support from his family. As her prognosis improved, he began thinking about changing careers. “I wondered if I could apply my knowledge and skills to something with great social impact across the country because I’ve lived it firsthand. It was also an opportunity to build a scalable technology business akin to Amazon or Uber.”

In 2021, Shah and Chief Technology Officer Gavry Eshet began building a technology platform that would compile self-submitted information from qualified caregivers and match them with people who need the care. CareYaya would provide only the online registry and would not employ the students directly. Families with care needs would directly pay the caregivers for their flexible services, with no minimum shift requirements. Some clients use the service a few times a month, others several times a week.

Shah and Eshet named the business CareYaya as a catchy, positive name, setting it apart from many other home care companies’ much more serious branding.

“Yaya is also the Greek word for ‘grandmother,’ and in Swahili and Thai, it means ‘caregiver,’” Shah said. “It’s also an acronym for ‘You Are Your Advocate,’ alluding to the future of self-directed care. We had a lot of intended meanings and the word conveyed them all.”

COLLEGE STUDENTS DISCOVER CAREYAYA

CareYaya officially launched in 2022 and initially recruited qualified caregivers of all ages. “I just thought by improving caregiver pay and connecting people directly with families and cutting out the middleman, everybody would be better off,” Shah said.

But the secret sauce for his business came quite by happenstance: College students started discovering his creation. Conventional caregivers who were used to working through agencies found the CareYaya software difficult and weren’t used to signing up for a service on their cell phones.

“But students were signing up at UNC-Chapel Hill,” Shah said. The students told him repeatedly that they could find no other job that would pay them well while offering the flexibility of working during the school term. Many were planning to pursue further education in health care which required many hours of caregiving experience. Some seeking to become physician’s assistants, for example, must earn a minimum of 1,000 hours – and for the most competitive programs, 2,500. College graduates often take one to two years off from their education to earn the hours.

“So these students were signing up left and right, sophomore year, junior year, and they’re like, ‘Well, if I can get flexible hours around my schedule I’ll just do this every week, as many opportunities as I can get.’ ”

Shah said that in addition to being bright and eager to do a good job, many of the caregivers are embraced by clients who welcome them into their homes like a child or grandchild. Young students often have a special way of connecting with older clients.

The students are not doing in-depth medical care, Shah says, but companion care. They’re not bathing patients, for example. “The easiest and safest need we can address is companionship. That’s a big need. A lot of people have companion care needs where they just want somebody around Mom and Dad because they’re recovering from a broken hip, or maybe they have mild to moderate Alzheimer’s or dementia,” Shah said.

LIKE A FAMILY

Nirvana Tari is one of those students who found the perfect relationship and working schedule for herself and John Moses, D.D.S., a 98-year-old former dentist who benefits from her companion care.

Tari, a graduate of Elon University, found the CareYaya platform as she was “scrambling” to find a way to beef up her care hours before applying to a PA program.

“I stumbled upon CareYaya and I realized that it was literally the perfect answer to all of my questions because they didn’t require any certifications on my end, so I didn’t have to spend thousands and thousands of dollars on top of the tens of thousands of dollars I’d already spent getting a four-year degree,” she said.

Tari said the hourly wage she earns through the arrangement with CareYaya was higher than any other program she could find. “The most important part of it was that I was going to go into somebody’s home and actually get to build a relationship with them rather than just being an EMT or something, which would have been an alternative.”

Tari was paired by CareYaya with Moses, who lives in Charlotte. His family found CareYaya through a care manager. Moses, who lives independently, needs somebody to assist him with tasks such as meal preparation, rides to church, and organizing his medication schedule.

“I was married for 68 years and my wife died in 2020,” Moses said. When Tari came, he said, “That was a great day in my life. I’ve been cherishing her ever since then.”

Moses, who practiced dentistry into his 90s, plays games, watches movies, and listens to music with Tari, who considers her relationship with him to be an education for herself.

“I’ve gotten to watch movies that I would have never watched otherwise,” she said.

Tari said a young woman in her 20s rarely has the chance to become friends, almost family, with a person several generations older, and she feels fortunate to know Moses.

Moses, whose family is from Lebanon, found an especially close bond with Tari, whose family is from Iran.

“I was fortunate to be invited to dinner by her mother and father,” Moses said. “And they are wonderful, wonderful people. And I found out that being from Iran, we had a lot of things in common things because of our culture.”

Shah said Tari and Moses are the perfect duo of caregiver and client – the blend that is a step above typical home care agencies.

Tari is a strong ambassador for CareYaya and she has become the company’s director of community engagement, a position that seems to come naturally to the bubbly young woman.

GROWING THE SCALE OF CAREYAYA

Part of Tari’s job will be to address a major challenge of CareYaya: helping to screen the hundreds of students and graduates applying to be caregivers. So far the CareYaya portal includes students in the Research Triangle, Charlotte, Concord, Greensboro, Winston-Salem, and other university towns in the region. The idea has spread through word of mouth and professors and health care career advisors telling students about it. Now students at Harvard, Emory, University of Michigan, UT Austin, Ohio State, and other major universities are signing up as well.

At this point, CareYaya is somewhere between a growth opportunity and a thriving business. It’s not making a profit because Shah isn’t collecting a fee when the company matches a caregiver with a client. His company is simply providing the technology platform that makes the new care model possible. Right now he is using money from investors and grants to reinvest in technology and strategically hire people who can help him improve upon and grow the concept.

But Shah has already attracted interest – and investment capital – from people in the health insurance industry and from employers who may someday see this as a valuable service to offer employees or insurance clients.

And that’s where Shah sees the business opportunity. He is also beginning to test some Artificial Intelligence applications that the students can use with their clients. The first project to launch has been an art therapy application that allows the student caregivers to generate on-demand art for the seniors, based on scenes they would like to see.

The possibilities of AI are enormous, Shah said. Smartphone applications are being developed that would use the phones’ eye-tracking technology to analyze the fluctuation of a person’s pupils – possibly helping to diagnose Alzheimer’s and dementia. Another application under development would use smartphones to help diagnose diabetic retinopathy.

Shah dreams big. “As CareYaya expands across the country with this college student care force that is tech-savvy, we think we can deploy a lot of technology and turn them into community health workers – something that is desperately needed as many elders have transportation barriers or limited access to the formal healthcare system. As CareYaya is rapidly spreading around the country, we dream of the impact we can soon make on the 50 million family caregivers who are struggling for better care options.”