Caring for elderly parents is stress incarnate. Having to help someone suffering from a serious illness or sliding into dementia is a huge burden to pile on top of the demands of everyday living. Taking care of the elderly in your home offers a needed service and can be a profitable business.
TL;DR (Too Long; Didn't Read)
Research your community's population and elder-care services to see if there are enough seniors in need of care that you can turn a profit. Then, define what services you intend to offer: purely socializing during meals and board games or will you offer medical care and physical therapy? Learn about the regulations covering adult day care, including licensing and certification requirements.
Adult Day Care
The simplest way to start taking care of seniors in your home is by setting up an adult day care (ADC). Unlike a nursing home or assisted living, you're taking care of the elderly in your home during the day, after which they return home. The importance of elderly care is that your clients get a chance to socialize and engage in activities together, which makes them healthier and happier. Their regular caregivers get a badly needed break.
The services adult day care centers provide vary greatly but often include art, singing, games, social work and meals. If you have trained medical staff, you can consider providing health monitoring, physical therapy or speech therapy. Some day care centers specialize in handling a particular population, such as adults with dementia.
The Importance of Elderly Care Locally
The first step to taking care of the elderly in your home is figuring out if there's a market for it. Unlike, say, Amazon, your customer base won't be too far from your home. If you need customers to come from more than an hour away, you may be out of luck. Market and community research can tell you whether you can make money caring for the elderly.
- Study the population in your community and neighboring areas. Is there enough of an elderly population to make a go of an adult day care? Demographics from the U.S. census can help you figure this out, and they're available online.
- What elder-care services are already available? It may be this market niche is covered or you may find there are nursing homes and assisted living but no ADCs available. Visit senior programs and existing centers to get a feel for what they're like; reading the website may not give you a sense of the offline reality. It's possible that even if there are ADCs in operation already, there aren't enough for the total senior population.
You should also interview a variety of people with specialized knowledge. People involved with the senior population will probably be willing to talk, as offering seniors and caregivers more help is a good thing. When you open your business, they may provide valuable referrals if they think you're worth it. Potential people to interview include:
- Local agencies dealing with Alzheimer's.
- Support groups for caregivers dealing with arthritis, Parkinson's disease, mentally or physically handicapped seniors and so on.
- Agencies and organizations that work with seniors.
- Social-service professionals at local hospitals and health-care facilities. They know what services patients need when they leave the facility.
- Physicians specializing in geriatrics.
Defining Your Mission
Once you have a grasp of the potential client base, you can focus on identifying your target market. This will reflect what services the elderly population needs and what services you or your staff are qualified to provide.
- If there's an underserved senior demographic, such as Russian or Mexican immigrants, could you build a connection with that group and cater to their particular needs?
- Is there a large enough diagnosis-specific population that you can specialize in? Possible options include the physically disabled, frail but mentally sharp seniors, HIV-positive seniors, dementia sufferers, people with chronic illness and so on.
- Do you have the skills to provide nursing care, physical therapy or memory care? Can you hire someone who does?
- Can you provide transportation for your clients or do their caregivers have to drop them off?
- How many clients can you care for effectively?
If you can provide skilled medical care on-site, that broadens your options. However, if there's a market in caring for elderly shut-ins who just need to socialize, you may be able to build a business taking care of healthy seniors in your home.
Paying for Services
Making money from an adult day care in your home is more complicated than, say, making money selling jewelry or designing websites. There are multiple possible funding streams that can make it easier to turn a profit but harder to chart the best path for your business. Private pay, where the senior or their family puts up the money, is the simplest but far from the only option.
You may want to work with multiple funding sources so you have flexibility in who you take as a client. The VA, for instance, may pay for adult day services but can limit coverage to two days a week. Medicaid may pay for services for some clients under a Medicaid waiver but only if you become a Medicaid-certified provider. Other options include:
- Private insurance
- Older Americans Act
- Social Services Block Grants
- Grants for caring for clients with Alzheimer's or other forms of dementia
- Child and Adult Care Food Programs (CACFP, USDA)
- State or county funding for senior-care programs
Licensing, Certification and Regulation
More than half of the 50 states require a license to take care of elderly people in your home or elsewhere. A minority require certification instead of or as well as a license, but some states require neither. Even states without licensing or certification may set operating standards for ADCs or require you to commit to state standards if you receive any public funding. Your local Council on Aging or state's health department can fill you in on the requirements.
- If you keep your daycare small, your state may exempt you from licensing. In most states, the maximum is three to five clients, but Tennessee allows up to 10.
- If you're providing medical care, you'll probably face tougher requirements than if you focus on fun social activities.
- If you offer meals, that may be another layer of regulation. Florida, for example, requires a food-safety inspection to make sure nothing is contaminated or spoiled.
- Some states limit the amount of time you can care for your clients or how sick they can become before you have to discharge them. In Vermont, for example, if a senior's needs exceed the level you're certified to handle or the client is a threat to themselves or your staff, you have to discharge them.
- Even if there's no formal regulation, you or your staffers abusing your patients in any way is a crime.
Is Your Home Suitable?
As your home is now a place of business, you should check whether this violates any zoning, homeowners association or other requirements on home businesses in your community. You should also think carefully about how to design the day care area to meet any state requirements, as well as keeping your clients safe and happy.
- Is everything ADA accessible?
- Do you have enough bathrooms for the number of clients you intend to care for? If you have physically frail or disabled participants, will they find the bathrooms usable?
- Do you have space for both group activities and private spaces? If your clients don't want to socialize, they should have the option not to.
- Are the premises clean and sanitary?
- Do you comply with building codes and fire-safety standards?
- Is the flooring non-slick? Are the carpets secured so they won't trip anyone?
- Is the furniture your clients will use sturdy enough not to tip over?
- Do you have storage space for cleaning equipment and chemicals, business files and any medication your clients need?
- Can you get everyone outside quickly if there's an emergency?
- AARP: Adult Day Care: What Family Caregivers Need to Know
- NADSA: Planning and Creating Successful Adult Day Services and Other Home and Community-Based Services
- Adult Day Care: Starting an Adult Day Care
- California Association for Adult Day Services: What Are Adult Day Services?
- Health and Human Services: Overview of Adult Day Services Regulations
- Florida Health: Adult Day Care
- Make sure you get to know your state's guidelines on taking care of the elderly in your home as a business.
- Talk to your insurance company on whether you need additional coverage if you plan to look after senior citizens in your home.
Fraser Sherman has written about every aspect of business: how to start one, how to keep one in the black, the best business structure, the details of financial statements. He's also run a couple of small businesses of his own. He lives in Durham NC with his awesome wife and two wonderful dogs. His website is frasersherman.com