Aid & Comfort

With Southwest Florida's population of elderly people-a group expected to grow dramatically as baby boomers reach retirement age-come a variety of business opportunities.

Some provide services to help people continue living in their own homes rather than moving to an assisted-living facility. Other entrepreneurs have found a variety of additional niches that focus on providing help and support to an increasing number of elders.

Geriatric Care Management

Linda Cramer grew up in a household with two grandfathers, an experience that left her with fond memories. After receiving a nursing degree, she became certified in geriatric-care management by the National Academy of Certified Care Managers and has worked for more than 23 years in healthcare with a focus on the elderly. Her company, Parent Care, was founded in 1998 with the goal of enhancing the quality of life for aging people and their families in Southwest Florida.

Even though adult children might visit their parents now and then, in between visits, they worry. A geriatric-care professional can act as the eyes and ears for a client's family, and the family sometimes foots the bill. Such professionals often have training in gerontology, social work, nursing or counseling. The services they offer might include providing for a companion to help with cooking, light housekeeping or other basic chores so a client can continue living independently-and making sure the companion is doing the job.

"I checked in on one client to find that the companion's entire family was having a party at her house and at her expense," Cramer says. "There are many, many caring people providing these services. Even so, you never know. We make unannounced visits, and we interview to make sure that the companion and the client are compatible."

Rates for a geriatric-care manager in Southwest Florida are about $75 an hour, $100 on nights and weekends. A comprehensive assessment to evaluate the condition and needs of the client and make recommendations is $400.

"We are not companions, although we do get involved with quality-of-life issues," Cramer explains. "We are the consultant. We do not have a fiduciary role, although we can be involved with managing households, hiring nurses, cooks or the cleaning service."

Cramer notes that not having a fiduciary role gives the geriatric care manager greater objectivity than some court-appointed guardians who have control of client funds.

Companion Care

For many clients, a trip to the store or help with light cleaning is a godsend. A number of local businesses provide companions who perform such services, at rates of around $17 an hour.

Companions assist with a wide range of activities from shopping and meal preparation to driving clients to doctor appointments or the bank, explains Phillip Millman of Alternative Homemaking with a Heart. They do not provide personal or medical care.

Agencies are licensed by Florida's Agency for Health Care Administration as Homemaker Companion Services (HCS).

Millman remembers mowing lawns and running errands as a child for elderly neighbors. When given the opportunity to open a non-medical homemaker-companion service in Collier County, both he and his wife, Tina, knew that was what they wanted to do. It took two years to make the business profitable.

Twelve years later, they still like the work, but find several forces-from stiff competition to a shrinking labor pool-are driving them out of business.

When Alternative Homemaking with a Heart opened its doors in 1993, the Millmans had little competition. At that time, seven or eight calls a week came from people needing assistance or transportation following a release from the Naples Community Hospital. The hospital has since started providing nursing and homemaker companion services.

"I'm lucky now to get seven or eight calls a year from people being discharged," says Phillip Millman. "The home market is now being captured by the hospital market."

As affordable housing disappears in Collier County, it's becoming more difficult to find employees willing to work for $10 an hour, and other service industries such as restaurants and hotels are drawing from the same labor pool.

"When I first started the business and began running ads, I'd get ladies between 50 and 65 years of age who were more than happy to be companions," he explains. "In the past four weeks, we've spent $200 in ads to find companions and have gotten one response. When you cannot find a home in Naples for less than $300,000 or $400,000, what do you expect people to do?"

Alternative Homemaking with a Heart now has 15 companions, down from 30 a few years ago.

"Originally we were the alternative to a nursing home because there were not as many assisted-living facilities and retirement communities in this area," he says. "When people take a closer look at assisted-care living, they often find the comprehensive package to be attractive."

Millman is so frustrated by the labor shortage and rise in competition that he's looking around the state, even as close as Bonita Springs, for a new home base.

"We may not be able to do it in Collier County anymore, but we like the business," he explains. "My wife and I have respect and empathy for the elderly and feel that this type of care is important."

Carol Fries and Nancy Markim

started We Care shortly after the Millmans launched Alternative Homemaking. The two companies have been known to work together if one or the other is short a companion for a job.

Fries decided to get into the business after watching her parents struggle.

"They were in their mid-80s and living outside Orlando when my mother was diagnosed with cancer," she recalls. "I had an accounting career in Manhattan and came down when I could. My dad didn't know how to boil water. Medicare provided enough for home healthcare and a nurse visited them, but I was just wishing that there was a non-medical service that could take my mother to her radiation treatments and make my dad a meat loaf, or just do anything to make them comfortable. That has become my passion."

Depending on the time of the year, We Care employs between 25 and 35 companions. Many are retired healthcare workers. All are screened for aptitude, to find companions with an interest and concern for others and an understanding of aging and functionally-impaired persons.

Like the Millmans, Fries has witnessed the rapid increase in competition.

"Many, many companion franchises have come into the area in the last four or five years," she says. "There is a strong demand. Sometimes it's strictly for the companionship for individuals that are lonely. When they reach their early 90s, most of their friends are gone and nobody drives anymore. The services that we provide make a huge difference in their lives."

Right At Home, a companion service in Bonita Springs, has seen healthy growth since opening two years ago. The franchise, which employs more than 55 caregivers in Collier and Lee counties, serves about 150 clients. Right at Home often works with assisted living facilities. Support from the franchise sponsor, which includes marketing and Web-page maintenance, gives it a competitive edge.

"This is definitely a growing market," says Danielle Mauder, office manager. "With baby boomers getting into the age where they need help, the momentum will continue to build."

On the Move

Moving is not something anyone looks forward to, but the decision to pack up and move can be especially traumatic for the elderly or infirm. Bill Tray's wife, Carol, visited Florida several times when her mother needed help. After overseeing three moves in a relatively short time, she decided to move her mother to Minneapolis to live with them.

"During that time, she was making a lot of trips down here, and all the movers wanted to do was come in, grab the furniture and boxes and move them," says Bill Tray. "She [Carol] said that if someone was smart, they'd cater to that market."

The Trays decided to open Next Move, a total relocation service that helps people pack, unpack, downsize and clean. While 90 percent of the company's business is geared toward seniors, the personalized moving service can accommodate all ages. When couples move from a home to assisted living, it is often necessary to sell furniture or cars, and send treasured heirlooms to relatives and friends. Next Move coordinates everything. The cost of an average move is between $600 and $750, Tray reports.

They assisted with 70 moves in the first year; by the second, they were receiving so much referral business that they were able to work five days a week and complete 250 moves. Next Move now employs seven, comprising two crews, with two large trucks. A part-time crew handles smaller jobs with a sport utility vehicle. In its third year, the company is on track for more than 400 moves this year.

"There are only a few companies in the United States that are geared for this kind of a total-moving service," Tray says. "If anyone asks, I tell them that I'm more than happy to give them names of several properties that use our service all of the time. Eighty-five percent of our jobs are from referrals."

A Calling from the Heart