Senior-care industry expands with elderly population

By Robert Rodriguez, The Fresno Bee

September 13, 2008

Winifrede Burke, 96, left, and Leone Burton, 87, get their exercise by hitting a beach ball at Pryor Falls Assisted Living Home on Thursday. Data from the Community Care Licensing Division show that there are 178 residential-care facilities in Fresno County with a capacity of 3,362 people.

California's elderly population is expected to grow twice as fast as the rest of the state by 2020. And those in the senior-care industry are ready and waiting. 

Competition in this multibillion-dollar market is brisk as existing providers jockey for customers and new companies open to join the fray. 

"There is money to be made out there and people know it," said Ivan Flores, coordinator of the Fresno/Madera Ombudsman Program, which helps monitor the senior-care industry. 

Industry publication Private Duty Insider estimates that the nine largest companies providing in-home care to seniors accounted for $1.4 billion in sales nationally in 2006, the latest numbers available. 

Entrepreneurs are jumping into the market, including James Waterman of Clovis, who is putting the final touches on his new company, SeniorCare Organizational Systems. He created the company after struggling to find care for his father. 

Waterman said he pored through books on the subject, made countless phone calls and spent many hours on the Internet. But he said the more information he collected, the more complicated the process seemed to become. 

"I went from one place to another," he said. "It was very frustrating." 

Waterman's company -- www.seniorsos.com -- is expected to launch in November and would provide customers an action plan, personal organizer, live support and advisory services. He said he will charge a flat rate of $199.

He said he realizes he is entering a marketplace with established competitors but believes there is room for more businesses like his. 

"Right now the market is huge," Waterman said. 

Older population grows 

Nationally, the population over age 65 is expected to double within the next 25 years. And by 2030, almost one in five Americans -- an estimated 72 million people -- will be 65 and older. 

In Fresno County, the number of people over 60 is expected to increase 149% from 1990 to 2020. Already, those over the age of 60 represent 13.5% of the 1.1 million people in Fresno and Madera counties. 

These days, nursing homes are not the only option. Private companies that provide in-home care can help seniors stay in their homes. Seniors also can choose to move into country-clublike facilities. 

Sorting out what's best for mom or dad isn't simple. Not only has that spawned referral agencies and consultants like Waterman, even some workplaces are realizing the need and providing elder-care services to their employees. 

Much of the demand is coming from adults squeezed by the responsibility of caring for their own children and elderly relatives. 

"Many more adult children are being thrown into this role, and they are reaching out for help," said Monika White, executive vice president of the nonprofit group WISE & Healthy Aging and adjunct faculty member at the University of Southern California School of Gerontology and Social Work. "They have lives, they have kids and they work. And they are having to make some tough decisions that can be complicated by the many different options." 

In-home care 

Among the more popular options for family members are in-home care providers and residential-care facilities for the elderly. 

David Phillips, a franchise owner of Home Instead Senior Care, an in-home provider of care services, said he remembers being one of the first providers in Fresno when he started 13 years ago. Now there are nearly 15. 

"And more competitors are coming into the market all the time," Phillips said. "In fact, one just opened an office in the same complex that I'm in." He operates out of a building on Sixth Street. 

Home Instead Senior Care is one of the leaders in the industry. Founded 14 years ago in Omaha, Neb., the company has grown to 800 franchises in 12 countries. 

The company provides nonmedical help for elderly people who choose to remain in their homes. Caregivers' duties can include housekeeping, driving to doctor's appointments and companionship. 

Phillips has 250 clients in Fresno and Madera counties and said he could add more -- if he had a more stable labor supply. Turnover in the senior-care industry is high, with entry-level salaries starting around minimum wage. 

Staffing a challenge 

Residential-care homeowner Peggy Staggs said it's hard to find good employees, in part because of the pay level. 

"Your business is only as good as your employees, and that is why we try so hard to find good workers," said Staggs, who operates two homes in the Fresno/Clovis area. "But if I pay more, then I will need to pass along the cost to my clients." 

And with more residential-care homes opening -- 15 in the region the past two years -- Staggs said she is concerned about pricing herself out of the market. Her fee starts at $2,750 a month. 

Data from the state's Community Care Licensing Division show that there are 178 residential-care facilities in Fresno County with a capacity of 3,362 people. While those numbers include large facilities -- like San Joaquin Gardens in Fresno, Orchard Park in Clovis and Elim Place in Fresno -- many are small like Staggs'. 

Ride the bus 

Nancy Altschuler, who has worked in senior care for 20 years, has witnessed many of the changes in the industry. She operates Residential Homecare Services, a referral agency. 

And like others who want to remain competitive, Altschuler is putting her own spin on the search for the right care facility. 

Altschuler is offering a bus tour Oct. 11 of four residential-care communities in the Fresno and Clovis area. Tickets are $15, and she has room for 35 people.

"People want the broad spectrum of what is available out there, and they want to be able to visit as many places as possible," she said. "This is a big decision, and people want to make sure they make the right one." 

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