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CareMates expands elder care platform from Japan to Hawaii
The startup brings the gig economy model to kupuna caregiving, applying technology to a distinctly human and increasingly important endeavor.
We are all getting older—I turn 49 today—but some communities are getting older faster than others. The number of people who will need eldercare threatens to overwhelm the number of people who can provide it, creating a predictable crisis… but perhaps an unprecedented opportunity.
CareMates, a marketplace for services for aging adults, is expanding from Japan to Hawaii, and founder Alan Raby spoke exclusively to Hawaii Bulletin about the local launch as he headed to Washington, D.C. for the annual U.S. Japan Council conference.
Age Is All About the Numbers
Regions worldwide are seeing unprecedented demand for senior care, and few developed nations are feeling this need more starkly than Japan, where nearly 30 percent of the population is elderly, the government recently reported, with one in ten now older than 80 years old.
Hawaii is also aging at a faster rate than most other U.S. states. The so-called “silver tsunami” will raise the percentage of our elderly population from 20 percent in 2020 to nearly 30 percent in 2030. Part of the reason is our higher life expectancy of 83 years, compared to 79 years for all Americans. Many more Hawaii residents are living past 85 than the rest of the U.S.—2.5 percent to 1.9 percent, respectively.
According to the Healthcare Association of Hawaii, the need for healthcare professionals exploded by 76 percent between 2019 and 2022. That reflects an average healthcare job vacancy rate of 17 percent, compared to 10 percent just two years prior. Job turnover rose to 20 percent, and the average time to fill a position is six to 12 months.
Without a doubt, addressing these issues will take a statewide, cross-disciplinary approach, involving public policy and the private sector as well as community and nonprofit commitment. But as we’ve seen the “gig economy” disrupt and transform everything from transportation to home and professional services, technology is a potent pathway to increasing access to elder care.
‘There's got to be a better way’
Originally from Canada, Alan Raby followed a decade in the military with a 30-plus-year career in tech. He started at PeopleSoft, then joined a mobile banking startup based in Toronto when mobile banking was just catching on.
“That was the first startup I did and how I ended up moving down to the states,” he said. “Exactly 23 years ago, I had Wells Fargo as a client and Visa as a client and Bank of America as a client.”
While he developed his entrepreneurial skills he also worked with familiar names in business, including Sony, AIG, and Mirai. The latter had him splitting his time between San Fracisco and Japan, and it was in Japan where he saw firsthand the demographic crisis facing the country.
It stirred in him memories from his early college days.
“Many years ago, when I was 18, I was going to university, but my parents lived about 4,200 miles away from my grandmother, my dad's mother,” he recalled. “And so when I was going to school in Toronto, my dad would tell me, 'Go visit your grandmother as much as possible.’”
“One Friday night, I'm over there for dinner, and she cooks me dinner—and about an hour after that she goes, ‘What do you want for dinner, Alan?‘“ Raby continued. “I'm, like, ‘Grandma, you just cooked me dinner.‘”
Over time, he noticed that his grandmother was forgetting information and misplacing her things. Finally, one night, she leaves the house.
“She ends up going to a house where my father and his brother were raised in the 1940s,” he said. “The door's unlocked, so she walks in, and she looks at these people— this family has been living there for about 20-some years—and says, ’What are you doing in my house?’”
Raby says she was eventually put into an elder care facility, where he would visit and watch her ongoing deterioration. Soon afterward, his best friend’s father went through the same decline.
“I experienced that firsthand,” Raby said. “I started looking at this and going, ‘There's got to be a better way for people to age in place.’”
CareMates was that better way, which he founded and started in 2021 in the midst of the pandemic. The platform grew to handle several paid pilot programs in Japan and drew a major strategic investor, and in sharing his story at an international tech conference—hosted on Zoom, of course—someone took notice.
“Literally this time last year, this guy tracks me down and he's in Hawaii and he goes, ‘Hey, you ever thought of doing something in Hawaii?’” he said.
“We started looking at the demographics of Hawaii and we're like, ‘Wow, this is identical to Japan: aging society, shortage of care providers, reverence for older adults,‘” Raby continued. English-Japanese bilingualism is also strong in the islands, with both languages supported in CareMates from the beginning.
“So here we are, we're in Hawaii now, in the process of onboarding people and launching in Hawaii as we speak.”
Connecting caregivers to empowering kupuna
Raby describes CareMates as a way to help seniors remain independent while getting support tailored to their needs, harnessing technology, the gig economy, and human compassion.
“Think of it as a shared economy platform,” Raby said. “We enable kupuna to age comfortably and remain active in their own homes.”
“We look at the aging journey in total,” Raby added. The platform offers financial planning, lifestyle coaching, daily caregiving, and even dementia prevention through analysis of users’ lifestyles and science-based “prescriptions. “We have these very unique curated services.”
He says he’s seen several pure tech plays in the space fall flat.
“When you start caring with older adults, if you do 100% tech, it’s not going to work—you’ve got to blend the technology with the people piece,” Raby explained. “We’re a blended people- and tech-driven solution.”
Key to the CareMates vision is that the pathway starts before someone is considered elderly.
“When you look at the aging journey, people are living a lot longer than they were 30 years ago, so when people start to realize that they're going have to retire, they tend to be in their late 40s, early 50s,” he said. “So right now we offer financial planning services to start.
“Then we offer lifestyle and wellness activities, because once people start getting into their 60s, and they're wondering what they’re going to do next and want to remain active and healthy,” Raby continued. “Then we have companion care services, because when you start getting into your 70s, you start running into mobility issues.”
Perhaps not surprisingly, artificial intelligence is also a part of the CareMates platform. Its built-in virtual assistant is called “Hachikō,” based on the legendary Japanese dog.
“It fetches information for you,” Raby said, noting that Hachikō can also translate among 12 languages, enabling caregivers who don’t speak the same tongue as clients—including Tagalog, as both Japan and Hawaii have strong Filipino representation in the health care field.
“In Japan, because the care provider shortage is so acute, they're actually recruiting people in from the Philippines, Vietnam and Indonesia,” he said, noting that ChatGPT was able to replace a more manual translation piece.
“With Hachikō GPT, you could probably do 100 languages,” Raby said.
For now, he said, the translation piece is text-based, but voice-based interactions are “coming down the road.”
Although CareMates is a startup, it has a solid foundation, with real revenue and yet-unnamed strategic investors that will probably be announced early next year. CareMates has a distributed team that includes staff in Japan, Hawaii, California, and Texas, a development team in the Ukraine, and an AI and machine learning team at the University of Toronto in Canada.
While it’s business-to-consumer based now, business-to-business deals are being discussed, Raby notes.
CareMates in Hawaii
Although Raby says CareMates is already built out well enough to function in as many as 40 different countries, it is currently onboarding local caregivers and clients specifically for its Hawaii debut.
While the demand side is obvious, the supply side is still carefully structured.
“We offer everything from financial planning, lifestyle and wellness activities, and companion care,” Raby explained. “When you go through the process, we do background checks on everyone, and that’s piece number one... it all depends on what you're coming in doing.”
“If you come in as a financial planner, we're going to want to see certification on that as well, it’s not just someone rolling om off the street and saying, ‘Hey, I got an MBA and I took a course in finance,’” he continued. “When you get into hands-on care, we're going to want to see certification for that as well, make sure you're actually a CNA or something, you're certified for lifestyle and wellness and companion care.”
The CareMates platform is fully up and running, e-commerce and payments included, and joining as either a client or service provider is straightforward.
“If you go to gocaremates.com, there's a form and you could register either as a provider or as a user, and we review those every day,” Raby said. “We also have Melissa Kim sitting over in Honolulu and you can just email her at firstname.lastname@example.org and she would be more than happy to meet with you.”