Services for aging in place – not provided, not coordinated, not enough

What you can’t see is what you get.  Rant on. You would think by now that there would be a traveling provider of just about everything anyone might need. You can order much of your supplies in your home from the Amazon of all stuff, uh, actually, that IS Amazon.com. These days – you probably know that doctors are making housecalls. Even podiatrists and dentists (did you know this?) will travel to assisted living facilities. Should people with dementia have annual eye exams? (Yes.) What about eye exams inside memory care units for non-verbal 90-year-olds? And what about the boxes of unclaimed eyeglasses by the nurses’ station? Who do they belong to? How can you tell? And how does a person with dementia verify that the current pair of glasses is inadequate? By rubbing their eyes and taking them off?

Looks like even eye care specialists travel.  So what about an optometrist or optician coming in to check the eyes of multiple eye-rubbing residents? Well it turns out that some do make house calls, actually, and they do quite nicely financially as a result. Reimbursements from various insurances cover the costs, and one business relationship with a single assisted living facility can turn up quite a bit of business. For example, check out the assisted living/nursing home page for Dr’s Eye Care in Burlington, NJ: The long-time coordinator there notes that after 20 years of practice, they now serve 20 nursing homes and another 10 assisted living facilities, facilitated by her role as coordinator to keep track of all of the visits, prescriptions, and eyeglasses (including identification schemes to go with easily-misplaced pairs). Now we’re talking about a real business – started by two young eye doctors right out of school.  

And others 'see the opportunity' and capitalize.  When you start looking, there are more and more of these out-of-office players, including traveling services for low-income populations in the Boston area, or various in-home eye-care services in New Jersey – or Eye Travel in Detroit for the homebound.  One wonders what the threshold population needs to be -- either home-bound or in senior housing communities -- for an enterprising eye care practice to capitalize on that opportunity, set up a traveling shop, and get those Medicare reimbursements that would supplement their regular in-office visits. The equipment is portable and the patient doesn’t need to verbalize about whether they can read the bottom row.

Which brings me to Amazon – which does offer in-home services.  Finding this type of service should not require endless online surfing and searching. There are aggregators out there for almost everything else, why not eye care? Let’s use the term 'Boots on the ground' – that term was used when Amazon launched local in-home services in July, 2014. Step one, get people to want to sell their services on Amazon, complete with background checking (fee to service providers is waived for a while).  No, there are no optometry services. No home companion services, no local ride services. Yet. But if you had a nationwide franchise of home care aides, or a nationwide network of assisted living communities, why wouldn’t you want to be on Amazon as a seller of services? Seriously, in this day and age, why is Google the best way to find in-home care or in-home optical care or in-home hair salon services within a specific geography or zip code? Rant off.