COVER SERIES
CARE IS NOT A PLACE
Why behavioral design is the next innovation in homecare
By John McLeod
Traditionally, innovation in homecare has meant adding more services, increasing specialties and integrating additional provider technology into current workflows. Yet despite these advances, families facing real-world care decisions often default to facilities. Not because homecare lacks compassion or capability, but because it lacks something more fundamental: a built-in confidence that things will be OK.
Care Has Been Treated as a Location, Not a System
Families navigating care decisions are rarely acting from a place of clarity or encounter homecare at a calm moment. Decisions are made after a hospitalization, a fall or a cognitive shift, when emotions are high and information is fragmented. For instance, a daughter might rush to find care after her father's sudden fall or loss of reasoning, overwhelmed by fear and uncertainty.
In these moments, families are not evaluating care models on paper; they are asking a more visceral question: How will my loved one be safe and cared for here? How will this hold together when things get hard? So, when deliberating on the best choices for their loved ones, they often are not actually choosing between “home” and “facility” but rather the perceived structure and security of each.
Facilities signal structure by default: Staff, routines and information flow seem reliable and predictable. In contrast, homecare is often characterized by "invisible coordination,” such as caregivers communicating through informal channels like group texts or handwritten notes, making it difficult for families to track care status who is responsible for which tasks. Caring may indeed be happening, but the system supporting it is hard for families to see.
Even though studies have shown that homecare patients often experience similar or even better health outcomes compared to those in facilities, families remain concerned due to the lack of visible structure. Without a system that provides clear structure and visibility, homecare can feel risky.
"When progress is visible & responsibilities are clearly defined, homecare becomes more manageable & family provider trust and relationships are enhanced."
Behavioral Infrastructure: the Next Innovation Layer
Homecare has traditionally focused on tasks and billable hours, which can hinder families from tracking changes and make collaboration among caregivers difficult. But care is a complex, ongoing process involving multiple people and locations, and it often lacks clear structure and systems for families.
Communication delays, such as updates not reaching every team member in a timely fashion, can increase the risk of incorrect care decisions and preventable health emergencies and erode trust among families and providers. For example, a family member might forget to administer important medication because a last-minute schedule change was not communicated to all care providers, resulting in a missed dose. Similarly, if a caregiver is unaware that a physical therapy session was rescheduled, the patient may miss critical exercises, potentially delaying recovery.
These scenarios illustrate how poorly coordinating care across various providers can easily lead to confusion and overlooked responsibilities. Rethinking care systems through behavioral design means building technology solutions that support and focus on what is happening now, matching care to real-life habits and reducing errors, all without replacing human interaction. Such innovations establish real-time connections that make homecare feel efficient and simple and strengthen relationships between families and providers.
Shared routines, structured check-ins and transparent records build trust and clarity. When progress is visible and responsibilities are clearly defined, homecare becomes more manageable and family provider trust and relationships are enhanced.
From Fragmented Tasks to Coordinated Outcomes
When care coordination and communication tools define the care structure needed, then the result is the achievement of the desired caregiving behaviors. Technology and artificial intelligence (AI) enabled infrastructure addresses these realities for families by making care visible—surfacing what needs attention, enabling routine and care momentum, and injecting motivation, team member insight and chat-based real-time connection. It doesn’t replace human care; it reinforces it. Simple mechanisms such as shared routines, consistent signals, structured check-ins and transparent records reduce ambiguity and build trust.
Families stop asking, “Is anyone really overseeing all this?” and start saying, “We know what’s happening, and we have peace of mind knowing what to do next.” That shift in perception is powerful. It reduces unnecessary escalation of questions and issues to in-home care agencies and strengthens their relationship with families, restoring their confidence in making a choice to age at home. Families can see progress, understand patterns and know who is responsible for what, and homecare shifts from feeling fragile to feeling well-managed.
Scaling Aging in Place Requires More Than Compassion
While the homecare industry is characterized by its compassion and dedication, it faces a systemic shortfall in infrastructure capable of supporting human behavior at scale. Homecare agencies should consider whether they wish to distinguish themselves in the method by which their care is delivered, rather than by the all-too-familiar offer to provide care.
As demand for homecare increases and patient acuity rises, informal methods of care coordination and trust will become insufficient. Adopting behavioral design can provide an effective solution without necessitating additional layers of staff or excessive documentation.
“Research has shown that tech-enabled homecare models can improve safety & reduce hospital readmissions by as much as 20%.”
In summary, when behavioral change is intentionally added to care and supported by technology and AI, families gain clearer insight into what’s happening and gain confidence through a stronger sense of security in aging in place. And research has shown that tech-enabled homecare models can improve safety and reduce hospital readmissions by as much as 20%. As a distinguishing brand proposition, behavioral design helps agencies distinguish themselves through more visible, effective care that delivers families next level peace of mind. In this way, technology and AI do not replace the human touch—they reinforce it, strengthening trust and confidence in the choice to age at home.
John McLeod is the founder and CEO of Proxwell, a care operating system advancing how families, caregivers and care organizations coordinate in-home care and aging in place. As an investor and advisor to CEOs and closely held business owners, he focuses on health care innovation, enterprise value creation and succession and transition strategy. McLeod has served on corporate and nonprofit boards, taught as an adjunct professor at New York University and resides in Bucks County, Pennsylvania. Reach him at john@getproxwell.com. Visit getproxwell.com.
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