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originally published: 2023-11-03 12:50:57
Tauseef Riaz and Saba Tauseef are Cofounders of ConsidraCare. I met with these inspiring founders to understand their personal journeys that led them to address the broader need to revolutionize the senior home care industry.
Tauseef and Saba have been married 23 years. Their journey to start ConsidraCare wasn’t a singular pivotal event, but rather a gradual evolution that has spanned many years.
Tauseef was as an engineer in Pakistan. After graduation, he was fortunate to secure positions with multinational corporations, which saw to work across Europe, including Sweden, Turkey, and Germany. An MBA scholarship at the Richard Ivey School of Business in Canada opened another chapter, where Tauseef made the critical decision to establish roots in Canada, instead of pursuing a career opportunity in German. Eventually, he met Saba, who was a physician in public health. They married and over the years, Tauseef took on more roles overseas, where Saba accompanied him. In 2004, their perspective shifted as they yearned to be closer to their aging parents. The birth of their first child further heightened their desire to relocate nearer to family. So, they ventured to the Middle East where Tauseef contributed to a large telecom expansion across 24 countries. During this time, they recognized that being separated from family due to career commitments wasn’t unique:
“There are many people who share the same worry where they’re separated from their parents. It’s a typical emerging market phenomena in middle class. A lot of parents put effort in educating their kids, and then those kids, to find better opportunity, emigrate, for example from the Middle East, India and Pakistan to Canada, UK and USA, and from Indonesia to Australia and Holland. This is more common today–people who are constantly in this state where they’re juggling their careers and live in multiple time zones away from their parents. Once we came back, I think this was at the back of our minds.”
When he returned to Canada, Tauseef reflected on his career, vital experiences where he directed significant investment in startup ventures and where he oversaw numerous acquisitions and development of multiple enterprises in over 30 countries. He aspired to be part of this ecosystem and subsequently took a position in government at National Research Council of Canada Industrial Research Assistance Program (IRAP), which oversees high potential technology startups. Meanwhile, Saba, despite her credentials as a physician from a prominent medical institution in the Middle East, encountered difficulties in securing a position in Canada.
Saba lost her father in 2015, and at the same time, had moved to Canada, where she witnessed challenges in being able to practice as a licensed physician in Canada, “… So I opened my own business, a senior home care company in Mississauga as I saw a lack of care and empathy, especially for seniors.”
Tauseef highlighted that less than 30% of immigrant international medical graduates, like Saba, manage to secure positions as doctors in Canada . Compared to over 95% Canadian medical graduates. This glaring disparity persists today. Tauseef noted the typical results,
“Even among those who do not find medical placements, a significant portion–thirty to forty percent–resort to unrelated jobs like driving for Uber. Additionally, 50% of this group remains unemployed.”
For Saba, veering towards roles like administrative assistants or clinic receptionists was not appealing. Eventually she decided to explore the nearest equivalent to the medical field, which was caregiving.
The journey for Tauseef took a more poignant turn. In 2021, Tauseef experienced a diagnosis of an uncommon ailment, known as vasculitis, which landed him in a hospital with multiple organ failures in the middle of the COVID crisis. He describes his experience:
“On the day of my admission, hospitals went into lockdowns, confining me to the acute care unit with around two dozen other seniors. It was painful to see what those elderly patients were going through. I stayed in the hospital for a couple of months, while the 9 specialists assigned to me took me through steroid therapy, chemotherapy, biopsies and surgeries. I couldn’t help but notice the striking lack of empathy, particularly among the specialists, when caring for the seniors in my ward. It was obvious they did not care about the quality of life. They only cared about prescribing the right medication to cure or halt the disease.”
Tauseef notes that despite Canada’s global reputation as an OECD nation and one of the top places to live, it emerges as one of the least favorable countries for seniors on many factors among the developed nations. For example, a study of 11 developed nations by the Common Wealth Fund showed that Canadian seniors have the highest social isolation, the worst access to short-term medical appointments, and the least satisfaction with the quality of health care compared with other countries. He continues,
“I could start feeling that doctors turning a blind eye to someone because they might think you’re a hypochondriac, especially if you are a senior, as there’s nobody advocating for you. Each of our clients, without exception, has encountered difficulties within this system. While the medical framework prioritizes health preservation and life extension, it demonstrates a marked lack of concern for the overall quality of life.”
In Canada, the current estimated cost to the healthcare system for senior care is expected to be $40 billion per year. Of this, 60% funds long-term care facilities vs. 40% on home care, despite majority of the Canadian seniors showing preference to age and receive care at home. Compare this to Denmark or Germany where over 60% of the funding goes towards home and community care. Tauseef suggests that this predominant allocation of funding towards healthcare facilities and long-term care homes, places which often function as “warehouses or mere processing units rather than places of comprehensive care.” is not sustainable. This is more apparent when it comes to underrepresented communities. “We live in Brampton. We see it every day. There’s a huge disconnect between the quality of life for the people with lower incomes vs those with better incomes.”
Saba echoes Tauseef’s sentiment. The interactions she’s had with various families surface a consistent theme: a deficit in the quality of care and the lack of transparency in the care process. Saba reasons that with a 40% government allocation towards home care, families are not getting enough hours of care, and in particular, seniors who require home-based care but are ineligible for facility-based options. She interjects,
“A senior family member called me a few days ago, letting me know their mother had a stroke in March of this year. She was in hospital for two weeks then was moved to a rehabilitation facility for a month. She was then sent home with only two hours of care per day. This proved insufficient for her needs as she struggled with basic tasks like transferring from her bed to the commode chair for toileting. She remained bedridden and relegated to wearing diapers, instead.”
This family’s experience highlights the significant gap in care. When the family contacted Saba, she deployed caregivers the same day. Their mother is now doing proper toileting and, more importantly, she is being treated with the dignity and care she deserves. Saba believes there are enough resources but how they’re allocated is problematic, “It’s just the disproportionate allocation. If the government were to redirect more resources towards home health care, it could offer a lifeline to the 90% of seniors who wish to remain in their homes, as well as alleviate pressure on the public health system in the long run.”
Tauseef points to the economic complexities and the structural issues that continue to perpetuate the problems within the senior home care system:
“I believe economic factors are also at play in this situation. Approximately 8 million Canadians are involved in some form of unpaid caregiving, including caring for parents and neighbors. This unpaid work, which often amounts to a few hours per week, has been quantified taking into consideration out-of-pocket costs, lost wages, and foregone vacations. These estimates tally up to an estimated $100 billion annually, equivalent to about 4% of our GDP. This essentially represents a significant contribution of free labor to the economy. If these caregivers were compensated, this 4% of GDP would flow into their earnings.”
Tauseef points out that many of the long-term care and retirement homes operate as real estate ventures, some of which are owned by prominent private equity (PE) firms in Canada. As a former PE investor, he remarks there is a typical focus on cost reduction at the expense of quality. He alludes to the study that marked Canada’s nursing homes which had the worst record for COVID 19 deaths among G7 countries at 69%, well above the international average. He winced, “And while everybody woke up, and there were no significant repercussions. There were no reports published, no stories told, and things were swept under rug because there was no one to speak on behalf of seniors.”
He raises the essential question of why Canada’s system doesn’t mirror the robust home care models of countries like Germany, Denmark and Japan, alluding to the overwhelming desire for seniors to age in their own homes.
If it is a system with resources constraints, Tauseef hypothesizes that if Canada were able to effectively integrate every international medical graduate and internationally qualified nurse into the care system, the problem could be resolved. He challenges this with the notion that the supply constraint is “manufactured”, saying,
“There’s an artificial constraint being created here, similar to what the taxi industry had before the launch of platforms like Uber challenging the status quo. The bottlenecks need to be circumvented through digital systems and platforms and more unique business models that do not tread on regulatory limitations but still fill the gap.”
Insurance does not provide additional coverage options for those who wish to receive care at home. Tauseef noted that while some companies previously offered such coverage, they have since withdrawn from it. In any case, families are reluctant to turn to private insurance, justifying their tax dollars should have provided the necessary coverage instead.
So, while their services are competitively priced, ConsidraCare is still considered premium and affordable for only the more affluent. Tauseef emphasized that for the broader population, government intervention is necessary to make homecare accessible on a wider scale, through subsidies.
Both Tauseef and Saba’s personal experiences and encounters have fueled their drive to bring change to the caregiver industry. Both share their vision of harnessing technology to address these three challenges: 1) cost, 2) quality, and 3) caregiver turnover in the senior care industry. Saba elaborates, “Starting ConsidraCare came from our collective learnings from the previous five years to help solve the problems of home health and the problems which seniors are facing throughout Canada.”
Without sufficient government programs, the industry currently experiences 8X the demand, translating into 400,000 seniors on retirement home waitlists.
At the outset, Tauseef highlights that the homecare industry has a substantial overhead of approximately 70% of the base wage of a caregiver. Traditional home care business is complex and requires management and coordination of a human resource in real time. To cover these costs, many agencies must charge 2X the caregiver wage. Caregivers and nurses are dispatched to various locations at different times, requiring meticulous oversight for quality maintenance. Currently, many agencies operate like staffing firms, providing minimal ongoing support once a caregiver is assigned, which has been a source of dissatisfaction among families.
ConsidraCare has done a complete audit on the home care delivery business, and has proceeded to digitize and optimize it, allowing the proper oversight and monitoring to ensure that quality care is delivered.
They also focus on hiring expertly trained and professional caregivers. Tauseef addresses the high turnover among caregivers today, “Typically, most caregivers and nurses in the senior care sector leave their careers within five years due to stress, citing inadequate compensation, and a lack of respect. Most private agencies see an annual caregiver turnover of 60% or more.”
ConsidraCare seeks to empower caregivers and create a shift in how they work. Tauseef highlights that through the support and connectivity provided through their platform, caregivers no longer feel undervalued or disrespected. Unlike the traditional model where caregivers often felt underpaid and overworked, ConsidraCare ensures fair compensation and a supportive work environment thanks to the efficiency achieved through end-to-end automation of senior home care delivery.
Saba elaborates on the multi-faceted benefits for caregivers, emphasizing how the platform enhances their experience. Caregivers can access a dedicated app that provides care plans and tasks, streamlining their daily routine. The platform’s transparency ensures families receive real-time updates improving transparency and trust between the caregivers and families, and their optimized solution enables higher payments to caregivers compared to the industry average, at the outset. Ongoing training, including specialized training in dementia care and chronic conditions, further empowers caregivers to provide exceptional care.
Saba stated that their platform constantly monitors caregiver activities, proactively generating alerts and alarms if there are any issues, which makes the life of the office staff managing the workforce and client relationship simple.
Tauseef also highlighted the unequal distribution of senior facilities and agencies, with concentration prioritized in affluent urban areas. Termed the “postal code lottery” in Canada, regions like GTA, Vancouver, Montreal, Ottawa etc. have an abundance of options for retirement homes, private care services, and even government involvement. However, given the current high cost of living, many seniors are opting to locate to smaller towns like London, Niagara Falls, Kelowna or Cornwall, which are without adequate care infrastructure in place. ConsidraCare has developed a hybrid SaaS option to scale into remote areas and underserved communities. As per Tauseef, “In our upcoming phase, we envision extending our reach to these smaller communities through a hybrid SaaS/low-cost franchise model. For instance, if there are international medical graduates or foreign-trained nurses residing there, we can offer them an enticing business opportunity. They can leverage our platform to provide exceptionally high-quality care, and more than just furnishing them with software, we also share our quality standards and assist in establishing a business that can catalyze this emerging cottage industry.” He adds that this focus towards senior care in smaller cities is scalable towards international applications as well.
For doctors, ConsidraCare provides increased visibility to the level of care once the patient has left the clinic. Tauseef elaborates, “The platform essentially assumes a central role within the circle of care. It initiates the assignment of tasks to caregivers and subsequently monitors delivery, generates comprehensive reports which can be shared among everyone within the circle of care. This mechanism not only enhances awareness but also empowers families with complete authority over the distribution of information and the recipients with whom they opt to share it.”
Digitizing their services allows ConsidraCare to offer higher pay rates compared to industry and has allowed them to operate at approximately 30-40% below the average market rate for top quality companies.
Tauseef stresses their company is driven by a mission, and this has led them to set an internal financial target and while this might impose limitations and result in cash burn, they are nevertheless committed to upholding this approach as it serves as a differentiating factor and a protective barrier for their business: “We view the investment in paying caregivers more and charging clients less as a strategic move. This approach fosters positive word-of-mouth, enhances caregiver satisfaction, and contributes to better overall quality of life. In essence, this perspective is embedded within our business model.”
He also adds that having a strong service element combined with a proprietary platform which reduces their fixed cost makes it easier to break even unlike pure software plays which burn cash and are always chasing profits, “If we do the math… we can break even around a million dollars in revenue. We hope to do this next year.”
Extensive research both within Canada and internationally has consistently demonstrated that delivering care at home is more cost-effective for the government than providing care in retirement home facilities. In this report by Deloitte, home-based care reduces the overall healthcare costs by minimizing hospital re-admissions, emergency room visits, and the need for long-term institutional care.
Here are some insights on the demand for senior care:
When considering families’ viewpoints, receiving care at home should intuitively be more affordable if they were to receive the same subsidy the government offers for retirement homes or long-term care facilities. However, the subsidies are making it cheaper for the worse option to be financially more attractive. Tauseef clarifies they are a complementary service to retirement homes, however, the pressing issue in Canada, particularly in Ontario, is that research shows there are twice as many individuals in long-term care facilities as there should be. A staggering fifty percent of those currently in these facilities don’t actually require that level of care and could be effectively cared for in their own homes.
By transitioning half of the population from long-term care facilities back to their homes while maintaining the same subsidy structure, it presents a compelling financial argument. In fact, moving 37,000 Canadians out of long-term care will save the health care system an estimated $794 million by 2031.
The issue arises when those who don’t need such extensive care end up occupying these facilities, effectively blocking access for those who genuinely need them. The concept of “aging in place” is key: individuals should ideally age within their homes until the point where more extensive medical care is necessary. Tauseef’s focus: “ConsidraCare is providing an alternative for the portion of the population who can be adequately cared for at home and, in doing so, relieving pressure on retirement homes.”
The impact on the caregivers, especially the family members who forego income to care for their parents, could be substantive should government subsidy be redirected to provide families with an allowance to cover homecare. In addition, the strain on the system would be alleviated: from health care costs, public health, hospitals, hospices and rehabilitation centre capacities. Saba emphasizes ConsidraCare’s value: “There’s a point where a person’s condition may require a move to a long-term care facility. However, our homecare company can help delay that point, making the overall system more cost-effective and granting families peace of mind and allowing seniors independence in their familiar environment – their own homes, to put it simply.”
ConsidraCare wants to also create opportunities for immigrant workers. Nearly all of their current caregiving staff are Black, Indigenous, People of Colour–immigrant women, many of whom hold significant qualifications from their home countries, often as nurses.
Saba adds, “They hit the ground running. The quality of care they provide is outstanding because they have worked in very difficult environments. They’re trying to establish themselves in this new country, and they’re excited to be given an opportunity where their skills are utilized. So, we help them acclimate very quickly to the practical aspects including how you engage with families, the level of professionalism required and advanced topics such as specialized care for dementia.”
Encouraging their progression is a priority for Tauseef and Saba. They note that about 20% of their caregivers are pursuing nursing studies, and they actively support them in building lasting careers. With ConsidraCare, they receive valuable experience, study opportunities, a fair wage and commendations for future references. Tauseef recognizes Brampton as an ideal immigration hub for highly qualified professionals and contributes to their ability to facilitate ConsidraCare in the Canadian healthcare field.
Saba is proud of their work to date: “We have helped 50 of our caregivers who are international nurses, and they are right now working towards their Bachelor of Science in Nursing (BNS) or Registered Nurse (RN) in the Canadian healthcare system. We help them build their proficiency through this experience and right now, they are integrated in the healthcare system as nurses.”
A Two-Way Strategy For Scale: Enhancing Canada’s Caregiving Landscape while Nurturing Global Impact
Tauseef and Saba identified an opportunity with growing immigration to Canada. Recognizing the challenges faced by expats, particularly from countries like India, Pakistan, Nigeria, and Eastern Europe, Tauseef emphasized that 20% of Canada’s population comprises expats, who often find themselves separated from their aging parents due to immigration restrictions. With Canada welcoming an estimated 500,000 immigrants annually, this issue is projected to intensify. Families encounter a significant burden as they navigate the challenges of long-distance caregiving, from hospitalizations to end-of-life care.
These circumstances prompted ConsidraCare to explore the potential expansion of their model to emerging markets, where similar challenges exist but are exacerbated due to inadequate homecare infrastructure. Tauseef highlighted the stark demand for reliable caregiving in these markets. Contrary to more developed markets, emerging economies lack the concept of geriatric care, which they intend to address by introducing geriatric telemedicine. The absence of geriatricians in these regions creates a substantial gap that our platform could bridge.
Expanding their presence into international and emerging markets is a strategic move that inherently fortifies ConsidraCare’s operations in Canada. Tauseef adds, “This strategic approach offers a dual advantage: it not only augments our use case in Canada but also propels growth in untapped regions.”
From a Canadian perspective, Tauseef outlined a promising pathway where proficient caregivers trained on ConsidraCare in emerging markets could seamlessly transition to Canada. “These skilled professionals, well-versed in caregiving through our platform, could bridge the existing gap as live-in caregivers, thus plugging an industry void.”
This idea resonates with Canada’s former live-in caregiver program, which unfortunately became a target for exploitation by placement agencies and families. ConsidraCare has the potential to rejuvenate this program, rectifying past missteps and providing a more equitable system that benefits caregivers and families alike.
Moreover, Tauseef emphasized the broader significance of this global workforce in tackling Canada’s caregiver shortage. By certifying foreign Personal Support Workers (PSWs) and granting them Canadian accreditation abroad, these caregivers could seamlessly integrate into Canada’s healthcare landscape, elevating the caliber of care available. This dual-benefit approach not only improves caregivers’ earning potential but also addresses the pressing shortage that Canada currently grapples with. This initiative will cater to Canada’s current demand for caregivers while accommodating the aspirations of foreign workers seeking economic opportunities without the complexities of full immigration.
As well, the global dissemination of Canadian standards and training in emerging markets ensures that a high standard of care transcends borders. This approach, as Tauseef highlighted, is a win-win: “It enhances the lives of caregivers and families in those regions while simultaneously creating an opportunity for Canada to enable immigration of more skilled professionals trained to our exacting standards. These adept caregivers could significantly contribute to addressing the evolving needs of an aging population, thereby reinforcing the senior care sector not only within Canada but potentially in other developed markets as well.”
Tauseef also shed light on the potential of remote care, envisaging the establishment of caregiving call centers in emerging markets, a novel approach that exemplifies how technological innovation can architect cross-border caregiving solutions that cater to the needs of seniors, families, and caregivers across the board.
The journey of Saba Tauseef and Tauseef Riaz serves as an inspiration from deeply personal stories of pain and resilience that brough both cofounders to their present journey. Addressing the health care challenges, the cultural nuances that have exacerbated the disproportionate distribution of care, and creating an environment of fair pay that allows caregivers to thrive reveals a startup that has a true vision for the world. As they continue to expand their footprint both locally and internationally, their mission to provide cost-effective care that prioritizes the well-being of seniors while alleviating financial pressures on families remains at the heart of their considerable endeavor.
Original article featured on Forbes.
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