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Is there a single right way to run a home care agency? We sure don’t think so. That’s why we’re interviewing home care leaders across the industry and asking them tough questions about the strategies, operations, and decisions behind their success. Join host Miriam Allred, veteran home care podcaster known for Home Care U and Vision: The Home Care Leaders’ Podcast, as she puts high-growth home care agencies under the microscope to see what works, what doesn’t, and why. Get ready to listen, learn, and build the winning formula for your own success. In the Home Care Strategy Lab, you are the scientist.
Hello, and welcome to the Home Care Strategy Lab. I'm your host, Miriam Allred. It's great to be back with all of you. Today in the lab, I'm joined by Christian Alaimo, the co founder of Caribou. Christian, how are you doing today?
Christian Alaimo:I'm doing great. I'm super excited to be here. Thanks for having me on.
Miriam Allred:Time to get you back in the lab and time to get down and dirty on some good topics. You all are a sponsor of the show and we did a mini podcast together a few weeks ago, but I wanted to have you on to dig into the problem beneath the problem when it comes to this caregiver shortage. And so I'm gonna ask you some pretty direct questions about your take on some of these things. Before we get into it, everyone about your personal background and why Caribou and how Caribou?
Christian Alaimo:Yeah, mean first of all, I joke with a lot of people that I could talk about this stuff for hours, so thanks for giving me an hour.
Miriam Allred:The platform, here we
Christian Alaimo:go. Yeah, I appreciate it. Yeah, so a little bit about my background in Caribou. I grew up living with my grandmother, my my Nona. My family's Italian.
Christian Alaimo:And as a when you're younger, you're not looking for business opportunities. So I I didn't really contextualize how impactful the experience of seeing her on her care journey was until much later in my life. But I have these very vivid memories of her experience receiving care. She she used to bring her walker to the to the door, and she would wait before her caregivers would come. And some days the caregivers would be late.
Christian Alaimo:Some days they wouldn't show up at all. And she was a really proud, Italian woman who immigrated to Canada, and she wasn't comfortable having her family know, shower or bathe her. So on some of the days, if they sent, you know, a man to to give her a bath, those would just be days or in some cases weeks where she would just go without. And so I had seen that experience and how it affected her, how it affected my family. And then, you know, obviously, years later, learning more about the space, just felt so called to trying to help solve the problem.
Christian Alaimo:My original connection to the industry was almost exclusively around how do I help families get better access to care. In peeling back that onion and meeting more caregivers and office staff, coordinators, owners, I just fell in love with the industry, and, you know, my cofounder, Alex, and I have just become more and more impassioned to solve problems that exist here. And as you certainly know very well, it's really hard not to fall in love with the people in this industry. So as we learned more and more about the problems that existed, that's really what's propelled the journey of Caribou, from originally focusing almost exclusively on recruitment to, you know, what we do now across the entire operating model, recruitment, retention, compliance, all of that. So that was kind of the first jump in.
Christian Alaimo:What was really that personal connection.
Miriam Allred:I love it. Thank you for sharing that. You used the word Nona. Have you watched the new movie Nonas on Netflix or at least heard of I
Christian Alaimo:have heard of it but I have not seen it yet. I've heard it's good.
Miriam Allred:I've heard it's good too. It's on my list and looks like a great maybe look into like women from Italy in their older years and cooking and just like the tradition. So you said Nona and that reminded me of that. If anyone's listened to it or watched it, you know, we'll have to keep tabs on that as well. Yeah.
Christian Alaimo:I'll open up my review next time. Yeah.
Miriam Allred:Perfect. Perfect. So you're already kind of getting into the origin story of Cariboo and you and Alex starting the company. Give us a little bit more color to that and your perspective on what was broken in the system truly that made you want to go all in on Cariboo.
Christian Alaimo:Yeah. And I think like most people, you you don't really find home care. Home care kind of finds you, and our story is not much different. Alex was working, in a finance capacity on some business deals for senior living facilities. And so he was the one who had the initial vision around, hey.
Christian Alaimo:There's some macroeconomic trends here. Peel back the onion a few layers and realize, oh my goodness. We have you know, there's a caregiver shortage today. And if we don't solve this, it's only going to get worse as the population ages. And so Alex initially left his his job in investment banking to pursue a solution.
Christian Alaimo:He and I were were friends from university. And when I saw that he was on that path, we connected and both have just been so passionate about solving the problem around the caregiver shortage. The way that journey has evolved has been really interesting. When we first started, you know, a lot of the research that we see today around lack of recognition and appreciation and schedule schedule stability, all of that was around, but the stacked ranking has kinda shift over time as well. But the challenge itself continues to persist.
Christian Alaimo:And so when we first started Caribou, we were really focusing on the recruitment side of things and helping agencies attract more quality caregivers. That was kind of the first foray in around, hey. How do we turn your existing caregivers who are exceptional into recruiters who can help attract more high quality staff? And that continues to be a core part of our system. But as we look at the way the industry has evolved, we see that there's a lot more competition with other verticals, right, or other sectors, whether it's retail, for example, where caregivers can, in some cases, maybe make a higher hourly rate.
Christian Alaimo:And when you talk to caregivers, you will hear some very consistent themes around a lack of, flexible schedules that have left them to to leave the industry or a lack of connectivity or sense of appreciation. And so I think when we when we talk about the caregiver shortage, it's really important that we recognize there's a variety of different factors at play. And what we're doing now is really working with agencies to help them understand, hey. Across a variety of different factors, whether it's financial, professional, social, emotional, where are you doing very well, and where are you maybe falling short with your existing caregiver experience? And then how do we pull different levers to help them improve the quality of that caregiver experience, then ultimately improve retention?
Christian Alaimo:So that's really been the journey that we've been on is figuring out which ones which factor is really causing an issue at your specific agency, and then what can we do about it to help improve retention.
Miriam Allred:Very, very good. Little sidebar here. When we were prepping for this conversation, I asked you what term or phrase you all at Cariboo use when it comes to the caregiver shortage, the caregiver crisis. You know, we see it labeled a lot of different things. And you said something interesting about shortage being the word that you all coined because there's room for opportunity.
Miriam Allred:It feels like something that we can attack and solve for. Explain a little bit about, like, your thinking with that phrase.
Christian Alaimo:Yeah. I think for for us, it's quite a we have a quite a visceral reaction on our team. And if you you know, something I feel really fortunate about is the people who work at Caribou now, it's like a mandatory requirement that you are called to the mission. And the caregiver shortage, it's strong language, but, you know, I personally I struggle with, you know, other language like calling it a crisis that that feels so doom and gloom versus the shortage feels like it's this is an opportunity for us. You know?
Christian Alaimo:There's there's a lot of demand. The demand is growing. This is a more positive spin on a problem space that I think for us as a partner to home care agencies positioning it as a shortage, at least feels a little bit more action oriented and motivating. It's like, hey. We can turn a lever here, and we can solve this problem rather than, oh gosh.
Christian Alaimo:There's this overwhelming crisis that no individual can solve on their own. It just feels a little bit more action oriented.
Miriam Allred:I like that a lot. And I think how we talk about it really does matter. You know, when you read headlines about crisis, you know, labor shortage, labor crisis, like, those words create imagery and emotion and ideas and plant ideas in people's heads. And so how we talk about it, think is really important. And not that we need to universalize a term in the industry, but just be really selective and intentional about what words we use that put things in more of a positive, optimistic, hopeful light.
Christian Alaimo:Totally. And and in an industry as as big as ours where there is no shortage of challenges, I think it's so important that we take this lens as, hey. We're in it, and no one else is coming to save us. You know, we have to be the ones who evolve from the inside of the industry to advance for whatever the needs are of the future. So wherever we can take that action oriented language, I think, is quite critical.
Christian Alaimo:Nobody's gonna solve these problems individually. We need to do it together. But if we don't have that positive language and view it as an opportunity that we quite literally can solve, then it's not gonna be motivating for anybody to come in and really try to solve these problems.
Miriam Allred:Absolutely. So you were already kind of alluding to this, but a lot of people talk about the shortage like it's just about wages or competition or supply, but there really is a deeper layer here. You keep using, like, the layer onion metaphor, which I like. There's there's a deeper story. There's a deeper layer here.
Miriam Allred:So what do you think most people, most owners, operators are missing about why they're struggling to attract and retain? Like, what are the deeper set issues that they're struggling to address or accept?
Christian Alaimo:I I think, you know, when we talk about the shortage, there's really there's two primary levers. Right? There's recruitment, and there's retention. And just going back to my previous life working in, consumer marketing, there's a framework of trial and repeat. You know, how do you bring somebody in to trial a product?
Christian Alaimo:And then once they trial it, how do you get them to come back and buy it again and again and again? And I think framing recruitment and retention through that framework is a helpful way of making it feel a little bit more digestible of we from a recruitment lens, there needs to be an effort to figure out what's the right story and positioning to attract caregivers in to try caregiving. Making a career leap is such a it's a big decision for anybody. But asking somebody to come and and try it for, you know, six months is a lot more digestible than asking somebody to come and try to do it for ten years. And so framing it as how do we drive trial and bring more people in is kind of the first part of the problem.
Christian Alaimo:And the second part is repeat. Once they're in, how do you fulfill the promising commitment you've made to these caregivers every single day? Every day a caregiver shows up for an agency is a day they are consciously choosing to continue working at that agency. And so thinking about the caregiver experience through that lens, I found is quite helpful to how we really frame up the problem. So looking at, you know, the the trial piece of that, I think a lot of agencies tend to overlook the value that comes from their existing caregivers.
Christian Alaimo:And so things like stay interviews, as an example, sitting down with high performing caregivers who've been there for a long time and really understanding, hey. What's kept you here? And what is it about us as an employer and the caregiving as a profession that has had you here for, you know, whatever the duration is, several years? That's gonna peel out specific insights that any employer can then take to understand, okay. What what promise can we make to, you know, others in the community who are maybe more purpose or mission oriented that are good candidates for caregiving?
Christian Alaimo:And so at the employer level, it allows agencies to really fine tune their positioning in a very specific way and make a promise that they know they can deliver on once they bring somebody through the door. Because if you bring someone through the door and they leave after thirty days, in some cases, that's costing you more money than had you not hired them at all. And so it's really important that it's not just making that upfront promise, but then delivering on that promise once they come through. So the trial part of it is kind of the entryway in understanding how do we attract more caregivers in with a promise that we can really deliver day in and day out. And then on the repeat side of things, there's a framework that we like to use.
Christian Alaimo:We there's basically four key components, and I I'd mentioned in an answer earlier, but financial, emotional, professional, and social. And just to kind of break down each one of those, the financial piece, it's easy to just kinda jump to wages, but it is it's a lot more than that. Quality of schedule is such a huge outsized driver of retention. And quality of schedule is not just, a full schedule. It might mean a flexible schedule.
Christian Alaimo:It might mean a different number of hours for every caregiver, a specific client, or a specific location. That on the caregiver level is the single biggest driver of retention. So nailing that quality schedule is a huge piece of it, but there is a lot more that goes into the caregiver experience. On the social side, there's an element of connection. This is a relationship driven business.
Christian Alaimo:There's so much research out there on, hey. If you if you lose one coordinator, you lose 10 caregivers. The relationships that caregivers form with the office staff, with their clients, that is a huge part of what keeps them coming back day in and day out. So as an employer, as an agency, it's so important to invest in that social dynamic and invest in those relationships and build them up. And then across emotional, there there's a lot more of this happening, which is wonderful, but things like grief counseling or support, how do you provide the right level of training to caregivers, supporting them on that emotional level so that when they go and see the client on a day to day, they feel like they are well prepared and well suited to tackle some of the challenges that they may face.
Christian Alaimo:And then on the professional side, I love hearing stories about agency owners who maybe started as caregivers or office staff or coordinators who started as caregivers, providing different pathways to develop. And every caregiver is going to be different, but creating those pathways that are specific to whatever the the level of, interest or ambition is for a caregiver is really critical to driving retention long term. So those are really the four that I think on the repeat side of things, the retention side can really move the needle for for an agency.
Miriam Allred:Okay. Lots of follow-up questions because there's a lot to unpack there. That was fantastic. The first thing I wanna ask about, you and I come from sales and marketing backgrounds, and we talk a lot about positioning and framing our company, our product, our service, the problem. You know, we we talk a lot about positioning.
Christian Alaimo:Mhmm.
Miriam Allred:And personally, I'm thinking back to times when I've literally gotten on Indeed and I scroll and I search my local area for caregiving positions and I just read through them. I'm just like, what are people saying? How are they positioning themselves? And I'm not gonna lie. I'm usually let down.
Miriam Allred:I usually think like, wow. This is a lot of AI, a lot of chat GPT, and a lot of copy and paste. Like, people are just pulling from other ads, and it's just so watered down and so generic. And I just am so, like, let down by that. So the question I have for you is when it comes to framing and positioning, like, where are we at as an industry?
Miriam Allred:Like, there it feels like to me, there's a lot left to be desired there, and we still need to get that nailed down. But, like, what's what's your take on how we're doing and where where we need to get to?
Christian Alaimo:Yeah. I I totally agree with you. I think the industry is getting, you know, to generalize, is getting a lot better. I think we are absolutely moving in the right direction, and I'm hearing a lot more about putting carriers at the center of what we do and the recognition movement. Like, there's a lot more language around this, but I do think there's a lot more to be desired to your point.
Christian Alaimo:And, you know, I I I'm personally of the opinion that there we can look to other types of professions and say, hey. You know, caregiving should be viewed in the same way as if you ask a parent if, you know, what their child does and their child is a doctor or an engineer, they will beam, and they will be so happy to tell you about that. We should have the same level of of social status associated with being a caregiver. These are people who do incredible, incredible work, but we haven't gotten there in championing this career, to be something that we celebrate so publicly on mass. And I think the more education we can do, the more storytelling we can do around who these people are and the incredible work they do, the more empathy we'll create, more broadly socially.
Christian Alaimo:I think that's gonna have an outsized impact on bringing more people who are called to purpose driven work. And as we, you know, look at things from a macro lens, people are more isolated and and search in search of purpose than possibly any other moment in time. Having a profession that creates this level of connection and purpose and service to a community and to someone else, this should be a hot commodity. And being able to deliver that work should be absolutely celebrated. So I totally agree with you.
Christian Alaimo:I think, you know, moving in the right direction, but aspirationally a long way to go before we get to the point where we are celebrating and positioning caregivers in the light that they absolutely deserve.
Miriam Allred:Something that's coming to mind is when when an agency first opens, especially with independents and franchises, you as the owner, the face of the business, know, it's like your personal brand is often very aligned with the company brand. But as you scale, you know, naturally, you become less of the face. And I still think we need to keep pushing like the caregivers are the face. They are the eyes and the ears and the bodies in the homes of these businesses. They are your employees.
Miriam Allred:And are we treating them like employees? Do they have professional headshots? Do we have videos and, and backgrounds and introductions about them on the website? Like, we need to make them the center of what we do. And, again, like you said, we're coming a long way, and I don't mean to sound doom and gloom on this, but I think we we just have a lot more to give when it comes to making them truly the face and the voice and the presence of these businesses.
Christian Alaimo:100% on the same page with you there. And they are the brand. They are the product. They are the assets. Like, they it really is caregivers make the whole industry work.
Christian Alaimo:And so how can we do more to support them through that experience and, and treat them as such is the it is getting better. No question. It's getting better. But I love the example you just share on, you know, things like headshots. Right?
Christian Alaimo:I'm obviously, you know, a little biased here coming from the rewards and recognition lens, but if you even look at things like performance bonuses, salaried workers across America have performance bonuses because they work. Incentive pay works. Why would caregivers be any different? You know, if a caregiver is showing up on time day in and day out, reaching three, four, five years of, you know, committed dedicated service, always compliant with their training on time, should that caregiver not be rewarded for that level of performance? And we know if we can retain caregivers longer, we can have higher clock in and clock out rates where compliance rates gross margin improves because replacement costs, training costs, recruitment costs go down.
Christian Alaimo:So how can we give the caregiver a share of that improved gross margin and recognize them through things like incentive pay? Obviously, at CareBoo, that's what we do with, you know, rewards and recognition. But you're absolutely right. There's there's examples of these these tactics and practices that exist all over the the corporate world. In many cases, they can be applied to caregiving.
Christian Alaimo:Sometimes I think it's easy to say, oh, it's it's a different workforce. You know, might it won't work here. But I think we should really reframe it to say, oh, well, why can't it work here? And build the case that way. And I haven't really heard a great argument against the incentive pay yet.
Miriam Allred:Yes. Yes. And I just wanna say 10 x for the people that are with you for a long time. These caregivers that are with you for three, four, five, ten years, they need to be recognized because if they're not, they are going to walk away. And so just extra emphasis on taking care of the people that have been with you for a long time.
Miriam Allred:Yeah. Christian, something else that you said that was really interesting to me was around this, trial period. You said kind of this trial and repeat. And I do think we need to attract people that have never been caregivers before. But like you said, they may think like, oh, I'm getting into this, it's gonna be three, five, ten years or they're, you know, jumping into something new, but positioning the opportunity like a trial.
Miriam Allred:Like, hey. Come try this out for six months and see what you think. I've never maybe heard of agencies approaching it like that. Are you working with anyone that you have seen that positions it like a trial period?
Christian Alaimo:I have not seen that either. I the the trial and repeat framework has been a helpful way of kind of diagnosing where the where the challenge is between recruitment and retention. Okay, if you have, you know, a repeat problem or retention problem versus, you know, bringing people in through the door. It's the trial idea, though, is really interesting because it lowers it lowers, like, the psychological barrier to entry, right, making a smaller commitment versus making a much larger one. So I haven't actually seen that, but it would be I'd be interested in seeing what the results look like is, you know, does positioning as a trial bring more people through the door if you can withhold the promise that you say?
Christian Alaimo:You say, hey. This is the standard we have. We have this commitment. You come in. This is what it's gonna be like.
Christian Alaimo:And if you can deliver on that promise, I think you would see repeat and retention very strong. But I also wonder if maybe it could position this in a way where people come for a shift and and then leave, and now you have all kinds of recruitment and replacement costs. I'm a very data oriented person. So without seeing it, it's hard to know. But I think that's a really interesting one to experiment with.
Miriam Allred:I think the word that comes to mind is like milestones. We talk a lot about like the first ninety days, the first hundred days, you know, think about the first six months, the first year. I think we for any career, you know, we were talking earlier about like drawing from other industries, other professions and bringing that here. Any employee needs milestones, needs things to look forward to, needs to break their career down in like bite sized chunks of like, okay, here's what I'm trying to do and accomplish for six months, here's what I want to accomplish at a year. Like we should take that same approach with these caregivers.
Miriam Allred:And I don't think we do enough of that.
Christian Alaimo:Abs absolutely. And connecting them connecting caregivers to the impact they're having is such an opportunity for all of us. We we actually just rolled out a new feature. We we call it my impact, where if you think about Spotify wrapped, what that is for our listening habits, it's kind of like that for caregivers to see the impact that they're having, number of hours, number of clients. So they can really contextualize, oh, I've been spending all this time, but it's it isn't just a paycheck.
Christian Alaimo:Very few caregivers stick around this industry for multiple years because it's just a paycheck. It's so much more than that. And so the closer we can connect them to being able to see and appreciate the scale of their impact, I think the more fulfilling the work is. And milestones are a way to kind of mark that journey, right? Whether it's certain number of hours, certain number of visits, certain number of years.
Christian Alaimo:The example we give often is on a personal milestone, a birthday. Sometimes we will have agencies tell us, like, you know, giving somebody, you know, 500 points, which is the equivalent of $5, it's not really gonna move the needle. But when you paint a picture of what it's like waking up on your birthday and you say, well, imagine you wake up on your birthday, and within the first hour you're up, you receive a text message from your employer saying, thank you so much for the great work you do. Here's coffee on us today. That makes a big difference.
Christian Alaimo:And when we surveyed caregivers, ninety percent of them said that receiving something on their birthday was very meaningful. That's, you know, not top two box. That's top one box. And so there are these little milestones that we can mark for caregivers to help them appreciate where they're at on the journey and the scale of the impact they're having. And that's just all a part of the formula of making it more rewarding and fulfilling work.
Miriam Allred:So we're talking about these micro moments, but it's also reminding me of kind of these, like, macro buckets that you're talking about before in this repeat stages. Name the four, financial,
Christian Alaimo:social Emotional, professional.
Miriam Allred:Emotional, professional. And that's a framework that you all have coined, but I think those buckets are a great lens to think through of like, these are the four buckets. How are we filling those four buckets for these caregivers ongoing, you know, you think of when they're first hired, and the efforts that you put in place and bringing them to the office for onboarding and training and you're kind of like filling that cup, but how are you filling all four of those buckets ongoing is how I'm thinking about it. Speak to those buckets a little bit more of like why those four and how do we fill those ongoing.
Christian Alaimo:Yeah. And it's to your point, it's kind of like a scorecard. Right? I I like positioning it as it's a bit like holding a mirror up to your organization, and and you can use things like stay interviews and conversations with your caregivers to help inform a real accurate picture of what it's like being a caregiver at an agency. And you can use it to evaluate, okay, how are we doing here?
Christian Alaimo:And most agencies will have one of those at least just totally rocking. They'll do it really, really well. And they'll also usually have one that's an opportunity area that they can really do better. It allows agencies to really pinpoint where are we strong, where do we have, you know, some opportunities that we need to invest in. And so, I think about it through, just to kind of get at your question, when I think about it through those four different buckets, it's not going to be equal for every caregiver, which ones matter most, right?
Christian Alaimo:It's going to be a mix for every single caregiver, if they care, you know, if they're more motivated or engaged by the social element or connection versus others who may be more financial. But what it helps us understand is what are the pieces that make a caregiver experience rewarding and fulfilling that keep them coming back to this job day in and day out? And then what levers can we pull? So we have this kind of framework when I think about, you know, incentive pay as an example, schedule stability, quality of schedule, that all falls under financial. Professional with the development, sometimes it doesn't necessarily need to be a a job change.
Christian Alaimo:It can be upskilling. It can be modules. It could be expanding their skill set to be able to cater for certain types of clients or patients. There's all kinds of opportunities and the training solutions in the space, most of them have these capabilities to be able to be able to bring that to life. So I think for agencies using this framework is kind of just an entry place to sort through the noise to be able to more accurately diagnose where there are opportunities.
Christian Alaimo:And in the same token, if there's pronounced strengths, going back to your earlier question on positioning, how do we really vocalize and communicate those strengths to bring in more people knowing that it's something the agency is doing really well?
Miriam Allred:Okay. I'm really liking this. I wrote those four buckets down and I'm just like stewing on them in my head right now. I really like this. You keep referencing like stay interviews and I have this picture in my mind of using like a scorecard with these four buckets as the framework for that conversation.
Miriam Allred:How are we as an agency doing for you financially, socially, professionally, and emotionally? Like, that is that would be so powerful if you were meeting with your caregivers periodically going through those four things because like you said, likely the agency has put emphasis or focus on one or two of those areas for a period of time and seem to be doing well at it. But that breaks down with each individual caregiver. Every single caregiver is so different, comes from a different background, they're all at different stages of life. And so what they value, what they prioritize is different.
Miriam Allred:So you have to take it down to that individual level. But then you use it as a framework every single stay interview that you have. It's like, okay, at six months, here's what you prioritize. We worked on that. It's going really well.
Miriam Allred:At a year, at two years, you know, maybe they wanna focus on professional growth. So I just love this concept of using it as a scorecard for those stay interviews. My question is, do you guys have some sort of resource or PDF or something that people could use that you've already created regarding this framework?
Christian Alaimo:Yeah. We so we have a employee listening component to Cariboo, and so we use that to be able to do this at scale. I think there's there's kinda two data points that agencies should be looking at. One is how do you listen more actively at scale? And those are things like, you know, and and things like that.
Christian Alaimo:And then there's how do you unpack those answers more deeply, which is what I think state interviews are excellent at. You had a question that we talked about, not to jump in too much, but we talked about before this around being reactive and proactive. And so I just want to kind of touch on this for a moment because I think they're really closely linked. Agencies who want to be less reactive need to have ways to identify leading indicators. And if you cannot identify leading indicators, you, by default, will just react to events as they come.
Christian Alaimo:And one of the best ways to identify appropriate indicators before of of certain events like churn before it happens is through listening, listening from surveys or listening through conversations like stay interviews. So I think the combination of those two elements can really help an agency understand, hey. Here's what we're doing well, and and here's what is kind of a problem area that we're seeing come through. We've seen it now the last three surveys, for example. We've seen that this is a trend.
Christian Alaimo:It's not getting better. And we know from the the stay interviews that no one is telling us this is something we're doing great. And then when we ask about it, we kinda get answers that fall flat. That is gonna be a really concrete way of saying, we know with certainty this is something we need to work on. And so I think marrying the more quantitative type of data that you would get from an employee listening tool, like what we have at Cariboo or some of the other providers with the, say, interviews and more of the qualitative, that's where you're gonna get all of the power to to have those types of leading indicators.
Miriam Allred:Fantastic. I wanna put you on the spot and ask about leading indicators because we talk a lot about KPIs. We talk a lot about metrics in the industry. Even so much so, I think, a recent episode, I said we probably have gone too far, but I don't think we're talking maybe enough about leading indicators. What you're bringing up right now is what trends can we identify over time that then help us in a way predict what's coming, you know.
Miriam Allred:What are some of those leading indicators that you think agencies may be missing the mark on today?
Christian Alaimo:Well, think in general, going to one of our earlier topics around is the industry getting better? I think the industry is spending a lot of time. There's some you know, a lot of the big tech companies that are servicing agencies today are doing a fabulous job at investing resources to get better here and use the data that's available to say, hey. We we need to become more proactive. And when you look at, you know, things like you know, this is all kind of future state now, but things like churn prediction.
Christian Alaimo:Right? If you if you were to build a churn prediction model, an an outsized input would be schedule stability. And has this schedule changed? Are the hours consistent? Has it gone down?
Christian Alaimo:You know, where is that caregiver at in their schedule stability journey at this moment in time, and how long can they stay there before they really become a risk of churn. We can use things like machine learning over time to get really, really good at that. But there are ways today that I think are hard to mobilize for an agency because they can be time intensive. So in the future, I think it's going to be very common practice that we have a good understanding of, hey. Here's some predictive models around churn, for example, that are pretty good.
Christian Alaimo:There's a whole I won't go down this rabbit hole, but there's a whole other question of, okay. So what? What do you do about it if you know a caregiver's gonna churn? Right? You have you have to be able to take action on an insight for it to be for it to be valuable.
Christian Alaimo:But I do think we're gonna get there. Today, going back to the employee listening piece, I think what gets really difficult with a lot of the tools that are out there is being able to trace answers back to the individual caregiver. And so how do you analyze the change in responses over time? Because there will be metrics that you'll have visibility to, like schedule stability, like clock in rates. If those things are trending downwards, it's probably not a good sign.
Christian Alaimo:But before that happens, you can probably get some pretty good reads on very binary things. Like, this caregiver has completed the survey three times, and they didn't do it this time. Or now we've sent it twice. They haven't engaged. They're not engaging with some of our calls.
Christian Alaimo:Like, there's there are metrics that you would see falling before you get to the point of ultimate churn. And as the caregiver goes further and further down that path without having any sort of intervention, I think that's where there's going to be opportunity for for flags. And the last piece I'll say on that around leading indicators is sometimes the lack of intervention in itself is an indicator. And what I mean by that is, you know, it's a tried and true comment about feedback. Right?
Christian Alaimo:If you're asking for feedback, you better be prepared to action it, or else the person providing feedback is not going to feel heard, respected, or, like, they you know, like, you actually care. What can happen in the in the throes of running an agency is collecting these responses and understanding, hey. We've got we have these opportunity areas. Carriers are giving us this feedback. But if you don't take action on them, now you've created a whole other issue.
Christian Alaimo:So I think it's really important that anyone who is going down this path of trying to identify leading indicators using things like employee listening tools is prepared to take action on what you learn. Otherwise, you could create an experience for the caregiver that might even be worse than had you never asked at all.
Miriam Allred:Okay. I'm thinking of an office team listening to this, everything that you just said and thinking we do bits and pieces of that, but nobody owns it. Nobody owns the caregiver experience. Nobody owns rewards and recognition. Nobody owns these things which is why it's slipping through the cracks which is why this breaks down in a business.
Miriam Allred:So from agencies that you've worked with who who owns this? And is it a single person? Or is it they build a culture around this and then delegate it accordingly? Like, I guess I'm just thinking, like, everything that you're sharing is amazing. But in application, who owns this?
Miriam Allred:And how does it actually function?
Christian Alaimo:Amazing. Amazing question. The what I've seen the the best versions of these initiatives, whether it's with Cariboo or even if it's a manual program that's being run, are both of what you're saying. So having somebody who is the dedicated owner who is ultimately accountable to the program's success, but the success of that program not stopping with that individual project owner. So in some cases, it is the agency leadership themselves.
Christian Alaimo:In some cases, it can be a scheduler who works at the office, who is kinda doing everything. But no matter who it is, the really important part is that expectation of this being widespread across the culture, where you can't just say to people, hey. We have this rewards and recognition tool. Now we're a culture that appreciates our caregivers. You have to really embody that with actions.
Christian Alaimo:And, that usually is most effective when there's one or two clear owners who are responsible for it, who will be asked questions about, you know, whether it's reporting or how's it going, even just asking engagement questions. You know, how you know, with technology like Cariboo, all of that's available to our partners. They can see how many caregivers are going in and actually engaging. That's a great indicator of, hey. Does this program have legs?
Christian Alaimo:Are are we using it properly and are caregivers seeing the experience? But it has to be both. If it's just one person, it it might just live and die, but with that one person. And if it's just a culture piece that's widespread and no one's accountable, then it will be really hard to move things forward.
Miriam Allred:Really great response. And I wanna take it one step further and argue that it shouldn't be the scheduler. The scheduler is oftentimes the point person between the office and the caregivers, and that's essential and that's their job, but we can't burden down the scheduler. They are already swamped, already stressed out, already have a headache all day long. We can't we can't put more on them.
Miriam Allred:I don't think we should put more on them. I do think that this other role, other person in the office should be someone else that is focused on retention, focused on recognition. Maybe 80% of their job is calling caregivers, just straight up calling them and checking in on them and conducting the stay interviews. Like, I I just feel strongly that that should be another role. And prioritize it early.
Miriam Allred:You know, some smaller businesses may be thinking like, don't have the funds to bring in someone dedicated to that, but think of how much you're doing on the client side. You have people dedicated to every client to ensure their satisfaction to, you know, focus on retention of clients. Like, we need to have that same perspective and emphasis on the caregiver side and having someone dedicated to caregiver attention will go such a long way because like you said too, one scheduler leaves five, ten, a dozen caregivers may leave with them and we have to avoid that from happening. So give them another point of contact that is equally close with them and maybe even closer than the scheduler because it's more kind of raw candid conversations that they're having with them.
Christian Alaimo:I have one. It's an and. I I I agree with that. I I think the the build is in some cases, you know, in it's not like Caribou is the only one who does this, but when the technology is built well, it shouldn't feel like it's an additional task. It should feel like a tool that's helping schedulers do their job more effectively.
Christian Alaimo:I'll give you an example of some feedback we've heard. When a scheduler is currently trying to find somebody to pick up a last minute or a difficult shift, it's usually just picking up the phone and calling. And in some cases, it can feel like you're just asking caregivers, the best, most reliable caregivers to just keep doing you a favor over and over again. But having an ability to offer something to that caregiver, whether it's, you know, recognition points, even just saying, you know, thank you in a different format than just doing it over the phone, that can shift the relationship between scheduler and and caregiver. And we talk a lot about positive engagement and and what does what's the knock on effects of positive engagement?
Christian Alaimo:I like to use the example I think we can all probably relate to in some in some ways of, you know, imagining somebody in your life who every time they text or call you, it's like a negative thing. They're asking you for something, or at best, it's neutral. You're you're you're probably less likely to pick up the phone for that person. But if that person, when they are calling you or texting you are it's a positive interaction, maybe there's some value for you in some ways, you're a lot more likely to pick up the phone and engage. And I think for a lot of schedulers, getting that first level of engagement can be a huge part of the challenge of really connecting with the caregivers.
Christian Alaimo:And so if we can help transform that and drive up engagement, so when you really need somebody, they're more likely to pick up the phone, and you can say thank you. And so the next time you need someone, they're there, and they're more more open to it. I think that can transform the relationship. And that's that's something that we were unexpectedly seeing early on is a lot of office staff coming to us and saying, hey. This has reshaped our relationship with caregivers.
Christian Alaimo:Because now when we engage with them, there's a positive energy to it versus before, it was a lot of, us asking them to do things or telling them what they need to do.
Miriam Allred:I think of the term like give and take. We are taking so much all the time. And can we give as much as we take? That's gonna take a lot of time and effort and consistent effort. But can we truly give these caregivers as much as we take or as much as we ask from them?
Miriam Allred:And that should be the goal of the business. How can we give as much as we take to create this really healthy long term relationship where both parties are satisfied and even happy?
Christian Alaimo:Totally. And it there's operational costs to taking too much. Right? Like, it's turnover or tax it puts on the office staff or the frontline, there's this this cost that you are incurring as an agency without necessarily realizing it until, you know, further down the line you have to replace that caregiver or you instead of making one phone call, now you're, you know, trying to call 10 caregivers to pick up a shift. That's happening.
Christian Alaimo:There there's all kinds of operational improvements that come with having that positive relationship between office staff and caregiver. And to your point, I think giving more actually in the long run ends up paying better back to the agency. So it's not just the right thing to do for the caregivers and office staff. It it ends up being the right thing to do for the business.
Miriam Allred:Absolutely. Christian, we're totally unscripted here. You're probably looking at the questions like, woah, where are we going with this? But this has been awesome. We're in we're in the weeds and in the application, which I love.
Miriam Allred:In our last few minutes, I do wanna zoom out though and think kind of from the macro lens and hit couple of these questions that are that you've thought a lot about because I think they're important. The first one is zooming out thinking of kind of like a macro caregiver lens. Is there something cultural about how we treat aging and how we value caregiving that is also undermining the workforce. Like we were just talking about what we can do and what we are doing and how it's working. But are there layers of this shortage that are being undermined by broader strokes in the industry?
Christian Alaimo:Yeah, I think I think the industry is working quite hard to try to shift the the conversation around what it means to be a caregiver. I think that's very positive. What I think the broader challenge is on the social level. And I'm sure you have people in your life who who've had this experience where for most individuals who are not in the the home care industry, this is something an industry they know nothing about until an event occurs and all of a sudden they need to know all about it. And I think one of the challenges that happens when you're this industry that, you maybe a lot of people don't have exposure to is it's really hard to have true empathy and understanding for the people in the industry.
Christian Alaimo:And so to bring it back to my comments, you know, around doctors and engineers and, you know, professions that we celebrate, I think with empathy, caregiving would naturally be a part of that conversation. We would be celebrating caregivers. Anyone who has experience receiving quality care from a dedicated caregiver will sing their praises for as long as you'll let them. There are such tremendous people doing this work, but it's kind of happening behind the scenes right now. And so I think the more we can do to tell the stories and create an understanding and true empathy for who these caregivers are, I think that's going to start to shift the tone of the conversation where we are going to start truly appreciating, respecting, and investing in the caregiver profession, and that's gonna have all kinds of really positive pronounced effects.
Christian Alaimo:It's harder for us to do that in the current climate because there's just so many people who don't have that understanding of who these incredible caregivers are. But as the population ages, as there's more and more investment in this in this industry, I do think that's changing. And I think all of us who are in it, you know, yourself, you are doing an amazing job by championing and giving voices to the people in this industry to tell stories about what they do and how they do it. The more we can do that, I think the better off everybody is going to be. And we're gonna start to see that affect business metrics and things like the caregiver shortage improving, access to care increasing, more pride in in the work, and I think that would be a really, really positive shift.
Miriam Allred:We are the sum of our parts. You know, we're all working so hard in our individual markets, in our individual ways, and I do think we're gonna come out on top. Like it's gonna be hard and we're struggling through it and we're figuring it out right now but we are seeing more awareness about home care. The pandemic shone the light. Here we are earlier I mentioned like the Nona's movie on Netflix.
Miriam Allred:Like, there's there's just more media about caregiving and about the struggle and about the shortage and about the opportunity. And so I think just naturally, all of all of those efforts, all of our efforts, everybody in their market just doing the best that they can, like we're going to get to a place where home care is a household term. Caregiving is a profession that is recognized and valued as much as the other traditional professions that we praise. And and we're gonna be a part of that.
Christian Alaimo:Yes. Absolutely. And I'm so optimistic about this industry. You know, listening to your conversations, the conversations that and we have the the privilege of having with our our customers and caregivers. There are there's no shortage of challenges.
Christian Alaimo:No question. But there's a lot of really, really, really good, smart people working on these problems. And I am feeling the industry come together more and more, and I think that's a extremely positive thing. So super optimistic.
Miriam Allred:Likewise. I mean, look at us, two young people nerding out over home care. I mean, if either of us thought we would be where we are today, like, there's just no way. But there is such an opportunity and it is so mission driven even for both of us seeing our grandparents and our community and our neighbors, you know, age. There's just it's so impact driven and there's so much more that we can contribute, which I love.
Miriam Allred:One last question I want to ask about the future. You know, here we are talking about the present, what's working and what we're going through and what can be applied today. But I want you to let your mind kind of run into the future five, ten, twenty years from now. What is the caregiving workforce going to look like or what do you hope it will look like?
Christian Alaimo:Well, I'm an optimist, I think and hope the same. So I really feel like the future of the caregiver workforce is going to be an exceptionally positive shift in evolution from where we are, you know, today. I think, you know, even, you know, versus ten years ago, there's already been, you know, positive shifts that are that have taken place, and I think that's only going to accelerate. When you look at the growth that's expected, just just taking a step back and looking at looking at the demographic shifts, there there's largely going to be three groups of new entrants who enter the caregiving workforce. It's going to be retirees who are working largely in more of a part time flexible capacity.
Christian Alaimo:It's going to be new grads who are digital natives who are very comfortable with technology and have grown up with the Internet and smartphones. Those new grads are going to be coming into this industry and really shaping the appetite for technology that is already there and emerging quite quickly. And then immigration will continue to play a role in the growth of this sector and and where we're getting a large number of caregivers from. And I think across those three groups, you know, the the differences can be pretty pronounced. But when I look at the common threads, that's where I see the biggest opportunity.
Christian Alaimo:The common threads of the individuals who are coming into the sector, these are gonna be people who are called to purpose. There's like I mentioned earlier, you know, social connection real true social connection is becoming harder and harder to create for the, you know, the average American, and the research suggests that. With automation coming into a variety of different workforces, I think being able to find real purpose and meaning and connection through work is going to be a true competitive advantage that the caregiving sector will have. And so I think the attraction of those groups is going to continue to increase, but then also the retention as well because of those unique angles. And what I'm really optimistic about is the role that technology plays in transforming that experience.
Christian Alaimo:I'm sure you and I probably can operate like experts on subjects we know nothing about today because we have access to things like, chat GPTs and other tools of the sort. Putting that type of technology at the front line for caregivers, I think will give them an opportunity to be truly that very, very cutting edge of the healthcare system that's going into the homes, diagnosing, anticipating, in many cases, intervening before an event occurs, we're we're going to have what feels like super caregivers in the home. And I think the the faster we can get there, the more we can invest in the workforce and drive adoption of technology, the better off we are going to see the entire health care system operate. We're going to see much improved outcomes from those receiving care. I think there's going to be a lot of very positive effects of that adoption.
Christian Alaimo:So that's more of the 10, 20 year, I think is a little bit harder to predict. But I can see that ten year very, very clearly, and I think it might even happen a lot faster than that.
Miriam Allred:Christian, there were several things that drew me to Cariboo as a sponsor, and one of them is this, the optimism. I feel it too in my bones, just like this optimism for home care, and I get that from you and Alex and the team. And it's contagious, know, it really is contagious. We all need to have and I think we're preaching to the choir. I think a lot of people in home care feel this and think this and feel it as deeply as we do but just this this genuine optimism about the future of home care and the future of caregiving, and it's drawn me to you all amongst other things.
Miriam Allred:And so I just wanna say thank you for radiating that optimism because, again, I think there's a lot in the industry, but we need more of it, and we should just continue to spread that as much as we can. Last last thing, a couple other things that drew me to Caribou. You all have been around for maybe the longest when it comes to the rewards and recognition platform in home care. So you're you're very tenured and very experienced, but also from behind the scenes, I've watched your innovation, I've watched your growth, I've watched the agencies that you've worked with, and I think you all are doing so much great work for these businesses that you work with. So I'm prompting you here for the last couple of minutes.
Miriam Allred:There's hundreds of people that are gonna listen to this. Who should engage with Cariboo? Who listening to this? What what do you wanna say to someone that's maybe not using a platform today or has kind of like a scrappy hodgepodge program today? Like, who who should engage with Caribou after listening to this?
Christian Alaimo:Well well, first of all, thanks for all the kind words. It means a lot, especially with you championing this message. Like I said, I think storytelling and providing more shared understanding is such a huge part about lifting this industry up, and the work you were doing is at the forefront of that. So the feeling is certainly mutual. And on the optimism side, I mean, there's big challenges.
Christian Alaimo:And I think we all in this industry have a responsibility to genuinely work to solve the problems or else they're not gonna get solved. And I don't think any of us wanna live in a world where that's the case. So it's a mix of optimism and and a and a deep sense of responsibility that not only for me, but our whole team at Caribou feels. And I wish I could get all of them on the podcast and tell their own stories. There's so many so many incredible people behind this tech.
Christian Alaimo:To answer your question, you know, I I think this has evolved over the last few years on who should be using a rewards and recognition platform because the data has become more and more clear. Where in an industry where it's really hard to even imagine what a magical silver bullet could look like, you know, doesn't exist. We are seeing really clear trends now over a larger period of time. You know, several years of data that are now showing rewards and recognition increases retention. It increases compliance, whether it's clocking in, clocking out, or training on time into completion.
Christian Alaimo:And it's a really powerful tool to drive agency growth through recruitment. And so for agencies listening to this, I would imagine almost 100% of them will say at least one of those things is a challenge for them. Being able to solve one of, if not many of those problems in a way that's not creating added work kind of feels like it's just, you know, table stakes at this point to running a really efficient growing operation. And from a caregiver perspective, as you see in this distributed workforce that now many caregivers work for multiple agencies, if you want to become the employer of choice, making investments in things like rewards and recognition, have the data set to show that it really pays off. So it's a bit of a bigger answer than I would have given you a couple of years ago where I would have said, hey.
Christian Alaimo:Most people start with pen and paper, you know, start with the caregiver of the month initiative, and I think that's still a great starting place. But as there's being more and more asked of office staff, of agency owners, of operations, finding tools that can take work off the plate and improve operational outcomes, they they need to be really strongly considered. And whether it's Cariboo or other other technology, it does really feel like the highest performing agencies that win over the long term with retention growth and performance are going to be ones who find ways to engage and appreciate their caregivers at scale, and that's what these programs are doing.
Miriam Allred:Fantastic. So well said. Christian, thank you for joining me in the lab. You came so well prepared. So much good information off the cuff today.
Miriam Allred:Thank you so much for being here.
Christian Alaimo:Thank you so much for having me. Like I said, I I do think I could talk for hours, so I appreciate it. And, for everyone listening, thank you very much for your time.