Caregiver workforce training & education

Peter Nicholson has over 35 years-experience in healthcare. After a successful 30-year career in the biopharmaceutical and medical devices industries, he transitioned to focus on social impact opportunities he identified for improved care delivery.  He is co-founder of Care Campus, a social impact company focused on professionalizing the vocation of caregiving to upskill workers and empower them to provide person-centered care for older adults.  He is co-founder of To Know Me, focused on developing digital tools that help support healthcare professionals deliver of the promise of person-centered care. 

He was responsible for the global strategy and business development functions at Nestle Skin Health, Galderma (Nestle Skin Health), and before that at Mentor (Johnson & Johnson) and Inamed (Allergan). He co-founded Blue Heron Biotechnology (Origene), focused in the area of genomics.

He has been awarded a Fellowship from the Stanford Distinguished Careers Institute and is nominated as an Ashoka Fellow.

We are focused on professionalizing the vocation of caregiving based on the principles of person-centered care.  We work with current caregivers, or those seeking to enter the field, to provide the comprehensive knowledge needed to help older adults age with dignity.  Through our structured learning programs, students can become certified as a caregiver and learn how and when to integrated into the broader care team including healthcare professionals.  Successfully matriculating students can then seek employment in country or look elsewhere.  We also train and educate family members seeking to provide better care for their loved ones.

Our curriculum democratizes advancements made in the world’s leading medical institutions and universities and provides it to those people who need it the most – caregivers – to perform their daily work with the greatest impact.  By doing so, we are able to improve care while lowering overall cost to the healthcare system.

In today’s world of unprecedented longevity, living better as we live longer has become a dominant theme.  With one billion people projected to be 60 years or older this year, and two billion by 2050, no government or healthcare system will be able to afford the growing costs of caring for an even older population unless we change the paradigm.

In many countries, the older generation cares for the young children, allowing both parents to work and raise the economic viability of the extended family unit.  When the health of the elderly is compromised, the negative impact can extend to the broader family. Women comprise the majority of unpaid family caregiver and paid care workers.

Policymakers and healthcare officials have cited the need to take effective steps for ensuring various necessary services for the poor, middle-class and affluent ageing population in urban and rural settings.  

The World Health Organization highlights the need to empower a new vocation of caregivers to help address the issues of successful ageing.  However, very few structured, accessible learning programs exists today in the world capable of engaging people who desire to join one of the fastest growing areas in healthcare in the 21st century.

The COVID 19 epidemic has highlighted the importance and need for care of the elderly.  We have worked with nursing and care experts around the world to develop structured on-line education through which students who complete the course work and successfully pass the tests to gain the education and insights needed to become caregivers.  Each vocational education program is comprised of courses in specific areas which  consists of modules which focus on key domains and are themselves devolved into lessons.  The lessons focus on individual topics and last five-15 minutes each.

In addition to three free preparatory courses (MOOCs) we have four different programs that result in certification levels (I-IV) of increasing complexity and sophistication.  Level I teaches the fundamentals of caregiving for older adults based on the principle of person-centered care.   Levels II & III provide in-depth insights into activities for daily life (ADL) and age-related conditions (ARC).  Level IV covers the most challenging cases including diminished mental capacity and early dementia.  The information contained in the learning modules is presented at a level that engages people with little formal education and does not require a university degree.  All of our courses will be available on-line and accredited.

Our proposal meets the needs of the population in not only building up a supply of credentialled caregivers but also it promotes a new career opportunity capable of addressing national, regional and international workforce shortages. We serve the broader community seeking to provide improved care to older adults seeking to age with dignity.

Because the role of caregiving falls predominantly on women in most the world, by professionalizing the vocation of caregiving we will provide jobs with opportunity for advancement for woman who participate and seek to progress their education and qualifications and with improved wages.    

We partner with government organizations, vocational training institutions and non-profit and for-profit entities that provide in-home person-centered care.  For all of these groups we seek to upskill people who are already working as caregivers or who are seeking to enter the vocation of caregiving.  We also serve families seeking to gain the competencies and education needed to provide more informed care to their ageing family members. We also work with government finance ministries, insurers and payers who are seeking to provide extended care that results in improved quality of life and well-being at a lower cost

People who care for older adults are overlooked and under appreciated.  We  help this critical workforce by bring a robust and structure curriculum that professionalizes the vocation of caregiving and provide opportunities for all to engage in what is recognized as one of the fastest growing and most needed skills for the 21st century.

Through our structured learning and training programs, family members, paid care pwrkers and those seeking to enter the field can learn how to deliver person-centered care with confidence.  They will be able to achieve progressively more sophisticated levels of skills enabling career progression.

While working in the biopharmaceutical industry I was given the opportunity to intersect with the aged care market.  After learning about this magnitude and need, I tried to get my employer to focus more on developing products to serve this growing market, specifically in the area of skin health.  After generating data on how our products can help, I met with leading care providers who became interested in including this approach in their work but had no training materials.  I worked with our CMO to write training materials for their caregivers and found the other training materials they had were poor to non-existent.  At the same time I lost my father and saw first hand how important caregivers are.  These two experiences motivated me to get involved.  

I collaborated with others to develop a comprehensive set of training materials and met with The WHO to discuss including skin health in their aged care agenda (they did).  I engaged with the leadership of the worldwide governing authority for nursing to develop training materials which led to the core curriculum we have today.  I then engaged with the leadership of the International Association of Geriatric and Gerontology to help guide our development.

Prior to leaving my last professional role at Nestle, I travelled extensively on the topic of global aging demographic and spoke at conference including Milken Asia.  I saw first hand and learned through many discussions about the needs and concerns and the gaps the society is facing.  After watching my father in his last years and getting involved to try and help with his care, I saw first hand how important caregivers are but how little trying they have.  At the same time, I was aware of the tremendous insights that were embedded in institutes of higher learning, but realized that sadly thee insights are rarely made available to the people who need them most in their daily work - caregivers.  As most caregivers are not college educated and receive little formal training, I decided to try and make a difference and create robust training and education materials for care workers and get the accredited and recognized around the world to help provide opportunity and elevate this role while sat the same time providing job mobility.

COVID 19 has highlighted the need for this type of program even further and I am discussing partnerships in India, Malaysia and Bangladesh now.

Through my 35-year career in healthcare I gained global exposure to the challenges related to the ageing demographic.  I have assembled a team with the isights, networks and passion to deliver on this mission including:

Francis Hughes, RN, PhD, ONZM has more than 35 years of healthcare experience with particular specialty in mental health and disability. She has worked in over 18 countries, having held positions with WHO, Chief nurse in New Zealand and Australia and as CEO of the International Council of Nurses.

Julia Hennessy, RN, PhD, MEd is President of the globally recognized Auckland Institute of Studies, one of New Zealand’s largest tertiary learning organizations. Her career has focused on the development of healthcare and social services program at local and international level.

Marion Clark, RN, MPP, has a 30-year career of management and leadership in the health sector focused in clinical (nursing), hospital management, health public policy analysis and policy management, health professional regulation and health international development working with governments, NGOs and industry.

Ershad Ali, PhD, M Engr, MSc, is a senior faculty of the globally recognized Auckland Institute of Studies. He has more than three decades indepth experience in both the private and public sectors and has strong network with government and non-government agencies in Bangladesh and India.

Monique Morrow, MBA, MSc, currently serves as President of the VETRI Foundation and Venture Partner for Sparklabs Accelerator.  She spent 16 years at Cisco as the company’s Services CTO.  She is also founder of The Humanized Internet.

I became very passionate about this mission in 2017 and resigned from my post at Nestle to focus full time.  I assembled a team and raised $1 million to fund my new initiative.  While fund raising, I accelerated in forming  key strategic relationships while developing the course work and building the organization.  When the funding needed to continue did not materialize quickly enough, I invested all of my own capital in the business.  We grew too fast and ran out of money and lost everything.  It was very painful and challenging and while it took me time to recover, I never lost my passion for the mission I was seeking to serve.

After taking time to regroup, I re-approached this issue but with a different and more disciplined perspective and the many lesson learned form my first attempt.  I slowly began to reach out to key people to help me restart this activity but with a different focus based on the insights gained and began to carefully advance our goals and objectives while ensuring we did not move too quickly and make commitments beyond our ability to deliver.

When working as a member of the executive leadership team at Nestle Skin Health I became involved in the aged care sector.  When meeting with the World Health Organization to discuss this in the context of their "World Report on Aging and Health" which was being drafted, I discovered that the topic of skin health was not included.  I subsequently galvinized a group of dermatologists from their governing body, the International League of DermatologicalSocieties, as well as policy experts from the International Association of Geriatrics and Gerontology to provide the information needed to the World Health Organization to have skin health included in their guidelines.

The recent COVID 19 pandemic has shown the vulnerability of the ageing population.  We have spent 18 months working with a global group of nurses having deep insights into geriatric care to create the world's most robust curriculum for training and educating care workers -those who care for the elderly.  We are seeking to democratize the insights generated in medical centers and universities and provide them in an engaging and easy to understand educational platform that allows users to up-skill and deliver improved care in the home or at assisted living facilities. This is an evergreen set of materials we are constantly updating while continuing to add others in response to the need to deliver person-centered care.

The program delivery system is flexible and can easily be adapted for specific countries.  It is planned to focus initially in developing countries that are lacking professional education and training for caregivers and will be internationally accredited, making it transferable for graduates who migrate.

We have put in place a robust quality management system and work with educators having deep experience in delivering on-line healthcare content to ensure we are constantly incorporating best practices in our educational platform.  The learning management system we have selected allows us to engage with student and issue certificates of completion after successful matriculation.

We integrate the best assisted-living technologies in our program to ensure that people who will use them, who are most-often less educated, understand how to use and integrate them in to their care protocols.

Students will complete the on-line course work and then the hands-on practical training to gain the education and skills needed to become competent and fully-functioning caregivers. They will also get exposure to the newest advancements in connective technologies so they understand how to incorporate them into their daily work routines.  This is critical as most of this workforce is under-educated and sometimes intimidated by technology.

In the short term, students will learn about issues that older adults can face, the impact these have on their health and wellbeing, how to intervene when the student encounters them and when to contact a healthcare professional if their intervention does not provide the needed outcome.  This virtuous circle will be key in expanding the broader care network in a way that lowers healthcare costs while at the same time delivering best-in-class care that helps older adults to age with dignity and live fulfilling lives .

After successful completion, graduates will be awarded a certificate as a qualified caregiver.  At the same time, they will gain exposure to potential employers while also being able to access micro-finance programs to enable them to finance and setup their own caregiving business.

Some student will take this certificate and seek to create a business locally.  Others will seek to immigrate where better paying job opportunities may exist. in the mid-term, students may seek to become instructors or to advance their training and education though higher levels of proficiency. 

Longer term, students may leverage this course work and its equivalency to use it as a bridge to complete a college degree or continue their medical training too become a registered nurse.  Thus by professionalizing the overlooked and under-appreciated vocation of caregiving we are able to provide a path to those seeking to elevate their earning potential and perform work with meaning that has the ability to become a long-lasting career with progressive levels of achievement and the benefits that go with them.

We are a social impact organization driving development and assessing material in Switzerland and New Zealand and through our group of expert geriatric nurses form around the world.

We are in discussions with groups seeking to train caregivers in India, Malaysia and Bangladesh.  They are interested in using our platform to training a new workforce, one much needed in the 21st century with longevity being our new reality.  We could have more than 2000 people on the system within three months of executing any one of these contracts.  

After initiating work in India, Malaysia and Bangladesh, we will expand in Japan and China.  We will also begin to engage across Europe.

Version 1 of the platform can support multiple languages and up to 25,000 users a month and version 2 would support 250,000 users a month.  Our business model focused on institutional engagement to build platform-load but we also expect to get interest from individuals and family members. Assuming we have traction with these groups, we would expect to serve 10 organizations and 5,000 – 10,000 caregivers in year one.  By year five, we project to have close to 500,000 people on the platform.

In the first year, we will finish and launch our platform in several targeted geographies working with local partners.  Our goal is to validate the platform, gain experience working in multiple languages, and understand how to implement successfully in resource rich and resource poor environments.  Its a global opportunity and we will progressively expand the scope of our activities to address it. 

We are beginning in Asia and then plan to expand into Europe and finally North America as we have deep networks in those geographies.  Within the next five years, we expect to have created several centers-of-excellence (COEs) where we can learn and evolve best practices and then use this to revise our on-line education content and field training materials.  At the COEs, we will be able to effectively run “train-the-trainer”programs to support a hub and spoke approach that facilitates out-reach from urban to suburban and event rural settings.  

Our vision is to define a new global standard for education and training people who provide care for older adults, either family members or paid care workers with certification and accreditation that support and allows for global mobility of this newly created, skilled workforce.

Our expectation is that caregivers who are certified through our platform will be globally recognized and accredited with student able to immigrate to meet jobs needs around the world.  These will be jobs with skills for the 21st century and with the potential for progression as more course work is completed.

Southeast Asia is a rapidly ageing and underresourced partof the world struggling to meet its basic needs including extreme shortage of skilled/ semiskilled manpower for health sector, particularly primary health care industry. Much of the people in this region live in urban or rural area where lack of healthcare services affect peoples’ life and hence the socioeconomic development of the country.  Our project will provide training and education for elder caregivers to create a more skilled workforce, improve quality of life and lower healthcare costs.

As we have now invested the time and money need to create the educational content, our biggest challenges are:

• Capital: to attract an appropriate amount of scale capital to invest in and support our business growth.  
• Government support: to achieve our objectives and have the broadest impact we need to have strong support at the government level.  
• Scalable platform: we need to anticipate our growth to ensure that our platform is robust enough to carry the load, with an ability to scale rapidly as demand increases.
• People: to attract and retain key talent who are inspired by our vision and ready to make an impact.
• Partners: to deploy locally, we need to find good partners who can help us reach and have an impact at the local level. Cost data: to generate good cost data showing the reduction in care burden that results when staff are trained and certified on our platform.  

We have developed concrete plans and strategies to address and overcome these barriers: 

• Capital: after self-funding this initiative thus far, we have three paths to secure funds: (a) grants which we are pursuing, (b) strategic partnerships which we are considering; and (c) external venture capital with whom we are discussing investment.  
• Government support: we are seeking to engage at the government level in the geographies we have targeted to ensure alignment and support and have good success thus far in Asia and Europe.
• Platform: we have identified our core platform and learning management system and have prioritized scalability in the initial architecture and product selection.
• People: we have a growing network of qualified and interested people who want to be part of this new initiative but will need to be careful about how we manage growth.
• Partners: we are evaluating potential partners and strategically choosing those who we think would be best as we focus on specific geographies. Cost data: we need to work further on this topic with the right people in conjunction with the payers or healthcare agencies to develop a robust data collection methodology.

In India, we are in discussions to partner with Kolkata-based International Institution of Management Sciences (IIMS).  International Institute of Management Sciences (IIMS), a non-profit management institution situated in Kolkata, is a pioneer institution in India to offer Management Education in the private sector since 1979. The Institute is the first in the country to receive All India Council for Technical Education (AICTE), Govt. of India, approval in 1991 for offering PGDBA (equivalent to MBA) in Distance Learning (DL) mode marking the recognition of its competency in fulfilling the commitment of excellence and outreach.

In Bangladesh, we are in partnering discussions with Dhaka-based Japan Bangladesh Friendship Nursing Institute (JBFNI).  JBFNI was established in 2012 for producing skilled nurses who would be nationally and internationally fit for working with their excellence in knowledge ,attitude and practice. keeping this mission in mind JBFNI governing body has been keeping no stone unturned to provide all possible world class academic and hands on training environment to bring out best in our nurses.

In Malaysia we are in partnering discussions with Kuala Lampur-based Universiti Teknologi MARA (UiTM).  UiTM is a leading innovation-driven entrepreneurial research university in engineering, science and technology.  UiTM as the biggest postgraduate research university in technology has also established a reputation for innovative education and cutting-edge research, with a vision towards the development of creative human capital and excellence in science, technology and engineering for the well-being and prosperity of mankind.

We have a hybrid business model that focuses on business-to-business engagement while also supporting consumers.  

We partner with organizations to provide training and education to their staff with an annual platform fee and a fee per employee, based on the total number of employees.  

We also partner with educational groups around the world seeking to expand their offering to include the training and education of caregivers.  Through joint ventures, we work with educational groups to establish urban-located centers-of-excellence in which we can engage with the community and pursue out-reach to rural areas.

To extend our reach further, we also provide training and education to individuals who are able to directly access our educational information on our platform via the internet.  

We charge a per student fee for our courses with an additional charge for certification.  Our pricing is based on the guidelines provided by the World Bank, with organization and individual in wealthy countries paying 100% of the index price, upper-middle income countries paying 60%, lower-middle income countries paying 30% and low income countries paying 10%.  Because we are a social impact company, we also provide our materials for fee in those cases where there are no resources available. 

There are other revenue opportunities we will be able to pursue, such as advertising for employers seeking to recruit caregivers but we have not included a meaningful contribution from this source in our revenue forecast.

We plan to source funding from grants, strategic partners and investors to meet our funding requirements.  Revenue will commence in the second half of 2020 following the release of version 1 in Inda followed by introductions in Malaysia and Bangladesh.  This SAAS business model is based largely on an enterprise-to-enterprise growth with relatively modest contribution for the consumer channel, particularly in the initial years.

We are seeking funding through grants and from private investors to help us reach the market.  We will carefully match our growth to the success in the market and provide mid-course changes in strategy or execution should we not generate the expected results.  Thus, we are focused on longer term sustainability rather than as growth-at-all-costs business model.  We target break-even cash flow in six quarters, once we launch and profitability beyond that as we grow our business and reach. 

We have had multiple discussions with professional investors - private family offices and venture investors focused on the field of online education - and expect to engage with them for growth capital so that we can expand our activities into other geographies and increase our staffing as the business as it grows.  We have been approach by impact investors and believe there will be opportunity with them given the social impact mission we serve.

More traditional venture capital firms are return driven and less interested the social impact facet of the business and thus think about how they will sell rather than long-term impact and opportunity.