Aging in place is becoming harder, not easier. The problem isn't just medical costs, health literacy, or access to specialty care—it's the lack of a trained, reliable human workforce. Millions of older adults would prefer to remain at home, but there aren't enough caregivers to support them, especially as needs increase with age, frailty, or cognitive decline. The result is delayed help, dangerous gaps, and avoidable transitions into institutional care.
Historically, the only way to deliver home-based support has been through people. The marginal cost of care has always been labor—hourly wages, scheduling logistics, transportation time. That's not a criticism. It's the design constraint we've worked within for centuries. But it doesn't scale, and it's already failing to keep up.
Now, for the first time, that constraint is loosening. With intelligent, always-on technology, certain forms of care—reminders, check-ins, gentle guidance, even simple conversation—can be delivered at a marginal cost closer to electricity than employment. That doesn't make people obsolete. It means the work of caregiving can be extended, supported, and made more available. The cost of delivering reassurance, structure, and continuity no longer has to scale linearly with staffing.
The implications are bigger than convenience. Many of the most expensive and tragic failures in healthcare happen near the end of life, often stemming from isolation, confusion, or missed signals: a fall that goes unnoticed, a medication that isn't taken, a caregiver who doesn't know what's changed. If every aging adult had access to consistent, thoughtful companionship—whether from a person, a system, or both—we would see fewer emergency visits, fewer unnecessary hospitalizations, and far more older adults living with dignity in their homes.
These benefits are especially critical for the millions of people living with cognitive impairment—and for the strained workforce that supports them. Memory loss brings unique challenges: disorientation, safety risks, communication breakdowns. It also deepens loneliness. Specialized memory care is expensive and labor-intensive, but some of the most important needs—structure, recognition, interaction—can be supported at scale with the right technology. Intelligent systems, including robotics and language models, can offer real respite to family caregivers and act as copilots to home care aides whose jobs are often tedious, isolating, and even unsafe.
The workforce problem in healthcare isn't just about wages or training pipelines. It's about redesigning care so that people are supported without being overwhelmed. That starts by rethinking what "work" in healthcare even looks like—and who, or what, is capable of providing it.