On a sultry day in April 2011, Denise Thomas, the owner of Home Instead, a franchise business in Austin, Texas, drives to the home of an elderly client. Ninety-one-year-old Emily Lake moved into her comfortable single-story house five years ago and plans to stay there, thanks to Home Instead's caregivers, who help her bathe, pay bills, shop, track medications and generally maintain her independence. For Thomas, visits to satisfied clients are the best part of her job.
“This is what it's all about,” she says. “The fact that Emily can live here, with her things around her, playing her piano, being able to visit the supper club she's gone to for decades, seeing the friends who live nearby: That's why I got into this business in the first place.”On this visit, Thomas, a gregarious woman with a wide smile, chats easily with the elegant older woman. Their conversation eddies around subjects like cats, classical composers and Lake's memories of hobnobbing with Austin politicos in the 1950s. “You were friends with Dick Cheney, weren't you?” asks Thomas. Well,” drawls Lake, “I wouldn't say friends. I'm friends with George W. and Laura. I love the Bushes, father and son.&rdquoAn hour later, Thomas says good-bye, confident that the caregivers she's selected to look after Lake have been doing a good job. For Thomas, the rewards of running an at-home senior-care business are personal as well as professional. “What I love about working with the elderly is that it forces you to slow down,” she says. “They're going to talk slow, so you're going to talk slow. It's not a bad thing to be forced to do.” She savors her conversations with clients and their families, getting to know each person's biography and then figuring out the right person to fill his or her needs: someone who can prepare meals and help create a family scrapbook? Attend concerts? Discuss the Bible? Clean the cat's litter box? “Our relationship with clients is very intimate,” says Thomas. “We are matchmakers in a way, putting together people with similar interests, personalities, backgrounds. Nothing is more satisfying than when it clicks.”
All of her Home Instead staffers are specially trained to help clients struggling with memory loss and dementia. “People with memory loss have a better chance of staying engaged if they're in familiar surroundings,” says Thomas. “In general, most seniors—about 90 percent—want to stay in their own homes as they age.” She's not against assisted-living communities. “If a house is falling apart, then it's not suitable for an aging person,” she says. “My mission is to respect the senior's wishes. For some, a move can be good. But if they don't want to move, that's where I see a problem.”
Since launching her business in 2003, Thomas has expanded from 30 caregivers and zero office staff to her current team of 150 caregivers and eight administrators, with annual gross earnings of $2 million. Her success has proved recession-proof; those who care for the elderly and ill constitute the fastest-growing segment of the workforce, according to PHI, a health care advocacy group, and by 2018 home-based workers are expected to outnumber nursing home workers two to one. The Home Instead parent company, which launched with one office in 1994, has expanded to 900 locations worldwide. The franchises now employ more than 65,000 caregivers and serve nearly one million clients.
Thomas got into the business after rising up through the corporate ranks at IBM and then becoming a marketing executive for the Discovery Channel's international development arm. “I wanted to see the world,” she says. In the 1990s, her globe-trotting work took her to cities in Europe, South America and Asia. She met and married a Japanese man, and the couple lived in Japan while Thomas learned the language and taught at a business school for Japanese nationals preparing for careers with American companies. The couple were also trying to have a baby. Then, in 2001, her husband, a venture capitalist, was transferred to Austin, where neither of them had lived before.