Child-Care Site Care.com Boosts Vetting After Scrutiny

Online child-care network plans in-depth background checks and lowers annual guidance

By

Gregory Zuckerman, Kirsten Grind and Kimberly Chin

Online child-care marketplace Care.com Inc. CRCM -2.34% said it plans to overhaul its business model to include in-depth background checks and other screening procedures for caregivers after its vetting practices came under scrutiny.

The largest online caregiver network in the U.S., which has almost 33 million members, said Thursday it would pay a provider of background checks and identity services to conduct screening of caregivers on its site, such as verifying their social security numbers and checking for criminal histories.

The company said it would display the date of its most recent check on caregivers’ profiles online. Care.com will begin implementing the screening enhancements in the next few months and additional improvements will be rolled out by the end of the year, it said.

The enhancements follow an investigation by The Wall Street Journal that found the company performed limited vetting of caregivers.

The Journal found instances in which caregivers who had police records were listed on Care.com and later were accused of committing serious crimes while caring for customers’ children or elderly relatives. It also found hundreds of instances in which day-care centers listed on Care.com as state-licensed didn’t appear to be.

Chief Executive and founder Sheila Marcelo said in a statement on Thursday that she and the company believe “in the importance of creating a new safety standard for digital care marketplaces and today’s announcements mark a substantial step toward that goal.” She had previously called problems with caregivers on the site rare but “very heartbreaking.”

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Care.com previously relied on a model of “shared responsibility overall,” in which it asked families and others to do most of the vetting of the caregivers that they hired, and encouraged them to pay for additional background checks on those individuals.

Care.com shares dropped about 8% after Thursday’s announcement. The shares are down more than 40% in the past three months.

The company’s moves come amid increased scrutiny of the responsibility of tech platforms, which have broad protections under an element of federal law known as Section 230. The law, which says technology companies aren’t liable for content posted by their users, was established in the mid-1990s to give protection to websites and has allowed many to flourish into global giants.

It has recently come under attack by lawmakers who say it shields the industry at a time when tech firms are an ever-larger force in the economy.

The shift at Care.com “goes to the very architecture of Section 230. There will be some companies that take the easy way out by not investing in the quality of their sites, but that is not what the market wants,” said Eric Goldman, a professor at the Santa Clara University School of Law.

Mr. Goldman noted that the billions of dollars being invested by Facebook Inc., Alphabet Inc.’s YouTube and Twitter Inc. to more aggressively police their sites are reflective of the same forces.

In a change announced in a securities filing after the Journal article was published, Care.com said it would no longer allow caregivers to begin applying for jobs on the site until the company had completed a “preliminary screening,” which includes checking multijurisdictional criminal databases and the National Sex Offender Public Website.

Thursday’s moves show the company further strengthening its procedures.

Related

The company said it is launching a pilot program this month that would use facial recognition to match a government-issued ID. Care.com will also seek to verify the state licenses on child care listings provided by business owners.

It appointed Clark Ervin, former inspector general of the Department of Homeland Security, to its board.

Separately, Care.com reported a first-quarter net loss of $1.03 million. The company lowered its annual guidance for earnings before interest, tax, depreciation and amortization by $8 million. Chief Financial Officer Michael Echenberg said on the company’s earnings call Thursday the weaker outlook reflected Care.com’s one-time expenses in responding to the Journal’s investigation and the safety investments the company is undertaking.

Mr. Echenberg said there will be one-time costs associated with the improved safety measures, as well as ongoing costs, as they are introduced.

“These investments while substantial in size, are aimed at making our service safer, increasing value to our consumers and clients and enhancing the category leadership of our brand, while ensuring we keep our services affordable for families,” Ms. Marcelo said.

Ms. Marcelo also said that “a handful of very small clients” have decided not to renew their Care@Work services, a program that provides employees with backup child care. The company says the result has been a “less than 0.10% effect on revenue.”

Best Buy Co. said in April that it had suspended its Care@Work relationship.

Corrections & Amplifications
Care.com reported a net loss of $1.03 million in the first quarter. A previous version of this article incorrectly said the net loss was $1.03 billion. (May 9, 2019)

—Allison Prang contributed to this article.

Write to Gregory Zuckerman at gregory.zuckerman@wsj.com, Kirsten Grind at kirsten.grind@wsj.com and Kimberly Chin at kimberly.chin@wsj.com

Appeared in the May 10, 2019, print edition as 'Child-Care Site Boosts Vetting After Scrutiny.'

Families Use Apps to Track Relatives With Dementia

Technology can keep tabs on people with dementia, but apps crash, batteries die and systems fail

Kim Rice places an AngelSense GPS tracker on her husband’s clothing each day so she can track his whereabouts. She tries to get home from work before he returns from adult day care. Photo: Nate Ryan for The Wall Street Journal

By Julie Jargon

April 16, 2019 5:30 a.m. ET

Kim Rice tracks her husband’s every move, including his arrival home each night from adult day care.

She’s among the millions of Americans caring for a loved one with dementia at home. And like many, she turned to tracking and monitoring devices to help her manage the daily juggle of working, ensuring her husband’s safety and maintaining her own sanity.

Most days, Mr. Rice’s bus driver walks him to the door of his home and sees him inside. But there’s sometimes a 15-minute lag before Ms. Rice receives the notification her husband made it home, courtesy of a GPS tracker she slips in his pocket.

Kim Rice and her husband, Greg, who lives with dementia, on a walk near their home in suburban St. Paul, Minn. Photo: Nate Ryan for The Wall Street Journal

“There are times he’s gotten back before me and it’s a race to get home,” said Ms. Rice, an occupational therapist whose husband, Greg, 63, has frontotemporal dementia. Their St. Paul, Minn., house is outfitted with motion detectors and door-lock sensors that alert her when her husband attempts to leave. “I have six different apps related to Greg on my iPhone.”

There’s a lot riding on technology that could keep people in their homes longer. As the number of older Americans grows, the number of family members available to care for them is expected to decline, according to the National Academies of Sciences, Engineering, and Medicine. More than 16 million adult family members provide unpaid care for many of the 5.8 million Americans living with Alzheimer’s disease or other forms of dementia, the Alzheimer’s Association estimates.

Greg Rice wears a Vitals beacon, at left, which can alert first responders of his condition. A Tile tracker, on his other shoe, is used as a backup.

Kim Rice places a Road iD bracelet—which lists diagnosis and contact info—around her husband’s wrist.

Photos: Nate Ryan for The Wall Street Journal(2)

Monitoring technology promises to prolong independent living for adults with memory problems and to provide respite for their caregivers but, as Ms. Rice and others have learned, technology isn’t a catchall.

“Putting on a watch sounds easy. Making sure the app works—not always. Making sure your parent or spouse is using it—even harder,” said Andy Miller, senior vice president of innovation and product development at the AARP. “This stuff takes money and time to set up and maintain. It either becomes a burden or something goes wrong and the stuff ends up in the junk drawer.”

Kim and Greg Rice on their May 6, 2000, wedding day. Photos of their life before Greg was diagnosed with dementia cover the walls of their Minnesota home. Photo: Nate Ryan for The Wall Street Journal

Ms. Rice has had some close calls. One evening when Mr. Rice got home before a caregiver arrived, Ms. Rice tried to speak to him through her video doorbell ringer, but the video stream on her Ring app was slow to load. She finally got through and explained how to enter the code to unlock the door. Once Mr. Rice was inside, she kept him stable by speaking to him through the Amazon Echo Show device in their kitchen, where he could see her on screen.

What the Rice Family Has Found Useful

AngelSense GPS tracker ($229; service starts at $33 a month): Location device marketed to parents of children with autism. Its maker says about 10% of its users are people with dementia and Alzheimer’s.

Vitals Aware Services: Created to help people with “invisible” disabilities, this service consists of a free app and wireless keychain beacon. (The first is free; additional beacons are $20.) Officers from participating police departments get a notification if they come within 80 feet of someone wearing a beacon, including tips for de-escalating confrontational situations.

Best Buy Assured Living ($50 to $150 per product; $30 a month for service): Devices, from door alarms to bed pressure sensors, are installed to help seniors live independently. The program is available in just over 20 U.S. metro areas.

“I feel safer with the things she’s put in place,” Mr. Rice said. “It’s very good to be in my own home.”

When the devices work smoothly, it can be liberating. Tracking her husband has enabled Ms. Rice, 53, to continue going on the bike rides that provide the only “me time” she gets, because she can have the door-sensor notifications sent to neighbors in case Mr. Rice wanders.

“Without technology, I couldn’t have kept him home this long, but there’s been a lot of trial and error,” said Ms. Rice.

Joseph Gaugler, a public health professor at the University of Minnesota, studied the effectiveness of remote activity monitoring technology over a six-month period for caregivers of people living with Alzheimer’s disease or a related dementia. His study, published in July in the Gerontologist journal, found that such technology works best for people in the early stages of dementia but even then, families often struggle with it. “It’s not a universal solution,” he said.

When Kathleen Daly was in the early stages of Alzheimer’s, the former epidemiologist went on walks around her neighborhood. Sometimes, when she got lost, she’d call her husband, Joseph.

Joseph Daly and his wife, Kathleen, on a trip to Croatia in October 2017. Photo: Daly Family

One afternoon in April 2017, Mr. Daly went upstairs to use the bathroom and returned minutes later to find the house empty. He drove around and couldn’t find his wife. It was after 4 p.m. and starting to get cold in Minneapolis. He called his daughter, who lives four hours away, and she posted a note on Facebook asking local friends to help search for her mother. One friend hung photos of Dr. Daly around the neighborhood.

At 8:30 the next morning, two women driving home from work saw a woman walking along a road and recognized her from the photos; they picked up Dr. Daly and brought her home. “That’s when I realized, ‘Oh God, we have to come up with something,’” Mr. Daly, 76, recalled.

His son-in-law had the idea to get Dr. Daly LG’s GizmoPal 2, a child’s tracking watch. Equipped with GPS meant for parents to track its location via an app on their smartphone, the watch also allows the wearer to call, and receive calls from, a limited number of contacts. Mr. Daly saw to it that his wife wore it every day.

Kathleen Daly wore a GizmoPal 2, a child’s tracking watch, so her husband could find and call her if she got lost. Joseph Daly referred to it as the ‘Dick Tracy’ watch. Photo: Daly Family

Dr. Daly, now 75, soon lost the ability to make calls, but the watch auto-answers after 10 seconds. “Twice since that April day she’s taken off from the house and I was able to find her immediately,” said Mr. Daly, an emeritus law professor at Mitchell Hamline School of Law in St. Paul, Minn.

Lately, however, Dr. Daly is no longer well enough to go out by herself. Even with the assistance of tracking technology, Mr. Daly said he doesn’t trust that he’d be able to find her if she got lost again, as she’s been known to turn off the watch, which can’t be powered back on remotely.

Instead, he’s opted for a low-tech solution to her wandering: He installed locks high on the doors, where she can’t reach.

Help When You Need It

Caring for a loved one with memory problems can be isolating and overwhelming. Here are some resources that might provide relief:

AARP : The senior-citizens’ group has a planning guide for families called “Prepare to Care,” (available for downloading or by calling 877-333-5885) with information on how to broach the subject of in-home or residential support.

Alzheimer’s Association : The organization offers tips for caregivers to manage the stress, depression and grief that can come from caring for a loved one with dementia. It hosts a 24/7 telephone helpline and assistance finding support groups.

CaringBridge : The website and mobile app allow caregivers to coordinate care and privately share updates on a relative’s condition with a group.

CareZone : The app helps caregivers manage their loved one’s medications and keep track of vital health stats.

—For more WSJ Technology analysis, reviews, advice and headlines, sign up for our weekly newsletter. And don’t forget to subscribe to our Instant Message podcast.

Write to Julie Jargon at julie.jargon@wsj.com

New Hopes for Dementia Care

Robot pets, counseling for caregivers and other tools can help patients avoid costly nursing-home placement

Illustration: Andrea Mongia

By Tia Powell

April 11, 2019 3:32 p.m. ET

A colleague called the other day, asking for help finding care for her brother, who was recently diagnosed with dementia. That’s a common enough request, but this colleague is a doctor, and she had already taken her brother to an elite academic medical center that did lots of tests and offered to enroll him in research studies. That wasn’t the help her brother was looking for, however, or at least not all of it. He wanted to know how long he could keep working, how he should organize his finances, and how long he could live at home as his illness progressed. His physician couldn’t answer those questions and didn’t really know who could.

As the baby boomer generation ages, many more Americans are going to be asking the same questions. More than five million Americans already suffer from dementia, a broad category that includes Alzheimer’s disease and other ailments that cause irreversible, progressive and ultimately fatal cognitive decline. Dementia affects not just memory but also executive function, learning, language and basic movements like walking and swallowing.

In addition to the emotional and physical burden on patients and caregivers, dementia also exacts a high financial toll. For patients on Medicaid, the average annual cost of nursing home care is roughly $82,000; if you don’t qualify for Medicaid, a semiprivate room in a decent nursing home in a big city costs $240,000 a year. In total, Americans already spend more than $200 billion a year on dementia care, and the figure is climbing.

Pushing back the day when a person with dementia needs a nursing home can both save money and improve quality of life. Unfortunately, it is all too common for a frail older person with dementia to live at home alone, with few services and supports. That makes it easy for them to miss meals, mix up medications or fall and break a hip, requiring hospitalization that costs tens of thousands of dollars—followed by expensive rehab or a permanent transfer to a nursing home.

For people in the earlier stages of dementia, a dog can get them out of the house and walking.

But with the right help, problems that lead to nursing home placement—including agitation, incontinence, wandering and falling—can be addressed at home, using innovative new approaches that promise to improve the quality of life for dementia sufferers. These programs aren’t a cure-all—people with end-stage symptoms of dementia may ultimately need a nursing home. But they can help the majority of people in the earlier stages stay home longer and more safely.

Pets are a familiar remedy that is gaining popularity. For people in the earlier stages of dementia, a dog can get them out of the house and walking, which is good for mood, may slow cognitive decline and facilitates friendly conversations with people in the neighborhood. Trained therapy animals can do a lot more, like help find a lost person or offer reminders to eat and take medicines. Highly trained animals are expensive and hard to obtain, however: Ohio-based 4 Paws for Ability offers dementia therapy dogs for $17,000—below their actual cost—and it has a wait list.

Unfortunately, older people walking dogs can fall and get fractures, which may mean a ticket to the nursing home. That’s why patients with more advanced dementia can benefit from fake pets, which help to calm agitation. Ageless innovation’s Joy for All robotic stuffed animals cost just under $100 and come in dog or cat versions that wag their tail or purr. One friend ruefully reported that of all the gifts and outings she’s offered her mother with dementia, her absolute favorite is her robotic kitty: Her mother was barely speaking before but now speaks to the cat and about the cat to every visitor.

Some people hate these phony pets, finding in them a way to trick the cognitively vulnerable. But calming agitation with a robo-kitty can reduce the use of antipsychotic medications (whose risks include that broken hip); the fake pet is better than a real fracture.

The PACE program has successfully improved patients’ function and decreased their health-care costs, and has been replicated across the country.

Those who need more intensive help can benefit from the PACE program, or Program for All-inclusive Care for the Elderly. Designed for people covered by both Medicare and Medicaid, PACE has successfully improved patients’ function and decreased their health-care costs, and has been replicated across the country. PACE provides social opportunities, music and art activities, modest exercise (think chair yoga) and basic medical screening like blood pressure checks. All that activity can also help to combat the disrupted sleep-wake cycles caused by dementia—a significant contribution, since a patient who is awake and noisy all night can overwhelm a family that has to get up in the morning for school and jobs.

Another promising program is Mind at Home, based at Johns Hopkins University, which sends workers to check out dementia patients’ homes for safety issues—like bathroom cabinets full of expired drugs and rugs that are tripping hazards—and trains caregivers to respond to dementia’s challenges. Care is coordinated with a multidisciplinary team that focuses on preventing falls, maintaining good nutrition and ameliorating symptoms like agitation, wandering and anxiety. The NYU Caregiver model is another excellent program, focusing on counseling sessions for family caregivers, support groups and as-needed backup phone calls. New York state is funding a five-year trial to expand this approach and to help stretch the time that people with dementia can live safely at home, where they say they’d like to be.

We currently have no cure for dementia, and we are unlikely to find one in time for the aging baby boomer generation. Dementia is tough on those who have the illness and those who care for them. It’s in everyone’s interest to design good dementia care and make it ready for the day we will need it.

—Dr. Powell is a professor of psychiatry and bioethics at Albert Einstein College of Medicine. This essay is adapted from her new book, “Dementia Reimagined: Building a Life of Joy and Dignity from Beginning to End,” published by Avery.

Corrections & Amplifications
Joy for All companion pets are made by Ageless innovation LLC. An earlier version of this article incorrectly stated that they were made by Hasbro.

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