Another new café has opened. Inside, students gather to socialize and colleagues to discuss work and business. Such a scene is nothing unusual in the Fengchia Commercial District. What is somewhat less usual is the number of older people or family members of elderly people coming in looking for long-term care information and assistance. They gather here because this establishment is a “care café.”

Lee Yi-jen, the 27-year-old manager of Roots Living Space, has just been attending to a group of customers. “We’re a one-stop community care platform, taking long-term care to people’s homes, so family members need not keep making multiple phone calls,” she says.

This single contact point approach was conceived to address family members’ pain points. If the health of a senior under care worsens and family members have the need, café staff can connect them with long-term care providers to access help with housecleaning and chores, giving family members much-needed respites from unpleasant tasks; home care actions as helping elderly people turn over in bed and bathe; services like purchasing wheelchairs and applying for stipends; and even hospice-related functions like changing catheters.

Since opening around eight months ago, the café has helped numerous families connect with out-of-pocket and government-funded long-term care resources, often delivering within three days. This alleviates the anxiety, confusion, and long waits families have typically experienced in the past in applying for long-term care resources.

“Can’t find it, can’t wait for it, unusable, unsuitable…” relates Roots Living Space founder Chi Chin-shan, professor in the Department of Social Work and Child Welfare at Providence University, listing some of the issues people face when using long-term care systems.

Modeling the operation after Japanese care cafés, Chi set Roots up as a “social enterprise” in Taichung. “Although I have been teaching social enterprise as a subject for a long time, I have never actually put it into practice. That will change as I find places to take root,” he says.

The ground for cultivation he describes is the setting for long-term care in Taiwan. Chi seeks to plant the seeds of innovation to grow big trees, metaphorically speaking. In particular, he believes that, if long-term care is to be sustainable, it should be “capable of breathing on its own,” rather than relying solely on government resources. After opening in April 2017, Roots managed to nearly balance its books within its first four months of operation.

From Suspicion to Convenience

Care cafes enter communities like interlopers, arousing local residents’ suspicions. Given the private nature of the care and its critical impact on life-and-death issues, residents are even more reluctant to come looking for resources. “At first, elderly people suspected that we were scam artists,” admits Lee.

They worked at thinking of ways to integrate the café into daily life.

“You don’t need a reason to come around and chat, and when something comes up you know where you can go,” relates Chi, whose ambition is for the café to become the 7-Eleven of the long-term care realm through convenience and close proximity to the community.

Café staff first actively went out into the community in the effort to establish trust. From visiting with neighborhood chiefs, or interacting with elderly community members at local temples and parks, seniors gradually came to accept café staff, subsequently extending their sphere of activity to the café.

“It’s one more place to go,” says 80-year-old Mr. Tsai. A retired teacher, he is one of the café’s diehard patrons. Since retiring 15 years ago, his life has revolved around volunteering at a publishing company, and recently he has taken to coming to the café on the way home for tea and conversation. As he suffers from early-stage Alzheimer’s, Mr. Tsai participates in the café’s music therapy course every Monday, which keeps his body and mind active and helps him meet new friends.

Café staff are keen to bring services even closer to local seniors. For instance, the first job new employees are given is in-home services. “Yes, it’s house cleaning, but we go beyond that,” says Lee. For instance, she relates that it is de rigueur for staff members to chat pleasantly while cleaning, which helps bring to light changes in seniors’ routines or their latent needs.

One staff member on house cleaning duty, discovering that a senior was walking unsteadily, acted promptly and got him involved in community events, increasing his activity and preventing a disability from developing further. This helped make housework services a calling card for other long-term service providers. “Willingness to open the door and let us into the home is equivalent to opening up the long-term care back end system,” says Chi, referring to the long-term process of slowly building trust.

Each month, the café holds platform meetings at which staff, assistive device evaluators, or cooperative service staff, and hospice nurses discuss strategies for improvement.

Among the resulting initiatives, three months after opening, they unveiled an out-of-pocket service they dubbed “micro home services.” When family members have work conflicts, are unable to accompany seniors for doctor’s appointments, or cannot pick a senior up from the daytime care facility, café staff go into action, taking up the slack where government-run long-term care services may lack flexibility.

“We are happy to listen to the needs of local community members,” Chi relates, adding that “filling gaps is an opportunity.”

Notably, the café has managed to break the spell of “young people’s unwillingness to go into long-term care.” Four of the café’s current full-time staff are under 30 years of age, with degrees in social work or elderly welfare.

Breaking the Spell for Young People

Lee is one such example. Since graduating from university with a degree in social work, she has worked as a caregiver, performing such routine tasks as helping patients turn over and giving back rubs, chores that made her entertain thoughts of quitting. “At one time I thought there was no future as a caregiver,” she recalls.

However, the care café paradigm has expanded her imagination regarding the possibilities of a career in long-term care.

“I’ve discovered that long-term care can be innovative, and even be a career,” she says. Crucially, she adds, “And now my only decision after four years of university study will not be to just quit this line of work.”

Since the café opened, Lee has set about learning how to control costs, formulating a menu fit for seniors, and coming up with improvements to the resource and personnel task dispatch process. Going far beyond routine chores, she is currently working on drawing up a training program and career path for café employees - from housekeeping service staff, assistant manager, manager to  coaching incoming managers - in order to attract new blood. “It’s always been challenging, but I love the feeling of building something from the ground up,” she says.

For its next steps, the café is expanding its location at Wuchi in Taichung, but Chi has ambitions to grow the operation in multiple locations. “By the end of 2018, we’ll have 50 locations in Taichung, and 200 around Taiwan within two years.”

Whether it is just a dream or it becomes a reality will depend on new faces joining the long-term care field.

Translated from the Chinese article by David Toman

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Additional Reading

♦ The Home Care Medical Revolution
♦ Preparing for the Golden Years
♦ Aging Society: The Job Market is Booming for Older Workers