When Does a Home Become a Place of Care? Care Products Coming Home, What Do People Buy for Care at Home?(Part 2)

 

Author's Note

This is Part 2 of the five-part series “When Does a Home Become a Place of Care?” The series traces how care has moved from being primarily a family responsibility into the market, and how products, industries, labor, and technology have increasingly become organized around the homes of older adults. In doing so, it examines how the global longevity economy—where healthcare, housing, daily living, culture, and technology intersect—has evolved, and how the care supply chain may be reshaped in the years ahead.

The Series

Part 1. Buying Care — When Care Leaves the Family and Enters the Market

Part 2. Care Products Coming Home — What Do People Buy for Care at Home?

Part 3. Care Industries Moving Toward the Home — Who Is Knocking on the Older Adult’s Door?

Part 4. Care Work Coming Home — Who Will Provide Care, Where Will They Come From, and Under What Conditions?

Part 5. How Will the Care Industries Around the Home Be Reshaped? — The Next Shape of the Home-Centered Care Supply Chain

A father needs to go to the hospital. Is calling a taxi enough? Getting out the front door, getting into the car, arriving at the hospital, checking in, waiting to be seen, picking up medication, and returning home can take several hours. In the past, families usually supplied that time. But if an adult child lives in another city or cannot leave work on a weekday, where does that time come from?

In one Japanese neighborhood, a refrigerated truck pulls into a narrow street. It is Tokushimaru, a mobile supermarket. Older people who find it difficult to travel far for groceries can choose fish, vegetables, milk, and other goods at their own front door. The salesperson who visits regularly does more than deliver groceries. If something seems unusual, that person may also connect the customer with local support organizations. From the older person’s point of view, the purchase is not only food. It also reduces the burden of travel, preserves the ability to choose goods personally, and creates a regular moment when someone sees how they are doing.

In the United States, families living far from an older parent have used subscription services to check patterns of daily activity and link them with fall-detection devices. In the Netherlands, a person receiving nursing at home may receive more than a clinical procedure: support can also connect family members, neighbors, and professional resources in the community. In China, smart beds, walking aids, and assistive care robots have emerged as options for helping people transfer from bed to wheelchair or move about more safely.

On the surface, these are entirely different products: a mobile supermarket, home nursing, accompaniment to medical appointments, sensors, robots, and home modification. One belongs to retail, another to care, and another to technology or housing. But viewed from the home of an older person, they are not so far apart. Each replaces or supports some part of daily life that has become difficult to sustain alone.

Part 1 examined the moment when a care Need that once remained within the family becomes purchasable Demand. It also traced how that Demand is increasingly moving toward homes and communities. Once Demand enters the home, what does it lead people to buy in the care market?

1. What Do People Buy in the Care Market?

When people think of the care market, home care and home nursing usually come to mind first. They sit at the center of the Core Care Industry. When a person needs help bathing, dressing, standing up, eating, or moving, the most direct thing to buy is another person’s hands-on help.

But a day at home does not divide itself neatly into long-term care benefit categories. After the care worker leaves in the morning, who prepares lunch? Who goes to the hospital with the person? Are medications taken on time? If the person falls while alone in the evening, who will know? Can the threshold and slippery floor in the bathroom simply be left as they are?

That is why other products and services gather around care. Meal delivery and grocery shopping, accompaniment to medical appointments and mobility support, well-being checks and emergency response, medication management, assistive devices, and home modification all enter the picture. As the number of services grows, care management and care coordination also become necessary to decide what should be used, when, and in what combination.

A person using Medicaid Home- and Community-Based Services (HCBS) in the United States does not choose only services that provide direct bodily care. Depending on the state program, support may include personal care, homemaker services, home health support, adult day services, respite for family caregivers, and help coordinating multiple services. Home modification, assistive technology, emergency response, meals, and transportation may also be included as supports for living at home. The point is simple: what a care consumer requires rarely ends with a single service that directly touches the body.

Older people in Japan likewise use more than long-term care services alone. Depending on need, they may rent or purchase assistive equipment and use home modification benefits to install handrails or remove thresholds. Japan’s Community-Based Integrated Care System connects housing, healthcare, long-term care, prevention, and daily-living support around the same living environment. In Korea, assistive equipment is available through home-based Long-Term Care Insurance benefits, while Korea’s 2026 Community Care Integration Act is moving toward connecting long-term care, healthcare, daily-living support, and housing in the places where people live.

Seen this way, the “care products” discussed in Part 2 are not limited to products covered by long-term care insurance. The starting point is Core Care, but the analysis also includes adjacent products and services—meals, mobility, safety, technology, and housing—that are purchased or chosen because of a care Need. Only then can we see what is actually being bought and used in the homes of older people.

So what does a care consumer really buy in the market: the name of a service, or a function of daily life that has become difficult to sustain alone?

2. How Have Care Products and Services Evolved?

If the history of care products and services is told only as a history of technology, the story becomes too simple: first there was home help, then home care, then sensors, robots, and smart homes. But if we ask why each product became necessary, a different pattern appears. Before any new technology comes a gap in daily life that existing forms of care cannot fill.

What Became Available Outside Institutions?

In 1983, Medicaid Section 1915(c) opened an important pathway in the United States for people to receive at home and in the community a level of care that had previously been tied to institutional settings. In Japan, the introduction of Long-Term Care Insurance in 2000 made it possible to use home-based services through insurance rather than relying only on family effort. In Korea, the launch of Long-Term Care Insurance in 2008 similarly enabled people to purchase home care, home bathing, home nursing, and related services through public benefits. The systems differed, but the change from the care consumer’s point of view was clear: some of the work that families had once had to perform themselves could now be chosen as paid outside services.

At this stage, the most visible thing people were buying was still human labor—the hands that wash, help someone eat, assist movement, and provide nursing. To borrow the language of Part 1, once Need was backed by purchasing power, a person who had depended almost entirely on family hands could begin to buy help from outside the family.

What Remains After the Home Visit Ends?

Living at home is not simply a matter of being washed and dressed. There must be food in the house. Someone has to shop, accompany the person to medical appointments, clean the home, and manage medications. As home-based care expanded, the gaps in daily life between care visits became more visible, not less.

For a person receiving care at home, the need is not limited to the hours when a nurse performs a procedure. A person using Buurtzorg in the Netherlands receives support from small, self-managing nursing teams that take into account the person’s home, family, friends and neighbors, and professional services already in place. What is needed is not simply “a few hours of nursing,” but support that connects people and resources so the person can continue living as independently as possible at home.

For older people in Japan who have difficulty shopping, Tokushimaru fills a different kind of gap. Launched in 2012, the mobile supermarket had expanded by 2025 to roughly 1,200 vehicles operating across all 47 prefectures. Customers choose groceries at their own doorstep, avoid the burden of traveling long distances to shop, and have regular face-to-face contact with another person. In many communities, that contact also serves as a well-being check. The item purchased may be food, but the functions gained can include less travel, less family time spent on errands, social contact, and a form of watchful presence.

How Do Families Check In When They Are Far Away?

Families living far apart in the United States faced a similar gap. They could not stay beside an older parent all the time, but they still wanted to know whether the parent was all right that day. Alexa Together allowed users to view activity information, receive alerts when no activity was detected for a period, and connect fall-detection devices with emergency response services. The service ended in 2025, but its significance from the buyer’s point of view remains clear: the everyday family function of asking, “Are you okay today?” can itself become a service once distance makes that checking difficult.

What the buyer purchased in this case was not the technology itself so much as the ability to know. Families may want continuous reassurance, but they cannot keep a person in the home around the clock; they may live far away, and care workers are limited. Sensors, remote monitoring, and emergency alert services become ways to fill that gap.

Can More Human Help Solve Everything?

If a bathroom threshold means a person needs physical assistance every time they enter or leave, one option is to increase the care worker’s hours. But installing a handrail and removing the threshold may reduce the amount of help required in the first place. Japan’s Long-Term Care Insurance includes assistive equipment and home modification within its benefit structure for precisely this kind of everyday reason. The OECD likewise treats appropriate housing and home modification, alongside home care, as important conditions for aging in place.

People who repeatedly need help transferring or standing now have other options as well. SIASUN in Shenyang, China, has developed more than 20 products, including assistive care robots, smart beds, bed-to-wheelchair transfer devices, and walking aids. For users and families, the value lies less in the “robot” as a machine than in the function it provides: assistance with movement and transfer, and reduced repetitive physical strain on care workers. When care Needs grow but human backs and human time are finite, Demand emerges for shifting some functions to machines and the physical environment.

Who Connects the Services When There Are Many of Them?

If a person needs only one service, choosing is relatively simple. But once home care, home nursing, meals, mobility, monitoring, and home modification are all needed at the same time, the care consumer faces a second question beyond “What should I buy?”: “Who will make these services work together?” Service coordination in the United States, Japan’s Community General Support Centers, care managers in Thailand, and the coordination functions of Korea’s 2026 Community Care Integration Act are institutionally different. Yet they respond to the same problem: people need multiple services to work together within a single life.

Seen over a long period, care products and services have not merely multiplied. The range of solutions has expanded from person-to-person services that substitute for direct family caregiving to daily-living support, checking and monitoring, coordination, technology, and the home environment itself. But this should not be read as a fixed sequence of development—“hands → time → eyes → space.” Many of these functions have long coexisted, and the order in which they emerged, as well as the ways they are purchased, varies by country.

The history of care products is therefore better understood not as a parade of new products appearing one after another, but as a process in which new services, technologies, and living environments have filled gaps that earlier arrangements could not resolve.

3. What Can Care Consumers Buy Under Different Market Structures?

If history has widened the range of care products that can be purchased, the choices actually available to a care consumer still differ across markets at the same point in time. Part 1 found three recurring differences when country names were set aside and markets were compared more abstractly: how much Need had entered formal services, who created the purchasing power, and what role the family continued to play. In Part 2, the same questions can be restated in the language of products and purchasing.

Degree of marketization → How much has become a purchasable product or service?

Source of purchasing power → Who pays for the product or service?

Role of the family → What does the family still do itself, and what does it begin to buy from outside?

The purpose is not to rank countries by which market is bigger or better. It is to see how, even for a similar care Need, the set of real choices changes depending on who pays and what functions families continue to perform.

Where Public Purchasing Power Draws the Line

In Korea, care consumers can use Long-Term Care Insurance benefits for home care, home bathing, home nursing, day and night care, and assistive equipment. But what can be purchased, and under what conditions, depends heavily on the benefit package and rules of public insurance. From the buyer’s perspective, the more important boundary is often not “public versus private,” but the line between what insurance will buy and what the family must solve separately outside the benefit system.

In Japan, the range available through public purchasing extends further into the home environment than in Korea. The assistive equipment, home modification, and Community-Based Integrated Care connections discussed above illustrate that broader scope. Even when purchasing power is publicly financed in both countries, the range of solutions a care consumer can actually choose through benefits and institutions can differ significantly.

In China, that boundary is now being drawn rapidly. The national long-term care insurance service catalogue issued in 2025 listed 36 items: 20 for daily living care and 16 for medical nursing. For the care consumer, that means the system specifies which forms of assistance—with eating, elimination, hygiene, dressing, functional maintenance, vital-sign monitoring, and safety—can be purchased with insurance funds. The 2026 direction for system expansion also placed service purchasing at the center and proposed exploring the coverage of smart care services and supportive assistive devices.

Part 1 said that “the state attaches purchasing power to Need.” In Part 2, we can look one step further into the buyer’s basket. Where public purchasing power is directed helps determine the boundary of what a care consumer can actually buy.

Even for the same need for help with bathing, one person may use a service within an insurance-defined benefit package, while another may receive public funds and choose a provider directly. The help needed may be similar, but the basket is assembled in a different way.

Where Public Funding Expands Individual Choice

In the United Kingdom, some people can receive public funding while still choosing services directly. A person assessed as having eligible care needs may have the local authority arrange services, or may receive public funds through direct payments and choose the support they need themselves. Others purchase services entirely with their own money. Even for the same care Need, the contents of the basket can therefore vary according to the funding source and purchasing route.

Public money does not always mean that the system chooses the product on the individual’s behalf. In some markets, public financing is delivered through a defined package of benefits; in others, purchasing power is transferred to the individual, widening choice. From the care consumer’s perspective, public financing and direct purchasing are not necessarily opposites.

In the United States, even people using the same HCBS program may fill the rest of their basket differently. Needs that public programs do not cover may be met through private-pay home care or by family members directly. A single person’s Need can therefore be divided among public programs, family time, and private purchasing.

Where Family Care Remains Strong, Products Enter at Different Points

In India, care consumers still rely heavily on family members. Studies by the International Institute for Population Sciences (IIPS) using Longitudinal Ageing Study in India data likewise show the substantial roles of spouses and children, while older people living alone are more likely to receive paid help from outside the household. It remains difficult to compare a comprehensive national “product catalogue,” but the entry point of paid outside help is visible where family hands and family time become scarce.

Thailand presents a different pattern from one in which family and community care are simply replaced by outside services. Under the National Health Security Office’s long-term care program launched in 2016, dependent older people use community-based care that links local government, health workers, trained caregivers, and care managers. In some areas, activities also include improvements to home safety and support with transportation to hospitals. From the care consumer’s point of view, functions once performed largely by family members are supported by public funding, training, and organization and turned into an accessible service system.

There is no need to force these scenes into national rankings or fixed types. As Part 1 showed, public purchasing, family caregiving, and direct purchasing overlap even within a single country. The important question here is the care consumer’s set of choices: how much can be purchased as formal services, who can pay or help pay, and what must still be supplied by family hands and family time. Following those questions shows how market structure is experienced in the act of buying care.

4. So What Are Care Consumers Really Buying?

Return to the purchasing scenes at the beginning. One older person buys groceries at the front door. One family pays for accompaniment to a medical appointment and help with errands. An adult child living far away uses a service to check a parent’s activity. A person receiving nursing at home is connected to family and community resources. Someone who needs help transferring uses assistive equipment or a robot, while someone at high risk of falling changes the bathroom and removes thresholds in the home.

By product name, these purchases scatter across groceries, home nursing, accompaniment, monitoring, robots, and home modification. But strip away the product labels and a common pattern appears. What buyers are really trying to secure are human hands that wash, lift, and assist movement; watchful eyes that can tell whether someone is all right while alone; family time for medical visits, shopping, meal preparation, and service coordination; and supportive space that allows daily life to continue even when no other person is present.

Will the number of people who need to buy these functions shrink in the future? Global population and household trends suggest the opposite. According to the World Health Organization (WHO), the world’s population aged 60 and older is projected to rise from about 1.1 billion in 2023 to 2.1 billion by 2050—nearly doubling. By 2050, roughly two-thirds of the world’s population aged 60 and older will live in low- and middle-income countries. Population aging is no longer confined to the countries where it began earliest; it is spreading across a much wider geography.

Aging does not automatically translate into care Demand. Many people remain independent well into old age. The WHO nevertheless estimates that about 1.3 billion people worldwide experience significant disability, a number expected to grow as noncommunicable diseases increase and people live longer. That figure cannot be used to calculate directly how many older people with disabilities will require care, but it does show why the overlap between disability and aging across the life course is becoming increasingly important.

Need also does not take only one form. In later life, mobility decline, chronic pain, frailty, and dementia may overlap, while the WHO estimates that around 15 percent of adults aged 60 and older live with a mental disorder. Loneliness and social isolation are also major risk factors for mental health in later life. Taking blood-pressure medication, walking, preparing meals, coping with fading memory, and enduring long periods alone do not appear in everyday life as separate institutional categories. They converge within the same home and the same day.

At the same time, the number of family members—and the amount of family time—available to absorb those Needs is likely to decline. OECD data show that across 19 surveyed countries, about 60 percent of older recipients of long-term care receive only informal care, demonstrating how important family members and other unpaid carers still are. But shrinking families, greater geographic mobility, and women’s increased labor-force participation all reduce the potential supply of informal caregivers. Projections of growing need for formal long-term care are closely connected to these changes.

Korea is a case in which these shifts are unfolding within a compressed period. According to Statistics Korea’s household projections, the share of one-person households is expected to rise from 34.1 percent in 2022 to 41.3 percent in 2052. By then, people in their seventies and older are projected to make up the largest share of one-person households. Even in a society with strong traditions of family caregiving, rapid aging combined with smaller households can cause the same level of functional decline to generate outside Demand for hands, eyes, and time more quickly.

Taken together, these changes suggest that the growth of the care market moving toward the home cannot be explained simply by the number of older people. As the forms of life requiring care become more diverse and Needs become more complex, it becomes harder to meet them through family hands, family eyes, and family time alone. More of the Needs once absorbed within the family are therefore likely to generate Demand for outside services and products. People may buy hands, eyes, time, and space in the care market, but they do not live these functions separately in everyday life.

Until now, a handrail has been classified as home modification, a sensor as a technology product, and home care as a care service. But if handrails, sensors, AI-based monitoring, and home care all enter the same home, will the buyer really experience them as products from separate industries? Everyday problems do not follow industrial classifications. AI can supplement the watchful eyes of a distant family member and help connect services. Robots can share the work when human hands and physical strength are insufficient. If more housing is designed to integrate safety, monitoring, daily-living support, and care services, what the buyer purchases may come to resemble not simply a house, but a living environment in which care and everyday life can coexist.

Taken together, the cases and indicators above leave an important question: how will AI, robotics, and care-enabled housing combine with existing care services in the years ahead? How far that convergence will itself become a care product—and how far it will extend the boundaries of the care market—has not yet been settled. But if the home is becoming a new care market, attention naturally shifts to who wants to enter that home. Why are care companies, housing companies, hospitals, AI and robotics firms, retailers, meal providers, and mobility companies all beginning to knock on the doors of older people?

Next | Part 3. “Care Industries Moving Toward the Home — Who Is Knocking on the Older Adult’s Door?”

About the Author

Dr. Sung-Ki Kim (Ph.D. in Social Welfare)

Director, The Care Biz Lab

Chairman, SE Empower Social Cooperative

Email: skkwelfare@gmail.com

References

Note: For institutional and statistical facts in Part 2, priority was given to official materials from governments and international organizations. Company cases are used not to generalize market size or business success, but to illustrate how a specific care Need can take concrete form as a product or service. The Korean-language book The Longevity Economy Is Coming (Jangsu Gyeongjega Onda) was used as supplementary material for identifying cases and understanding context.

International Comparisons and Long-Term Care

OECD. The Economic Benefit of Promoting Healthy Ageing and Community Care. 2025. [Source]

OECD. Health at a Glance 2025: OECD Indicators — “Informal carers.” 13 November 2025. [Source]

World Health Organization. Ageing and Health. 1 October 2025. [Source]

World Health Organization. Mental Health of Older Adults. 20 July 2026. [Source]

World Health Organization. Disability. 7 March 2023. [Source]

Lee, Wi-jae, Nam, Min-woo, et al. The Longevity Economy Is Coming [Jangsu Gyeongjega Onda]. Hans Contents, 2022. [Korean-language source] [Source]

United Kingdom

UK Government. Care and Support Statutory Guidance; Direct Payments. [Source]

UK Government. Apply for Direct Payments. [Source]

United States

Centers for Medicare & Medicaid Services. Home & Community-Based Services 1915(c). [Source]

Amazon. “Alexa Together launches to help customers remotely care for loved ones.” [Source]

TechCrunch. “Envoy, A Part-Time Concierge Service For Seniors, Raises $3M.” 2015. [Source]

Netherlands

Buurtzorg International. Our Model of Care. [Source]

Japan

Ministry of Health, Labour and Welfare, Japan. Community-Based Integrated Care System. [Source]

Tokushimaru. Mobile Supermarket Tokushimaru. [Source]

Korea

Ministry of Health and Welfare, Republic of Korea. Understanding Long-Term Care Insurance. 2026. [Source]

National Law Information Center. Act on Integrated Support for Community Care, including Medical and Long-Term Care Services. Effective March 27, 2026. [Source]

Statistics Korea. Household Projections: 2022–2052. September 12, 2024. [Source]

China

National Healthcare Security Administration of China. National Long-Term Care Insurance Service Catalogue (Trial). 2025. [Source]

National Healthcare Security Administration of China. Accelerating the Establishment of the Long-Term Care Insurance System. 2026. [Source]

Xinhua. “China’s leading robot maker improves lives of the elderly — SIASUN.” 2019. [Source]

SIASUN. “SIASUN Partners with Baidu AI Cloud to Chart an Innovative Blueprint for Robotics + AI.” [Source]

Thailand

National Health Security Office, Thailand. Long-Term Care Program: Thailand’s Preparation for Entering an Aged Society. [Source]

India

International Institute for Population Sciences. Living Arrangements and Care Needs among the Older Population in India. [Source]