When Does a Home Become a Place of Care? Care Industries Moving Toward the Home, Who Is Knocking on the Older Adult’s Door?(Part 3)

 Author's Note

This is Part 3 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

1. What Is the Care Industry, and Where Are Its Boundaries?

Does caring for someone at home really require only one care worker?

Part 1 examined how a care Need acquires purchasing power and becomes Demand. Part 2 asked what people buy when that Demand moves into the home: the “hands” of home care and home nursing, the “eyes” of well-being checks and monitoring, daily-living support that substitutes for family time, and the housing and service connections that make care possible.

If Part 2 viewed the market through the buyer’s eyes, Part 3 shifts to the supplier’s side. Who creates these functions, and how are they delivered all the way to the home?

The most visible suppliers are care-service providers such as home-care and home-nursing organizations. In this essay, the Core Care Industry refers to service industries in which human labor is directly deployed to sustain the daily lives of people with care needs—including older adults, people with disabilities, children, and patients.

Behind them are Upstream Industries that enable Core Care through assistive technology, rehabilitation equipment, platforms, AI, sensors, and robotics. On the other side are Downstream Industries—housing, food, retail, mobility, and safety—that meet people directly in everyday life.

These are not formal industry classifications, but analytical categories used here to trace movement within the care supply chain. In the actual market, the boundaries are already shifting: housing companies add daily-living support and home care, platform companies operate care services themselves, and care providers expand into housing, devices, and training.

Part 3 focuses on this movement of boundaries: how far Downstream and Upstream Industries are moving into the care market around the Core Care Industry, and how these different industries are becoming connected around the home.

2. How Far Has the Core Care Industry Come—and Where Is It Going?

People remain at the center of the care industry. Bathing someone, helping with meals, monitoring medication, or tending a wound is difficult without human labor. When care first moved beyond the family, the earliest market was built around services that sent people into the home.

The First Industry Was Built by Sending People Into the Home

Home care—paid workers taking over bathing, meals, mobility, housework, and daily-living support once performed by family members—became established as an industry in many countries as long-term care systems and public financing expanded. The names and institutions differ, but the common feature is simple: a person goes to the home where care is needed.

According to the OECD, across 23 member countries the share of long-term care recipients receiving care at home rose from 66 percent in 2013 to 70 percent in 2023. Demand to remain longer at home and in the community is changing the structure of supply. Yet home care is difficult to make more productive in the way manufacturing can be. As the number of users rises, more workers are still needed to go to those homes. The OECD estimates that maintaining today’s staffing ratios alone would require roughly 13.5 million additional long-term care workers by 2040.

Korea’s home-care sector shows this structure clearly. At Jung-gu Haengbok Care Center, about 85 percent of revenue comes from Long-Term Care Insurance benefits, effective labor costs account for roughly 86.5 percent, and the operating margin is about 4 percent. The productive capacity of a home-care provider depends less on the number of users than on its ability to recruit, train, deploy, and reliably supply workers’ time without service gaps.

When Nurses Went Home, a Different Industry Emerged

Care workers were not the only professionals to move into the home. As more people live at home with illness and functional decline, nursing has also moved beyond the hospital. Home nursing differs from home care because nurses bring professional judgment and clinical interventions into the home. It covers needs that home care alone cannot address, such as wound care, health-status assessment, medication, and other forms of clinical management.

In the Netherlands, community nursing has become a major pillar of home-based care, and Buurtzorg is its best-known provider. From its first team in 2006, it has grown to around 850 teams and 14,000 nurses. Instead of relying on a large managerial hierarchy, Buurtzorg organizes small nursing teams that serve local clients and coordinate care. More recently, Buurtzorg+ has expanded collaboration with physiotherapists and occupational therapists, organizing care around sustaining life at home rather than around a single visit.

Korea is different. OECD analysis found that home nursing accounted for only about 1.6 percent of home-based long-term care services in 2020. The OECD identified restricted clinical autonomy and regulation affecting long-term care home nurses as one factor constraining supply.

Even when both systems are ‘sending nursing into the home,’ the size of the industry can differ depending on who may prescribe the service, what nurses are allowed to do, how much insurance will pay, and how much professional discretion the system allows.

Healthcare and Care Are Being Reconnected Into One Supply Chain

As home care and home nursing expanded, another problem became visible. An older person discharged from hospital may need long-term care, nursing, medication management, rehabilitation, and housing support at the same time, yet the suppliers operate within different institutions and organizations. Recent change is therefore moving less toward adding one more visiting service and more toward reconnecting healthcare and care providers that had been separated.

Japan’s health and welfare cooperatives have long connected hospitals and clinics with medical and long-term care services and community mutual aid, with more than 1,000 care managers active nationwide. Their federation identifies “seamless community-based integrated care” as a major direction.

Canada’s home and community care likewise combines health and social supports outside hospitals, including nursing, rehabilitation, personal care, homemaking, and meals. In 2024, about 7.5 percent of households used home care, and roughly 81 percent of recipient households said it had helped them substantially to remain at home.

In Korea, health-and-welfare social cooperatives and home-based medical providers are also building this supply chain. The Ansan Health and Welfare Social Cooperative offers a particularly clear view of the direction of change.

In Ansan, Providers Converge on One Person’s Home

The Ansan Health and Welfare Social Cooperative brings together a clinic, a home-nursing service, a home-based medical care center, home-based long-term care, personal assistance for people with disabilities, 365 Integrated Care, a nursing home, and a day-care center. It is a structure in which healthcare and care can be connected within a single organization.

Under Ansan City’s integrated-care program, physicians, nurses, social workers, physical therapists, and occupational therapists visit homes, while pharmacists’ medication counseling, hospital discharge coordination, and improvements to the home environment are also connected. Smart Care is added to this network. In the cooperative’s integrated-care program for older people with disabilities, a multidisciplinary team conducts health assessments and develops care plans, then links smartwatch-based digital health, home nutrition, home-environment improvements, and rental-housing support.

The significance of the Ansan case lies less in the number of services than in a supply structure that can connect clinics, home nursing, home-based medical care, long-term care, rehabilitation, medication, housing, and smart health around one person’s life. Home care converted family daily-living support into paid labor; home nursing brought professional nursing into the home; and integrated health and care services have begun reconnecting the gaps among healthcare, long-term care, rehabilitation, medication, and daily-living support.

Following the development of these three areas reveals an expanding role for suppliers. This need not be treated as a fixed sequence that every country follows, but as Demand for living at home grows, the capacity to organize professionals and connect multiple services becomes as important as the capacity to send workers into the home.

The competitiveness of Core Care providers is therefore likely to extend beyond workforce recruitment and organization toward the ability to connect healthcare, rehabilitation, daily-living support, community resources, and—where necessary—technology.

Why, then, have companies that originally stood outside the care industry begun knocking on the doors of people with care needs?

3. How Far Have Downstream Industries Moved Into Care—and Where Are They Going?

It is natural for a home-care agency to provide home care. The picture changes when a company that once built houses begins checking residents’ well-being, or when a supermarket salesperson watches for signs that an older customer living alone may be in trouble.

Housing companies supplied homes, and retailers sold goods. But as older people seek to remain longer in their own homes and communities, the boundary between those products and care has begun to blur. In this essay, Downstream Industries refers to existing industries that meet the everyday lives of people with care needs directly and enter the care market by adding care functions to their products and services. It is an analytical concept for understanding the supply chain, not a formal industry classification.

Industries Outside Care Have Begun Entering the Care Market

Even after Japan’s Long-Term Care Insurance institutionalized Core Care services, older people living at home still needed meals, grocery shopping, cleaning, laundry, and well-being checks. Daily-living support services recognized by Japan’s Ministry of Health, Labour and Welfare include well-being checks, meal delivery combined with monitoring, and support with shopping, cleaning, cooking, and laundry, with private providers participating as suppliers. In 2025, companies providing daily-living support and meal-delivery services outside public long-term care insurance formed an association for care-related service businesses, while the Ministry of Economy, Trade and Industry issued related industry guidelines that same year. It is a visible example of established industries moving toward the care market by following the everyday needs of older people.

Korea’s 2026 Community Care Integration Act (the Act on Integrated Support for Community Care, including Medical and Long-Term Care Services) took effect on March 27, 2026, requiring healthcare, health management, long-term care, daily-living care, and housing to be integrated and coordinated in the community. Local-government programs now combine home nutrition, accompaniment to medical appointments, home-environment improvements, and Smart Care. This does not mean that government produces every service directly. It means there is more room for different suppliers—healthcare, long-term care, housing, nutrition, mobility, and technology—to connect around one person’s life.

What does this movement of Downstream Industries look like in practice? Housing is one of the clearest places to see it.

How Far Will the Housing Industry Go in Selling Care?

In a home where an older person expects to live for many years, space alone cannot solve every problem. Stairs and bathrooms must be made safer, and someone or something must be able to notice an accident when the person is alone. At first the physical space changed—thresholds and handrails. Then services were added.

Japan’s Service-Linked Housing for Older People provides every resident with at least well-being checks and daily-living consultation, while some properties directly provide or connect residents to medical care, long-term care, meals, and housekeeping services. By the end of June 2026, 8,312 properties with 290,803 units were registered. The United Kingdom’s Extra Care Housing likewise allows people to live in their own independent homes while receiving meals, personal care, and household support as needed. More recently, sensors and digital technologies have also become part of the housing-service package.

At this point, what exactly is the housing company selling? A home, safety, daily-living support—or even the assurance that care will be available when it is needed?

The deeper change in housing is that the home is shifting from a backdrop for care into a platform through which multiple services can be delivered.

Why Did Companies That Sold Food Begin Checking on People’s Well-Being?

When walking and driving become difficult, the customer can no longer go to the store—so the store goes to the customer.

Japan’s Tokushimaru mobile supermarket loads food and household goods from local supermarkets into vehicles and visits older customers’ homes on a regular route. Because salespeople repeatedly meet the same customers, they can notice when something looks different. Through local ‘watch-over agreements,’ they may report unusual signs to municipal authorities or Community General Support Centers. As of July 2026, 1,204 Tokushimaru vehicles were operating across Japan. The supermarket did not become a home-care agency. What matters is that it kept its core business while adding a care function—a well-being check—to assets it already possessed: logistics and repeated visits. In the same way, meal delivery can expand into nutrition management and well-being checks, while cleaning and household support can become points of contact for observing a person’s living condition. This helps explain why the Japanese government has begun treating daily-living support and meal delivery as important parts of the care-related service industry.

For daily-living service companies, an older person’s home can become more than a delivery address. Through repeated contact, it can become part of the care supply chain: a place to notice changes in condition and connect needed services. Mobility services can expand into accompaniment to medical appointments and boarding assistance; safety and security services can expand into fall detection, emergency response, and monitoring for unusual patterns in daily life. The key is that existing industries add care functions to assets they already have—customer touchpoints, physical spaces, logistics networks, and mobility networks.

Housing and daily-living service industries began in different places, but the longer older people remain at home, the more they encounter the same problems: safety, meals, mobility, monitoring, and service coordination. At first, one small care function is added to an existing product. As those functions accumulate, the supplier’s position changes. The expansion of Downstream Industries is therefore less about creating entirely new care sectors than about existing industries moving into the care supply chain by layering care functions onto assets they already possess—space, customer touchpoints, logistics networks, data, and brands.

For these companies to bring services all the way into the home, however, Upstream Industries—sensors, software, robotics, and assistive technologies—must also move.

4. How Far Have the Upstream Industries Supporting Care Come—and Where Are They Going?

Providing even one hour of home care requires more than a worker. It also depends on assistive technology, rehabilitation equipment and robotics, and systems that connect users, workers, and organizations.

In this essay, Upstream Industries refers to industries that supply the technologies, equipment, and connection systems that make Core Care services possible. For a long time, these industries operated behind care, supporting equipment, records, and connections. More recently, devices are doing more, robots are assisting movement, and platforms are taking on supply-chain operations—bringing these industries progressively closer to frontline care.

How Did Assistive Devices Become “Able Tech”—Technology That Makes More Possible?

Assistive devices such as canes, walkers, wheelchairs, and bathroom grab bars compensate for tasks that are difficult for a person to perform. The right device can reduce the amount of work someone else must do and increase what the individual can continue to do independently. In this essay, “Able Tech” is not a formal industry category, but an analytical term for technologies and services that expand what people are able to do for themselves.

In the United States, Assistive Technology (AT) includes not only devices that maintain or improve function, but also services for assessing, selecting, acquiring, applying, and repairing the equipment a person needs. Oklahoma ABLE Tech, an AT program established under the federal Assistive Technology Act, connects device demonstrations, short-term loans, reuse, and financing support. In federal fiscal year 2024, the program served more than 37,850 people, loaned 4,498 devices on a short-term basis, and redistributed 1,645 used assistive and medical devices. Against roughly $500,000 in federal investment, the program estimated about $5.9 million in cost savings.

The case shows how the assistive-technology market can extend beyond product sales into assessment, trial, rental, repair, and redistribution. Instead of filling every hour of care with human labor, a broader supplier ecosystem can grow around expanding what people are able to do for themselves.

Rehabilitation equipment is also evolving as sensors, motors, and control technologies are combined into robots that read a user’s movement and provide the force needed to support it.

China’s Ministry of Industry and Information Technology and Ministry of Civil Affairs are piloting smart eldercare service robots in homes, communities, and care institutions from 2025 to 2027. Home-use products are required to be deployed in at least 200 households and in quantities of at least 200 units. The pilots run for at least six months to assess safety, reliability, and usability and to improve the products. In effect, they are testing whether rehabilitation robots can move beyond hospital equipment into everyday living environments. At one community rehabilitation center in Shanghai, exoskeletons, upper-limb rehabilitation robots, and digital occupational-therapy systems from Fourier Intelligence are used alongside therapists. China’s policy and field examples suggest that rehabilitation robotics is currently moving less toward replacing people than toward reducing burdens on families and frontline staff while extending the reach of therapists’ services.

Platforms began by connecting care workers with families, users with agencies, and agencies with workers, reducing information asymmetry. Business models now range from worker matching and user-agency matching to agency-worker matching and hybrid models that combine these functions. But as the market grows, connection alone is no longer enough. Scheduling, vacancies, credentials, training, records, billing, and quality management all have to be operated as well.

Honor’s Care Platform in the United States works with local home-care agencies on caregiver recruitment and training, client matching, scheduling, billing, and payments. Families can view visit schedules and service records through an app. When Honor acquired Home Instead in 2021, its technology and centralized operating infrastructure were combined with a large local home-care network. At this stage, the platform looks less like a simple intermediary and more like operating infrastructure for the care supply chain—coordinating large numbers of workers and clients, schedules and vacancies, training and records, billing, and family communication.

In 2026, the U.S. Department of Health and Human Services’ Administration for Community Living identified caregiver support and training, condition monitoring, record and administrative automation, and efficiency and scheduling for home-care agencies as areas for AI application in its Caregiver AI Prize Competition.

If platforms connected suppliers, AI may go further by reading accumulated records and schedules, users’ conditions, and families’ needs, then proposing what should be connected next. It is still too early to speak of an “AI care-agent industry,” but the direction is visible: platforms are moving from intermediation toward operating infrastructure for provider management and service coordination.

Assistive technology, rehabilitation robotics, and platforms support function, movement, and connection in different ways. Across all three, a common shift is visible: from selling products to providing function-support services, from hospital equipment to robots used in everyday living environments, and from simply connecting people to operating the care supply chain itself.

If Upstream Industries continue moving toward the design and operation of care, what will the supply chain become when all of these elements connect in one person’s home?

5. How Is Smart Care Reshaping the Existing Care Supply Chain?

The market for older people was once described as the ‘silver industry.’ Later came the language of the ‘100-year life.’ More recently, the term ‘Longevity Economy’ has emerged to explain how longer lives are reshaping consumption and industry structure.

The McKinsey Health Institute projects that the global population aged 65 and older will reach about 1.6 billion by 2050. It also estimates that scaling proven health interventions could generate up to $12.5 trillion in additional annual economic value by 2050. This is not a measure of the care market; it is an estimate of the economic value of healthier longevity. But it does show that longer lives are no longer an issue confined to healthcare or welfare alone.

As more people live longer, Demand also grows for housing, meals, mobility, daily-living support, assistive technology, robotics, and digital services. That is why the Core Care Industry, Downstream Industries, and Upstream Industries discussed above are all moving toward the same home.

Smart Care emerges where these different supply chains connect around one person’s home. In this essay, “Smart Care” refers to a care delivery system in which people, housing, healthcare, daily-living services, technology, and data are connected around the home.

What Smart Care changes is less the product itself than the way care is supplied. Housing can evolve into housing with integrated services; assistive technology into function-support services that include assessment, rental, and maintenance; rehabilitation robotics from equipment delivery into combined rehabilitation and maintenance services; and daily-living services into integrated offerings that combine meals, nutrition, well-being checks, mobility, and accompaniment.

Concierge services may also become an important coordinating function. When a concierge that once handled everyday tasks evolves into a care concierge that understands health and care needs and identifies suitable providers, the ability to assemble multiple services becomes a product in its own right.

When AI is combined with platforms, the function can move beyond search and matching toward reading records, conditions, and schedules, then recommending or coordinating the next service. The 2026 U.S. Administration for Community Living Caregiver AI Prize Competition likewise identified caregiver support, monitoring, administrative automation, scheduling, and training for home-care agencies as areas for AI application.

It is still too early to say that an “AI care-agent industry” has fully formed. But a direction is emerging in which providers do not produce every service themselves, but instead bundle and connect healthcare, long-term care, meals, mobility, and housing services seamlessly.

The unit of transaction may also change. More offerings may combine functions from different industries: housing + safety + daily-living support + concierge; home-based medical care + nursing + care; assistive technology + maintenance + rehabilitation; meals + nutrition management + well-being checks. The movement is from product sales to service-based models, from stand-alone services to integrated offerings, from individual providers to supply-chain integration, from one-off transactions to ongoing management, and from institution-centered delivery to home-centered delivery. As that shift advances, competitive advantage may depend not only on having a good product, but on controlling everyday-life touchpoints, using data effectively, coordinating services, and reliably supplying the human labor needed at the very end of the chain.

Smart Care does not simply eliminate labor. It can also create new labor demand in smart-home and sensor installation and management, Able Tech and robotics deployment, data monitoring, AI and platform operations, and coordination across healthcare, long-term care, and daily-living services.

Yet a person remains at the end of the supply chain. Even if sensors detect something unusual, AI coordinates services, and robots assist movement, someone still has to enter the home, help wash a body, assist with meals, and make judgments in exceptional situations. Human labor is also needed to connect those technologies to care itself.

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

[International Organizations, Government, and Public Institutions]

1. OECD. (2025). Health at a Glance 2025: OECD Indicators. OECD Publishing.

2. OECD. (2020). Who Cares? Attracting and Retaining Care Workers for the Elderly. OECD Health Policy Studies. OECD Publishing.

3. OECD. (2022). OECD Economic Surveys: Korea 2022, “Strengthening the Social Safety Net.”

4. Health Canada. (2026). Home, Community and Long-Term Care. Government of Canada.

5. Canadian Institute for Health Information (CIHI). (2025). Home Care Services Helped the Recipient Stay at Home.

6. Japanese Health and Welfare Co-operative Federation. Initiatives: Long-Term Care, Food, and Housing. [Japanese-language source]

7. Ministry of Health, Labour and Welfare, Japan. Long-Term Care Service Information Publication System — Daily-Living Support Services. [Japanese-language source]

8. Ministry of Economy, Trade and Industry, Japan. (2025). Establishment of the Care-Related Service Business Association. [Japanese-language source]

9. Ministry of Economy, Trade and Industry, Japan. (2025). Voluntary Industry Guidelines for Care-Related Services. [Japanese-language source]

10. Service-Linked Housing for Older People Information System / Association of Senior Housing. (2026). Latest Trends in Service-Linked Housing for Older People. [Japanese-language source]

11. NHS. (2024). Moving to a New Home: Housing Options for Older People or People with Disabilities.

12. Wandsworth Borough Council. (2026). Adult Social Care Market Position Statement: Messages to the Market.

13. Small and Medium Enterprise Agency, Japan. (2022). 2022 White Paper on Small Enterprises — Case Study: Tokushimaru Co., Ltd. [Japanese-language source]

14. Tokushimaru Co., Ltd. (2026). Nationwide Operating Status. [Japanese-language source]

15. Ministry of Health and Welfare, Republic of Korea. (2026). Community-Based Integrated Care. [Korean-language source]

16. Ansan City. Integrated Medical and Long-Term Care Program. [Korean-language source]

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18. U.S. Department of Health and Human Services, Administration for Community Living. (2026). Caregiver AI Prize Competition.

19. Ministry of Industry and Information Technology of China & Ministry of Civil Affairs. (2025). Notice on Pilot Programs for Joint Development and Scenario Application of Smart Eldercare Service Robots. [Chinese-language source]

[Company and Industry Cases]

1. Buurtzorg International. Buurtzorg+ — Integrated Community Care.

2. Oklahoma ABLE Tech. (2024). FFY 2024 Oklahoma ABLE Tech Annual Report. Oklahoma State University.

3. Shanghai Municipal Government. (2026). Intelligent Robots Aid Elderly Rehabilitation in Shanghai.

4. Honor Technology. Honor Care Platform.

5. Honor Technology. (2021). Honor Acquires Home Instead.

[Longevity Economy and Future-Market Outlook]

1. McKinsey Health Institute. (2024). The “Evergreen Economy”: Harnessing the Power of Healthy Longevity.

2. McKinsey Health Institute. (2026). The Health of Nations: Stronger Health, Stronger Economies.

[Korean Research and Books]

1. Kim, Sung-Ki. (2026). Case Studies of Care Social Enterprise Business Models. The Chaeum Care Startup & Management Lab. [Korean-language source]

Used for analysis of the home-care business structure at Jung-gu Haengbok Care Center and care-enterprise business models.

2. Lee, Wi-jae, Nam, Min-woo, & Bae, Jeong-won. (2022). The Longevity Economy Is Coming: Leading Companies Heading for the $15 Trillion Senior Market. Hans Contents. [Korean-language source]