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Respite Care Share [Updated 8.22.16: Added testimonial examples]

Respite Care Share is a digital platform that provides vouchers for family caregivers who are stressed and need a break.

Photo of Joy Johnston
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Who is your idea designed for and how does it reimagine the end-of-life experience?

Our target audience is a 45-64 year old female caregiver, who has to care for frail parent(s) and children with minimal caregiving support, lives with chronic disease(s) and is exhausted from “24/7” caregiving. She is a low to lower-middle class income earner, and faces system discrimination – visible minority and/or LGBTQ. By offering no-cost respite care options presented in a convenient online format, caregivers are more likely to utilize beneficial respite services.

For quick access to documents, use links below.






According to the Family Caregiver Alliance, ~ 44M Americans above the age of 18 provide unpaid care to older people and adults with disabilities.[1] The value of this unpaid labor force is estimated to be $306B annually, when compared to the total cost of home health care ($43B) and nursing home care ($115B).[2] Female caregivers make up about two-thirds of all unpaid caregivers.[3] They report higher levels of anxiety symptoms, lower levels of well-being and physical health. They are less likely to proactively manage their own health, be it from getting mammograms[4] to exercising.[5]  Further, they face financial hardships if they cut back on work hours – loss in pension contributions, promotions and job security. This is estimated to cost US businesses ~ $33.6B per year in lost productivity.[6]

Health and social care services are not integrated from a funding and delivery perspective.[7] A 2012 Canadian study indicates that 30% of caregivers of children received government financial assistance, while only 5% of caregivers of parents received government financial assistance.[8] The same Canadian study showed that caregivers would have liked more help than what they received.


In its initial ideation phase, J Johnston focused on providing a physical break from daily caregiving, via Airbnb rentals. This was based on her experience as a caregiver, and the need for mini-getaways, without "going broke." Together with feedback from the OpenIDEO Community, the idea has now expanded to provide a broader definition of respite. Respite is defined as a "space" for a caregiver to rest and recoup from caregiving. We have added a diversity and inclusion lens to the issue, and is illustrated by our Persona, "Jane Smith." (See attached figure for persona and user experience map.)

Respite Care Share addresses the lack of personalized services offered to caregivers, and disparity in service offerings for those caring for children and parents. It addresses respite as that defined by the caregiver, including consistent and reliable caregiving options, be it a local community (e.g. faith-based) or network (e.g. veterans) one belongs to. It will be delivered in partnership with a healthcare provider, where poverty and social isolation as clinical priorities are integrated into the organization’s corporate strategy.  

Respite Care Share, a B Corp, will be an online platform that provides caregivers with respite care vouchers at zero cost to them. A Health Promoter will counsel the caregiver on using Respite Care Share, and help them determine “caregiver care packages” they can choose. These vouchers include vacation rental properties on Airbnb, massages and memberships to gyms/yoga studies, and local arts organizations (e.g. local painting classes) and coordinated caregiving options for children and elderly parent.

The Health Promoter is the interface between the healthcare system and the patient. S/he advocates on behalf of caregivers, to ensure that they can care for themselves and manage their own health conditions. We suggest the caregiver care packages can be modeled on a few existing programs, The Positivity Pack for younger audiences, and Grandbox and Gramsly for older generations.

The business model is inspired by SaveUP (a free product that provides prizes to incentivize Americans to save money and pay down debt), Iora Health (primary healthcare provider that improves the lives of their patients first, and in turn their health), St. Michael’s Hospital (urban hospital in Canada that prescribes income to patients) and Airbnb’s ability to build community resilience (housing relief for people affected by emergencies such as hurricanes and fires).

Further, there is an opportunity to take a Value-based approach to Healthcare Delivery, focusing on target demographic: middle-age caregivers to frail parents and young children, living with chronic disease and no social support. Sutter Health can collaborate with Prof. Michael Porter at Harvard Business School to determine what value is for caregivers, clinicians and system players. This option would provide a better understanding of true patient care costs, ability to measure outcomes systematically, reimburse via bundled payments and advance Sutter Health’s leadership in the end-of-life care space. 


  • Decreased caregiving burnout – better emotional & mental health
  • Reduced financial burden
  • Ability to personalize their caregiving options
  • Proactively manage their health, improves self-confidence & builds self-resilience


  • Improved utilization of healthcare resources
  • Sharing costs of delivery across multiple payers
  • Brand & Reputation
  • The opportunity for scale and ultimately drop unit cost of care delivery


  • For AirBnb – building on its resilience program, which was started by a community member
  • For other providers – another revenue option
  • Brand & reputation for building resilience and community building

SERVICE DELIVERY – LAUNCHING: (see user experience map )


In order for the program to be successful, Respite Care Share needs to be delivered in a meaningful and personalized manner. We identified multiple avenues for distribution, where the caregiver would be assisted in completing the initial paperwork and gaining access to the system. A prescription for “respite care” will be provided to the caregiver, via the Health Promoter. We could connect our target caregiver with Respite Care Share via multiple points of contact:

  • Health Promoter at Doctor’s office – either family doctor or visit to specialist (e.g. endocrinologist) [illustrated in user experience map]
  • Community Social Worker – provides home care for children with disability – acts as a Health Promoter
  • Hospice/Palliative Home Care Worker – who provides care for elderly parent  – acts as a Health Promoter


We assume that our target caregiver has average technical skills. She can complete an online form, has a Facebook account, but sometimes needs help from her children. The Health Promoter explains Respite Care Share to our caregiver, and helps her sign up for the service, and choose a respite care package that works for her.

The vouchers are designed to work like a gift card, and would be universally accepted. An online directory of available caregivers would be made available to the user, so their loved ones would be well-taken care of while she is utilizing her respite care prescription.

At this phase, vouchers would cover lodging and caregiving expenses, workout memberships and meditation classes held in a local community center for caregivers.


Initial funding can come from the following organizations to create a proof-of-concept:

  • Grants from National Caregiving Alliances and disease-based charities (e.g. American Diabetes Association) 
  • Donors – unrestricted seed funding
  • Bootstrapping - Sutter Health, with unrestricted seed funding
  • Crowdsourcing (to determine “appetite” for a potential product)


This first phase should provide data on utilization of services. We suggest using data analytics and user surveys, to provide evidence for proof-of-concept. The data from this phase can be used to expand funding opportunities for the next phase. 

User survey conducted by J. Johnston

Data on the caregiver’s health will also need to be collected and analyzed. It can determine if these changes are positively contributing to improved health outcomes.



Using an evidence-based approach to service planning, we believe the data collected from the survey and analytics during the Launch phase will indicate a direction of the demand for certain programs.  At this stage, we believe the Respite Care Share program can expand to best meet the needs of the caregivers.  This would include meal delivery options like BlueApron (as mentioned by an OpenIDEO community member Jim Rosenberg), free public transit cards, or Uber/Lyft gift cards.  We assume that a family caregiver would not take a respite far away enough that air travel would be necessary; if those cases arose they could be addressed on an individual basis.


Initial funding for this can come from:

  • Grants from National Caregiving Alliances and disease-based charities (e.g. American Diabetes Association) 
  • Insurance companies – bundled payments; value-based healthcare delivery
  • Advertising revenue from vendors
  • Health Tech Venture Funds – to help with scale
  • Partner with SaveUP – allow cash prizes to be donated for caregivers in one’s family and/or used towards saving products
  • Government funds – federal and state


We believe Respite Care Share will be an initial conversation on changing the way society views death and dying. In its future iterations, we believe the model can evolve into the following options:

  • Building a freestanding national/international network of properties owned by people willing to set aside for use by family caregivers at reduced or free cost. It would be similar to how Airbnb works, a database with online search and scheduling.
  • Creating a new network of caregivers – youth seeking employment, people in between career transitions, and Baby Boomers seeking a career in retirement. 
  • Provide a caregiver with a dream vacation after their loved one dies (part of the will).
  • Connect individuals who wish to wish to die in a serene, comfortable environment with those willing to provide a "transition house" for short-term rental. This would create a new option for the growing dying at home movement.
  • Flip the concept: Die in another physical space. For family left behind, the death of a loved one can leave traumatic memories. By moving the death experience to a neutral, serene and comfortable location, all involved can experience the death in a nurturing environment while leaving the family home less burdened with sad memories.


Below are two examples of state-sponsored respite care programs.

Take Time Texas


Take a Break SC

2013 Respite Plan

On respite care: "It is the number one need identified by family caregivers; it is an essential service that keeps families together by protecting the physical and mental health of the caregiver and providing relief from the ongoing responsibilities that caregiving entails."

"It is important to note that because of the great demand for respite services, many of these programs must place applicants on waiting lists."

While S.C. provides modest respite vouchers, this is to help cover cost of caregiving while they are away, not actually covering the caregiver's cost of respite.

"Respite is not covered by most insurance and most families in South Carolina cannot afford private providers on an ongoing basis, if at all." (Demonstrating need for national program to fill the gaps.)


-Testimonials from caregivers who have enjoyed the benefits of respite care were included in state-funded respite program literature.

-States seem eager to promote national respite care organizations and programs as part of their state-sponsored respite care services.


Maintaining a relationship with the caregiver and providing crucial follow-up is key to the success of any respite care program.

  1.    A community social worker, where available, could serve as a bridge between doctor, home care/hospice and caregiver.
  2.    Promotion of Respite Care Share via brochures available at doctor's offices, adult day care programs, government agencies and online.
  3.    Testimonials: Use testimonials from caregivers who have used respite care in promotional materials, like South Carolina did for their state program. View screengrab of testimonials. 
  4.     Prompts: AARP Caregiving text tips: As part of the caregiver care package, caregivers could sign up for tips, discount codes, etc. via text, similar to a program that AARP offers. The texts could offer reminders about respite care services to further encourage usage.  



[1]; accessed on July 31, 2016.

[2] Arno, P.S. (2006). Economic Value of Informal Caregiving: 2004. Presented at the Care Coordination & the Caregiver Forum, Department of Veterans Affairs, January 25-27, 2006

[3] (i) National Alliance for Caregiving & AARP. (2004). Caregiving in the U.S. Washington, DC: Author. (ii) Johnson, R.W. & Wiener, J.M. (2006). A Profile of Older Americans and Their Caregivers (Occasional Paper Number 8), Washington, DC: The Urban Institute.

[4] National Alliance for Caregiving & Evercare. (2006). Evercare® Study of Caregivers in Decline: A Close-up Look at the Health Risks of Caring for a Loved One. Bethesda, MD: National Alliance for Caregiving and Minnetonka, MN: Evercare.

[5] P Sequeira – Interviews with female caregivers to (i) young children and elderly parent, or (ii) young children and (ex-) spouse.

[6] MetLife Mature Market Institute and National Alliance for Caregiving (NAC), MetLife Caregiving Study: Productivity Losses to U.S. Business (Westport, CT: MetLife Mature Market Institute, and Bethesda, MD: NAC, 2006). The lost productivity estimates are based on the 2004 survey of U.S. caregivers conducted by NAC and AARP, Caregiving in the U.S. 2004.

[7] Family Caregivier Alliance – National Policy Statement:; accessed Aug 1, 2016.

[8] Turcotte, Martin. 2013. “Family caregivers: What consequences?” Insights on Canadian Society. September. Statistics Canada Catalogue no. 75-006-X.

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

Reach out to existing caregiver communities like Caregiver Action Network, Caring Across Generations, Family Caregiver Alliance, to get feedback on a prototype of service. J Johnston created a survey for caregivers and distributed it to the above organizations via Twitter. The initial test response was positive, and participants responded favorably to respite care options presented in this model. Reach out to Airbnb and determine their interest in potentially expanding their partnerships.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

Overall feedback – what issues have we not covered to take this idea towards second phase prototyping/piloting? Insurance – feedback into feasibility and challenges on paying for non-healthcare services, especially for Government-backed insurance plans. Establishing standards: Tackling the challenges of setting requirements and standards when program may be implemented via multiple points of contact. (Example: Setting criteria for and verifying that a user is a legitimate caregiver.

Tell us about your work experience:

J Johnston is a digital journalist with a deep understanding of social media and how to make content go viral. She was a caregiver for her mother, who had cancer, and personally understands the importance of respite care. She is a contributing author for The Caregiver Space and a blogger.

This idea emerged from

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Attachments (2)

Respite Care Share.pptx

Powerpoint showing origins of mock Respite Care Share ads, based off of real Airbnb ad campaign.

user persona empathy quadrant.PNG

User persona and empathy quadrant.


Join the conversation:

Photo of OpenIDEO IDEO

Congrats on being a Top Idea, Joy! It's been absolutely inspiring to see how you've developed Respite Care Share to reimagine the end-of-life experience for ourselves and our loved ones. What an amazing journey it has been. In the coming weeks, we'll be making an official announcement to celebrate you and the other Top Ideas of the End of Life Challenge.

In the meantime, we would love for you to share your story in the upcoming End of Life Impact Phase. The Impact Phase is a space where the OpenIDEO community can share updates on how our projects are progressing beyond the challenge. For reference, here's a template for writing an Impact phase story: Well done Joy!

Photo of Joy Johnston

Thank you, it is an honor to be in the top 10. This has been an inspiring and enlightening experience and I look forward to building on the idea framework developed here. Big thanks to community prototyper Pearl and the entire OpenIDEO community for their assistance and feedback.

Photo of Ivor Williams

Great idea, issue does however remain who is caring for the patient while the carer is away. I also think capacity will be an issue sites like Ellie’s friend ( provide free or discounted hotel stays but you have to apply and it’s a lottery basis as to success. The number of full time carer’s who would benefit from the service is massive. Also its unclear who you would prove you were an end of life care giver? In UK official carers are those providing over 35 hours a week of care. It could therefore be possible to ask for proof of receipt of carers benefits and the prognosis of the patient – as end of life. This however is also problematic as there are different definitions of end of life in relation to time frames. In practice you may well have applicants wanting to apply for vouchers who are caring long term and may need a system to differentitate.

[Contribution from Anny Ash, Macmillan Social Prescriber Senior Navigator, Macmillan Cancer Support]

Photo of D'vorah

Hi Joy!  
What an interesting idea, and there’s such great need for more, and better, respite care. There is a lot of potential for tapping into the community of people around the world who want to offer support to the dying.

I have a few questions about logistics (1) How would the Airbnb model work for someone receiving medical or hospice care? Would there be a way for the family/caregiver to easily identify if the Airbnb has the medical care (hospital, hospice, etc.) nearby that they would or might need? (2) Could the Airbnb list include local support people (for free or at reduced rates) who could be called upon (such as local clergy, social workers, grief counselors) (3) Would there be a vetting process to make sure the new living setting would meet the needs of a dying person?

I would also suggest including in the database for those who are caregiving at home, grief counselors, clergy trained in pastoral care, medical social workers, family therapists, and spiritual directors who would be willing to donate time/provide visits at reduced fees. And for those who feel their home is now a sad place, these providers could be very helpful in processing through the caregivers’ experiences, beliefs and feelings.

I'm looking forward to seeing how this develops!

Photo of Joanna Spoth

Hi Joy! I wanted to quickly pass along some feedback we recently received from our challenge sponsors and advisory panel: "We love that this idea is rooted in reality and reflects real need. This is great. It would be good to see how this could be developed, what kind of models of house sharing could exist. Beyond the commercial appeal of Airbnb (replacing expensive hotels, allowing you to tap into local areas with local experts), the fundamental value here is giving people another space to exist, to take a holiday from their life. This could easily be prototyped with a small cohort also. Would be incredible to see if Airbnb would be involved!"
Another provocation is what it might look like to do a super lightweight prototype on Facebook, or an existing tech platform instead of building a new one right away. I'd love to hear your thoughts on what this might look like, considering your awesome background. 
We're looking forward to seeing your idea continue to evolve in this last week of our Refinement phase.

Photo of Joy Johnston

Thanks Joanna for the helpful feedback! Pearl and I have learned a lot during refinement and will be uploading additional content this week through the end of the refinement phase.  

I agree that launching on an existing platform would offer the chance for greater visibility while refining the program to best meet users' needs. 

Photo of Shane Zhao

Love the updates Joy and Pearl Sequeira ! Have you already created a FB ad for the Respite Care Share or is it still a mockup? Very convincing mockup if it is:) We also love how you've spent time to create a user persona. Perhaps a simple next step can be to dig deeper into how things will play out for the persona by creating a User Experience Map:

We're looking forward to hearing more about the Feedback you're getting on this idea!

Photo of Joy Johnston

Thanks Shane! The Facebook ad is a mockup and hope to gather more survey feedback before end of refinement. Will post results here. We just need to add visuals to our user experience map and then it will be uploaded here. Working with Pearl has been great and we've learned a lot together.

Photo of Lois Perelson-Gross

Question: How are the expenses of the temporary caregivers covered?
Question: Would you consider a range of shorter respites that don't necessarily involve travel (e.g., yoga classes, pool membership, free concert/theater tickets, free wheel time at a pottery studio, etc.) With many membership organizations, members could be asked if they would like to help subsidize a membership for a caregiver. A single annual membership could be split among local caregivers (like Zipcar).  

Photo of Joy Johnston

Hi Lois, thanks for the question/suggestion. I think this could be a logical expansion of the idea. Other commenters have suggested a kind of voucher system and reaching out to existing service providers for things like meals, transportation, etc. I like the community-oriented angle of your suggestion.

Photo of Sherri McElroy

I think it would be great if the existing companies could offer this service. Maybe caregivers could get a "discount code" from a nonprofit that would oversee the usage.  Analogous organizations like McDonald house that provide lodging for families of inpatients could be a model.

Photo of Jim Rosenberg

Nice idea Sherri. Building on top of the platforms that are already in place seems like a great way to go.

Photo of Joy Johnston

Like the discount code idea, and totally agree, adding to existing companies would give the concept the most opportunity for success.

Photo of Anne-Laure Fayard

Great idea Sherri! I like the idea of building up on other platforms and having a discount code! 

Photo of OpenIDEO

Congrats on being today's Featured Contribution!