Nursing homes have been one of the main victims of this coronavirus crisis. 

Due to the elderly age of the vast majority of residents using these facilities, they are a high risk demographic for getting the virus and their aging health means the virus is more likely to have a devastating impact. 

This has led to what the government of Ireland calls ‘cocooning’- where elderly people limit their interactions with as few people as possible. Many have not seen family members in months and subsequently, another plague ensues – loneliness. 

Adam Keane, the entrepreneur behind the nursing home communication service provider Altra, hopes his new family engagement tool will offer support to nursing home residents and their relatives during this unprecedented time. 

“The emotional toll of this I don’t think can really be explained, especially with the residents and their families,” says Keane.

“It was very difficult. The restrictions on residents’ families being able to visit was extremely, extremely difficult for everyone and nearly worse than what actual Covid would or could do. The loneliness aspect of that during those times was just so difficult,” he adds.

*****

Keane launched his company Altra (meaning nurse in Irish) last September. His business originally only offered one service called Altra Staff which was developed to provide better communication for nursing home staff. 

“It cuts down on the manager’s reliance on WhatsApp, email, phone calls when communicating with staff for anything and everything. From filling shifts to new policies, whatever it was,” says Keane. 

He and his team built Altra to provide one space for managers to communicate with staff in one place, “almost like a corporate SMS inbox.” Keane built this tool as he saw that managers and directors sporadically communicating through different platforms which became unnecessarily time-consuming. Altra Staff is being used by 45 nursing homes in Ireland at the moment.

Keane went into this niche area, having already a wealth of background knowledge in nursing home care. His family owns Newtown Park House, a fully private nursing home that does not operate a fair deal scheme, in Co Dublin’s Blackrock.

“I always wanted to do something in the nursing home space. I didn’t necessarily want to work in the family business. I just had more ambition of basically setting something up myself,” says Keane.

The nursing home has been in his family for 30 years and was originally set up by Keane’s grandfather. His father is now the director of the nursing home. 

Keane began working there at 15 years of age and worked part-time at the nursing home through school and college. 

“I was doing everything apart from the clinical side. You’re talking like gardening and maintenance. I only got to graduate into the office when I was actually in college. Before that, it was all the dog work,” says Keane.

*****

Once Covid hit Ireland, Keane stopped selling Altra staff and gave his attention to developing a separate tool that would help families engage with their relatives and carers in nursing homes. 

“I could see with my own family’s nursing home how bad things were and basically I wanted to focus my efforts on helping in the family business at that time,” says Keane. 

In Newtown Park House alone there were up to 80 calls a day from family members of residents in the nursing home along with all the other challenges that came with operating a care facility during this pandemic.

“You’re dealing with staff that were sick, trying to get tests done, trying to get PPE from every which place. It was a very difficult time,” says Keane. 

However, Keane saw one area that he could improve with technology and that was the communication between the nursing home and the family of residents living in it. He knew he could build a tool that would make this communication easier, having already done something similar on a staffing level with Altra staff.

“The one thing though that came up continuously over that period though with my clients was that it’d be great to communicate with families through this,” says Keane. 

Building a family engagement tool was always on the roadmap for Altra but the progression of Covid brought this plan forward, states Keane. He started developing Altra Family during the first few months of lockdown. 

“This [the family engagement piece] seems to be more important than the staff side of things. So, instead of basically making minor feature updates on the staff side, we essentially decided to roll out product two quicker than we had envisaged,” says Keane. 

Keane describes this family engagement tool as a private social channel for the nursing homes to share moments and pictures, videos, voice notes, messages with residents’ families on everything that’s going on in a nursing home daily.

Before Covid, nursing home staff communication with family members was done mainly through visiting and the focus of these meetings was usually on the health aspect and not on the social aspect of everything else that’s going on in the facility, states Keane. 

A family member of a resident would have traditionally communicated with just one staff member of the nursing home where their relative is living. Keane hopes Altra will make this communication more inclusive for staff and family members. 

“Everything is siloed between residents’ profiles. So if you are the daughter of a resident in a nursing home, you’re seeing everything that’s relevant to that resident,” says Keane.

Keane also wanted to create a product that would emphasize the work nursing homes do aside from end of life care.

Branching into the US

Although his new family engagement tool is relatively new, Keane chose to expand into the US market with it now while there is a demand for it due to Covid. 

Elderly care in the US is sometimes broken down into what are called senior living communities, where they integrate independent living, assisted living memory care and skilled nursing facilities, explains Keane. 

Keane entered into an agreement with three operators of these US elderly care communities. One of these operators owns 18 communities overall. Keane’s Altra family engagement tool will be used in one of the communities owned by each of the three operators he entered into a deal with. He did not want to disclose the name of these companies at this point. 

Growing a presence in the US market made sense for Altra as approximately 1.4 million people live in nursing home care facilities in the US compared with around 32,000 nursing home residents in Ireland. 

Currently, 16 elderly care facilities, including some in the US, are using Altra’s latest product. He established these connections through cold outreach and emailing players in the US market. 

The money behind

Altra Staff takes into account the number of staff working in a nursing home and then sets the price based on that headcount. A monthly charge is then set for that nursing home to use that service. Similarly, the price for Altra Family is based on the number of residents it has. 

Keane did not want to tell The Currency at this point what the cost was per resident or per staff member as some users are on different rates. For example, these tools cost more in the US. 

*****

Keane got the company off the ground by investing €30,000 of his own money and securing investment from his business adviser Stephen Moore, owner of Ember Capital, who invested €50,000 into Altra. Moore was also the finance director of Nua Healthcare, which is one of the largest domiciliary care businesses. Unlike many other entrepreneurs, he decided not to go down the Enterprise Ireland route. 

Annual recurring revenue for Altra in 2020 is over six figures, states Keane without going into specifics. His biggest costs to date have been tech and salaries. 

He and his lead developer are working full-time at Altra. Kean also employs a part-time designer and is currently looking for a front end developer. 

Keane is not planning on fundraising any more funds for Altra and is focusing on expanding into the US.

“My plan is to be in over 200 communities (in the US) by the end of 2021. I think that’s very easily done,” says Keane.