The War in Paris to Clean your Home

Riding the Paris metro or walking the streets, it’s impossible to miss the increasing number of advertisements for tech startups. Airbnb, Drivy, Blablacar, Uber – the sharing economy is after you, whether you’d like to share or be shared. And, in the past 60 days, the latest war isn’t over your car, or your bed, but over your dirty floors.

Since September, three different services offering cleaning services online have launched in Paris – HomeJoy (US, Y-Combinator), Hassle(UK, Accel-backed), Helpling(Germany, Rocket Internet) & Handy (New York, not yet launched in Paris). These four services compete not only with each other, but with traditional maid services in Paris, like Shiva.

Differentiation in this market will be hard, and these companies are competing to attract cleaners, who, in Paris, have increasingly rejected working for cleaning services due to the increased taxes imposed by the state. In addition, these services compete for your floors – churn rate on house cleaners is relatively low beyond the one-off uses – once you’re hooked, you’re not going anywhere.

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The War in Paris to Clean your Home
Oct 28, 2014
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Liam Boogar
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Riding the Paris metro or walking the streets, it’s impossible to miss the increasing number of advertisements for tech startups. Airbnb, Drivy, Blablacar, Uber – the sharing economy is after you, whether you’d like to share or be shared. And, in the past 60 days, the latest war isn’t over your car, or your bed, but over your dirty floors.

Since September, three different services offering cleaning services online have launched in Paris – HomeJoy (US, Y-Combinator), Hassle(UK, Accel-backed), Helpling(Germany, Rocket Internet) & Handy (New York, not yet launched in Paris). These four services compete not only with each other, but with traditional maid services in Paris, like Shiva.

Differentiation in this market will be hard, and these companies are competing to attract cleaners, who, in Paris, have increasingly rejected working for cleaning services due to the increased taxes imposed by the state. In addition, these services compete for your floors – churn rate on house cleaners is relatively low beyond the one-off uses – once you’re hooked, you’re not going anywhere.

Nonetheless, the largest points of differentiation of the product happen behind the scenes. For example, while Hassle charges customers the least here in Paris, the cleaners themselves actually make the most, due to Hassle’s use of the Auto-Entrepreneur status. Homejoy, on the other hand, provides materials to all of its cleaners, where other services require clients to provide materials.

Handy has begun to branch out into repairman & plumber services, while Hassle CEO Alexandra Depledge says that, while users are used to paying a flat rate for cleaning services, plumper & repairman rates have so many variables that it’s difficult to put a standard price-tag on a catchall service; therefore, Hassle has chosen to focus on providing the best cleaning service.

I gave one of the services a test drive, and the service is simple: i selected a time and a cleaner was chosen for me. She was punctual, was polite, was well-dressed & professional, and she asked questions when she couldn’t find something. After she had been working for an hour, I left her alone in the house and went off to work, and when I came home, the place was clean. For someone like me, I could easily imagine having a 4-hour clean once every two weeks.

The market is still young, but it money is being poured into this market fast. The next 12-18 months will be key for this market in France – interestingly enough, no significant players from France have emerged beyond the ‘old world’ brick and mortar models.

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Could new technology help older people in Barcelona create stronger networks?

As life expectancies grow ever greater, cities around the world are being forced to face up to the challenges posed by social isolation and deteriorating health among their ageing populations.

More than 20% of Barcelona residents are 65 or over, according to city data, and that is expected to rise to 25% by 2040. To combat the problem the Catalan capital has come up with VinclesBCN – an app which helps at-risk elderly people, and their families and helpers, create collaborative care networks. The project won the Bloomberg Philanthropies Mayors Challenge 2014 last month, scooping the top prize of €5m in funding.

“People in cities tend to be anonymous, while in a rural context they look after each other and relationships are closer,” says Josep Maria Miró, who is head of the social innovation department at Barcelona city council and has been part of the multidisciplinary team working on VinclesBCN. “This also worries other European cities because most of their population is living in urban areas where solitude and isolation are intensified.”

Fernando García Bernal, a mobile developer and project contributor, explains that the app generates a trusted network of people who can organise activities for elderly users: “It can be installed on a tablet or mobile – allowing the elderly to make calls, send and receive multimedia content, share a calendar and transfer money easily and safely.” The hope is that, as well as helping the older people meet their basic needs, VinclesBCN will also encourage them to try new things, adds Josep Maria.

The city council – which is currently trialling the initiative with 20 elderly people in Barcelona – will provide training and help to users, who will be able to invite up to 10 close family members, friends, neighbours, social or healthcare employees to be part of their private circle. These network members can then respond to the user’s alerts, reminders and needs, interact with other people in the circle and organise activities.

The initiative hopes to reduce the isolation felt by some older people and provide careworkers with a network of support. Fernando believes that the app will give both groups improved connections to wider society and a better quality of life.

The app is expected to reach 20,000 over-65s, and integrate about 100,000 people in total through their trusted networks. “Barcelona can do it,” says Josep Maria. “People are receptive and my intuition is positive … Our hypothesis is that VinclesBCN overcomes urban isolation. We believe this but we need to find data that corroborates it. If the tests give us good results, the project might be replicated in other European cities.”

Confusion in the elderly — a life-threatening condition

Illness in the elderly is often manifested with a condition called delirium. This is an acute state of confusion presenting with drowsiness, loss of memory, fluctuating levels of consciousness and frequently hallucinations and delusions. Many individuals who are frail often do not present with the symptoms of a disease such as a urinary tract infection or pneumonia, but with delirium.

While uncommon in the community, delirium occurs in anywhere from 14-34 percent of hospital patients, but amongst those over the age of 80, over 70 percent have symptoms of delirium, particularly if they are about to undergo major surgery or are being treated in the ICU.

Delirium is often the initial symptom of an acute medical illness such as a urinary tract infection, pneumonia, sore throats, bronchitis and influenza. Many medications can lead to delirium, as can major illnesses such as a heart attack, stroke or hip fracture. On occasion it may be situational — brought on by a change in environment such as moving to a new facility or being admitted to a hospital for an elective procedure.

There are many risk factors for delirium, but far and away the most common is dementia, caused by strokes, Parkinson’s disease and most commonly Alzheimer’s. Delirium is more frequent in those with sensory deficits such as hearing loss or blindness, immobilization because of catheterization and frequently by the use of restraints. For reasons that are ill understood, delirium is more common in males and those with chronic renal or liver disease. The greater the number of chronic medical conditions, the greater the risk of delirium.

Dehydration is frequently present in patients with delirium and is the most common underlying cause of an acute state of confusion in the elderly. Compared to young people, older persons have a markedly reduced thirst drive. When they become ill, water loss is increased. Frequently the fluid loss is not replaced, and this in turn leads to increasing confusion and continuing worsening of symptoms.

When hospitalized, patients with delirium frequently become more agitated, pull out intravenous lines and may remove urinary catheters kept in place by an expanded balloon. This leads to injury and even worse, agitation. Often patients are restrained and prescribed psychotropic medications that may cause some but insufficient improvement. The combination of restraints to prevent injury and medications to reduce agitation frequently cause more harm than good. Hospital stays are increased, complications are high, and death is frequent.

There is much that can be done to prevent and manage delirium in ways that minimize complications. The importance of assuring adequate fluid intake is critical if an older individual develops an illness or shows signs of confusion. The earlier a diagnosis is made and the medical condition appropriately treated the better. Admission to hospital must be avoided as much as possible. Sadly, many families wait too long after symptoms develop to consult their doctor. Even over the phone, the physician can often help identify and treat the problem.

Hospitals are now more aware of the problems of delirium in sick older individuals. New guidelines have been developed to minimize the risk of confusion both before and after surgery. Appropriate anesthesia can do much as well. And today many hospitals have specialized delirium units. These often have four beds and are monitored continuously by one or more nurses. The goal is to avoid the use of restraints, assure hands on nursing care to reduce risks of removing tubes and minimizing drugs that can aggravate the problem. Wherever possible, family members are encouraged to spend as much time as possible at the bedside. A familiar face and voice can do much to help disorientation and reduce agitation.

Often patients remain confused throughout the hospital stay. For this reason, the patient is better off at home, provided the family has the resources to assure recovery. These days, the push to shorten hospital stays paradoxically leads to discharge too early that in turn increases complications and results in multiple readmission to hospital.

The solution to confusion in sick older patients is to assure a team of health care providers who participate in care prior and during an illness. Providing appropriate care after hospitalization can do much to improve chances of recovery and assure a better quality of life.

Elderly Housing Authority resident suffers stroke, receives eviction notice

Oh, the San Francisco Housing Authority. Its staff is always good for a “They did what?” article — but at least this one doesn’t end as badly as they usually do.

You may recall the sad story of Mary DiGuiseppi, a 94-year-old woman who has lived at Clementina Towers South of Market for 29 years. She lives on the 10th floor of the public housing high-rise for seniors and disabled people, and whenever the frequently malfunctioning elevators are both broken, she’s stranded in her room.

In September 2013, DiGuiseppi was dropped off at Clementina Towers in a shuttle van after visiting her adult day care program. The elevators were both out, and DiGuiseppi was stranded in the lobby for 10-1/2 hours with no food, no water and no access to a restroom.

“I was in the lobby all alone, and I was frightened and cold,” she told The Chronicle later, noting the only help she got was from a security guard who put two chairs together for her to lie on. “It was very uncomfortable and painful.”

DiGuiseppi became one of 24 tenants to sue the Housing Authority for not fixing the elevators despite years of complaints. In April, Mayor Ed Lee said he found $5.4 million in his housing budget to finally get the elevators at Clementina Towers and other public housing projects fixed – though the ones in DiGuiseppi’s building won’t be completed for another year.

DiGuiseppi suffered a severe stroke about six weeks ago and after a brief stay at St. Francis Hospital is being cared for in a rehabilitation center in the city. Her husband and two sons are dead, and DiGuiseppi has no power of attorney in place. She failed to pay her October rent of $259.

On Oct. 21, a notice from the Housing Authority was taped to DiGuiseppi’s door telling her she had 14 days to pay her back rent or she’d be evicted. Obviously, she wasn’t inside and wouldn’t have known she received it.

Her neighbor and friend, Terry Bagby, spotted the note, read it — and gave us a call. We contacted the Housing Authority about the matter, and Director Barbara Smith said it was a mistake. The 14-day notices are automatically generated by a computer when back rent is due — although we saw the notice, and it was hand-signed and hand-delivered so it wasn’t exactly automatic.

“When you got involved, housing wanted to change their tune,” Bagby said. “They don’t like the media attention they get.”

Smith said the agency staff is now working with DiGuiseppi’s social worker to help a conservator get put in place to manage her money and pay her bills. In the meantime, the eviction is off the table.

“Of course we’re going to keep her apartment for her while she’s convalescing — absolutely,” Smith assured us. “We have absolutely no intention of any kind of eviction against Miss DiGuiseppi.”

 Smith even visited DiGuiseppi at the rehabilitation center. She visited her after the 10 1/2 hour elevator malfunction too.

“We’re hoping she recovers and comes back,” Smith said.

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Residential homes, nursing or respite: Choose the right care home for you

We are living longer than ever before, with life expectancy rising year after year thanks to better lifestyles and advances in medical technology. In the past three decades the number of people in the UK aged 90 and above has almost tripled, according to figures published by the Office for National Statistics.

However living longer presents its own challenges. Although we all dream of enjoying a comfortable retirement where we live independently in our own homes what happens when we need the help of others to deal with the health problems of old age such as dementia or osteoporosis?
Although we are often reluctant to think about it many people will need care at some point.
The word "care" covers a wide range of services from having a care worker visiting for an hour or two every day to going to live in a home after being unable to carry on independently.
It can also be difficult to work out whether someone we know - friends, family or loved ones - needs assistance and equally tough to make the decision that they can no longer live on their own.
The type of assistance people need can change significantly over time
It's never too early to start thinking about the financial, logistical and emotional issues that could arise if you or a relative need care.
In some cases, following an operation or a serious health problem for example, it will be obvious that support is needed.
At other times a gradual deterioration in health and independence can make it difficult to know when to look for an At other times a gradual deterioration in health and independence can make it difficult to know when to look for an alternative.
Often the decision is made in the heat of the moment following a fall or a bout of ill-health and without time to consider all the options.
If possible start by talking to your GP or your relative's GP for guidance. Then ask your local authority for a care needs assessment to make clear what help is needed and provide an idea of what financial aid you or your loved one is entitled to.
To help steer you through the maze the Daily Express has published a free guide to Elderly Care in association with private healthcare provider Bupa.
It can help answer any questions you may have about the types of care available and how it can be funded.
The type of care people need can significantly change over time as their health deteriorates or improves.
These are the main types available:
CARE AT HOME
If you or your relative can manage alone for most of the time but need help with daily tasks such as washing and preparing meals you or your local authority may decide that having care workers visit a few times a day is sufficient.
RESIDENTIAL CARE
For those unable to live independently on their own care homes provide rooms, meals and personal care such as help with washing and dressing.
NURSING CARE
If health problems require constant medical attention nursing care should be made available in a care home or in your own home.
RESPITE OR SHORT-TERM CARE
In many cases residential care may be needed only temporarily. For example if a carer needs some time off the person they are caring for may go into a residential or nursing home for a few days or weeks.
Short-term or short-stay care may also be useful for those who are recovering from illnesses or operations.
It may also give someone who is thinking about going into a care home an insight into what life would be like there.
DEMENTIA CARE
As the number of people living with dementia increases more and more homes are specialising in looking after people with these conditions.
Depending on the severity of the condition these could be nursing homes or residential homes.
PALLIATIVE CARE
For terminal conditions palliative care in hospices or care homes can help relieve pain.
CHOOSING A CARE HOME
Whether you are paying for care yourself or relying to some extent on local authority funding you should have a choice about which care home you go into.
So what do you and your relatives need to bear in mind when making a decision? A key point is whether the home offers the kind of care needed. Some homes specialise in looking after people living with dementia for example.
The needs assessment carried out by your local authority should identify the specific care that should be provided for you or your relative, as well as whether the support of trained nurses will be needed.