A New Era of Care: NCOA Reports Share Vision for AI in Home Care

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CAST's Scott Code contributed to a three-part series on how artificial intelligence can support direct care workers.

For those considering the potential of artificial intelligence (AI) to support home care, the National Council on Aging (NCOA) has released a series of three reports, supported by the Department of Health and Human Services' (HHS) Administration for Community Living (ACL), that chart a solid direction for the future.

A New Era of Care shares the basics of AI, its current use in home care, and ways to shape AI's use so that it supports care workers and increases their ability to offer the human touch that is essential for older adults.

The reports cover these key areas:

Report 1 - Understanding Artificial Intelligence and Implications for the Direct Care Workforce

This primer on AI and its importance for home- and community-based services (HCBS) includes examples of how AI can strengthen direct care jobs and care if adopted collaboratively, with strong guardrails to protect workers, clients, and the data AI relies on.

Key points:

• The home care sector needs a shared, foundational understanding of AI before scaling AI's use, which is more likely to augment jobs than replace them.
• Thoughtful adoption could streamline administration, improve safety, and support better care and jobs, but only if paired with investments in home care job quality.
• Potential risks around bias, privacy, surveillance, and over-automation will require clear governance, transparency, co-design, shared learning, and human oversight.

Report 2 - Reimagining Home Care Work with AI

AI is already moving from theory to practice. The report shows ways AI is reducing administrative and operational burden in direct care-and maps concrete use cases to 40 responsibilities (20 worker- level, 20 agency-level).

Key points:

• AI is currently being used in home care, and real-world examples demonstrate how it is deployed across worker tasks and agency operations.
• The report describes use cases across eight focus areas highlighting high-potential tools like fall/emergency detection, medication support, training, scheduling, care planning, and compliance.
• It emphasizes "technology with a human touch" adoption should strive to balance technological innovation with human connection, with a clear focus on safeguarding privacy, mitigating bias and errors, and ensuring accessibility.

Report 3 - Beyond the Algorithm-Expert Insights on AI and the Direct Care Workforce

The third report highlights perspectives from stakeholders, including direct support professionals, to understand how AI affects the responsibilities of home care workers today and what guardrails are needed for the future. It synthesizes interviews, surveys, and a clear set of risks and considerations to guide responsible, worker-centered AI adoption in the home care sector.

Key points:

• Experts agree that AI's greatest near-term impact will be on administrative and clinical support (documentation, scheduling, monitoring, medication management, and coordination).
• Important considerations include over-reliance on AI, poor data quality, privacy and surveillance concerns, algorithmic bias, and gaps in training and digital access.
• Successful adoption will benefit greatly from transparency, co-design with workers and clients, independent evaluation of AI tools, sufficient funding for AI adoption and the sector writ large, and parallel investments in job training and quality for the home care workforce.

AI's Power to Level the Playing Field Among Direct Care Workers

LeadingAge Center for Aging Services Technologies' (CAST) Vice President Scott Code joined other technology, workforce, direct support, and policy leaders in contributing expertise to guide the report.

Code pointed to the power of AI, when provided with supportive training, to expand direct care workers' capabilities. "Generative AI probably has the most immediate potential for the home care workforce-especially in leveling the playing field. Research shows lower-performing staff often see the biggest gains, but only if employers provide access and education," he said. "If AI tools are unevenly available or staff aren't trained, you risk widening productivity and equity gaps instead of closing them."

Code also cautioned organizations to ensure data privacy, especially when integrating consumer-facing AI tools with internal data.

AI Use Must Be Shaped with Workers' and Older Adults' Needs Top of Mind

AI has the power to strengthen the workforce, improve care delivery, and build a more resilient and accessible home care system for the future, according to the reports. The extent to which this vision will be achieved depends on how thoughtfully the tools are designed, how grounded they are in the realities of direct care work, how keenly their implementation is guided by the needs of workers and care recipients, and how effectively they are evaluated in practice.

The authors emphasized that realizing this potential will require sustained attention to usability, accountability, and the human relationships at the core of home care.