Why More Home Care Agencies Are Building Their Businesses on Culture-Based Care

Over the years, home care providers that have provided specialized care have positioned themselves to stand out among their competitors. Some providers have gone even further — tailoring care to best fit the needs of their clients’ ethnic or cultural backgrounds.

One such company is Circle of Life Home Care, a Minneapolis, Minnesota-based provider that serves Native American communities, both on and off reservations. Circle of Life Home Care operates across Minnesota, Montana, Colorado, Arizona, New Mexico, South Dakota and North Dakota.

There are a number of different brands under Circle of Life Home Care’s banner. Each brand is designed to serve a number of different nations.


For instance, Circle of Life Kola provides home care services in North and South Dakota, caring for seniors that are part of the Sioux tribes. The company’s Soaring Eagles brand provides care on the reservations for the Navajo Nation in Arizona and New Mexico.

The COVID-19 emergency has had a devastating impact on the Navajo Nation, which has faced some of the highest rates of the virus in the U.S. This is compounded by health care access barriers. 

Circle of Life had to be proactive in its response to the public health emergency, Himmat Singh, CEO of Circle of Life, told Home Health Care News. 


“As a company, we were ahead of the curve in immediately issuing guidelines for providing care during the pandemic, which relied fully on guidance issued by the CDC and other global health organizations,” Singh said. “We set up both internal and online platforms to disseminate information, best practices, policies and training. We also invested heavily in PPE.”

Circle of Life also cares for seniors that are part of the Apache, Zuni and Hopi tribes.

One of Circle of Life’s main focuses as a company is providing culturally sensitive care to individuals. This is especially important when taking into consideration the history of forced displacement and the ostracization of Native American people, according to Singh.

“There’s this concept of intergenerational trauma,” Singh said. “So being culturally sensitive takes time. Even in my case, I’m still a student.”

While most home care companies strive to provide high-quality care to seniors, the idea of honoring clients holds additional weight and takes on a cultural significance among the communities that Circle of Life serves, according to Singh.

“Honor is a huge component of the Native American [culture],” he said. “I’ve always felt, for us, it’s not just a home care services company. There’s a huge cultural piece that is at the crux of what we do. It’s a special ‘extra sauce’ that is almost intangible.”

Generally, when a caregiver begins working with a senior there’s an adjustment period while both parties get to know each other. Caregivers who understand cultural nuances remove an additional barrier that allows them to zero-in on the well-being of the company’s clients.

Circle of Life is also attuned to the specific health concerns of various Native American communities.

“For example, when we look at the health issues impacting Native Americans, the number of people who have chronic diabetes or liver problems is significantly worse than any other population in the U.S.,” Singh said.

Indeed, in some Native American and Alaska Native communities, the diabetes rates among adults are as high as 60%, according to the CDC and Indian Health Service (IHS).

Even as non-medical care providers, home care workers often play a major role in helping seniors avoid rehospitalization. Having a sort of cultural shorthand potentially lowers the chances of a caregiver missing vital care needs, according to Singh.

Overall, Circle of Life has roughly 1,400 clients.

Most of these clients have stayed with the company over the years. When clients do leave, many end up returning, citing a disconnect between them and a more mainstream provider.

“They believed that no one understood their unique circumstances,” Singh said. “What really distinguishes us … is most of our folks and our leadership are Native, especially at the grassroots level of the offices. These are people who know the life of our clients.”

Business opportunities, recruiting 

Home care agencies that can serve micro-targeted communities develop a level of client loyalty and satisfaction that few businesses can match.

From a business perspective, that can help with word-of-mouth referrals and financial stability, since so many clients often stay on service as long as they need home care.

These built-in advantages are partly why the number of community-specific home care agencies has spiked in recent years, according to industry insiders. 

“We can attest that specialization as a differentiator is truly what stands out from the medium agency to the master’s segment,” Todd Austin, chief operating officer at Home Care Pulse, told HHCN in an email. “The best use case for this would be dementia or Alzheimer’s. Agencies that use this as a unique [offering] have the highest hours per client and were the fastest growing in the industry. The same could be said for cultural specialization.”

Lombard, Illinois-based Sahara Home Care was initially founded to serve the South Asian and Middle Eastern communities. While the company has since broadened its client base, it hasn’t shifted its focus away from taking care of these particular senior populations.

The personal care company offers senior assistance and respite care services to over 3,000 clients across 10 locations.

For seniors, getting older can make additional adjustments more daunting, Samina A. Saeed, program coordinator at Sahara Home Care, told HHCN.

“At a seniors age, it can be hard to accept change,” Saeed said. “So they feel more comfortable with their own culture, whether it’s food, daily routine and especially their own language.”

One of the biggest challenges home care providers continue to face revolves around the recruitment and retention of caregivers. For companies such as Sahara Home Care, there is the additional responsibility of hiring workers who are attuned to the culture of the communities they serve.

In order to recruit caregivers, Sahara Home Care’s outreach team has found that getting out into the community and attending culturally significant events help.

“Our outreach team goes out and does marketing at the cultural holiday events like Diwali and Eid al Adha,” Saeed said. “They attend all different kinds of religious events.”

Additionally, Sahara Home Care relies heavily on word of mouth, which is possible because of the company’s strong ties to the communities they work with.

On the retention side, the company has a number of benefits in place including profit-sharing, annual bonuses and travel mileage perks.

Sahara Home Care and Circle of Life aren’t anomalies.

Across the U.S., other in-home care providers that have built specialized client bases include Sagrado Corazón, Casa Central and First Nations Home Health, all of which have focused on fulfilling the care needs of Latino, Asian or Native American communities. Asian American Home Health — an affiliate of Kindred at Home — is another example.

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