He Needed a Caregiver As His Body Shut Down. AI Found Him the One.

Christina Evers, 42, watches on, holding the back of Merrill Hale’s motorized wheelchair, as he controls his screen with his eyes.

It’s the only way Hale, 57, has found to effectively communicate with Evers, his caregiver. Hale was diagnosed with ALS a decade ago and has slowly lost the ability to speak, eat, and move.

“Tech is essential to my survival,” Hale says, read aloud by a computerized voice.

“He’s the brightest guy in the world,” his mom, Judy, says as she watches him in their Oregon home.

Evers and Hale have formed an incredibly tight bond, Judy says. That’s by design. They were matched, in part, by AI.

The two were connected through Home Instead, a home healthcare services company that operates in 1,200 locations across six countries. Home Instead was acquired in 2021 by Honor Technology, which has integrated AI algorithms and machine learning tools to match eldercare workers with clients.

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Honor’s tech has allowed for “smart matching,” using algorithms to analyze caregiver availability, personality traits, skill sets, and prior client familiarity. The algorithms target patterns in how people work, such as ideal schedules or locations for caregivers, based on thousands of data points. The algorithms also anticipate future events, such as identifying when a caregiver may be at risk of missing a shift before it happens.

“I was lucky to have found her,” Hale says. “Caregiving, I feel, is deeply personal, and you spend so much time with people at the most difficult time of their lives. I look forward to her visits every time.”

Up until 10 years ago, Hale said life was rich and fulfilling. He played sports in high school and held jobs as a drafter, then an engineer, for a railcar manufacturer. He left his two-decade career to pursue music, playing drums in a Led Zeppelin tribute band. He raised two children and had been healthy and active, aside from minor back and knee pain, until his mid-40s, when his body began to shut down. ALS destroys motor neurons, leading to muscle weakness and loss of movement.

“The change in roles is difficult, because instead of being equals, it’s now caregiver and recipient,” said his wife, Karen, who works full-time.

His health has been steady, as the progression of his ALS has been relatively slow compared to other forms. He recently had a tracheostomy to stabilize his condition and make caregiving responsibilities easier for his caregivers. One of Hale’s friends had recommended Home Instead as his condition worsened, and he wanted to prioritize at-home care.

Hale said that while he doesn’t understand how all the tech works, he has seen the benefits. CEO Seth Sternberg said Honor has been developing an algorithm that analyzes a client’s service history and generates summaries that indicate what’s most important to them. He said this algorithm has reduced handling time and allowed caregivers to be in agreement about care decisions more easily. Of course, AI makes mistakes sometimes, Sternberg added, but so do humans, and AI is better at taking feedback.

“AI is literally orchestrating all of the complexity about that single client and their whole history, and then making it so that we can have a really smooth, seamless conversation with that person,” Sternberg told Business Insider.

Sternberg added that the algorithms have reduced staff turnover because caregivers are assigned clients whose needs match their capabilities, and clients are often more satisfied with their care. Sternberg said yearly caregiver churn for Home Instead is about 30%, compared to 80% industry-wide. The tech also reassigns visits when scheduling gaps arise and identifies where a caregiver might need additional education.

“There are exactly zero customers of ours who want to hear about our technology,” Sternberg said. “Rather, they want to hear about why their care pro is a better care pro, or why this service is a better service.”

Christina Evers hadn’t anticipated being Hale’s caregiver. Her last client had died, and she thought she would quit caregiving because of the emotional pain. She previously served in the Army and decided to enroll in college to get a master’s in psychology to work with veterans with PTSD. Hale resembled her last client, though, and after a few sessions, she committed to staying with him.

McDermott said Home Instead’s AI helps with match criteria, but it ultimately requires a human to make the decision. Evers and Hale checked all the boxes: Evers was tech-savvy, equipped to work with high-acuity people, and had a warm personality. Hale was closer in age to Evers and very vibrant.

Evers has been his caregiver for three years, working 9 a.m. to 3 p.m. Monday through Thursday. When she started with him, he could speak and had more mobility. She’s responsible for bathing him and getting him ready for the day, as well as keeping him entertained. His physical decline hasn’t taken away, though, from their elaborate conversations, including their bickering about music or sports. It often takes a minute or two for him to formulate his response with his eyes.

“The lag is definitely a reality for Merrill, and based on what he’s told me previously, it’s the hardest part about his life,” says Rachael McDermott, home care liaison at Home Instead, who was previously Merrill’s care coordinator. “The trickiest part about the lag time is that his dad jokes aren’t quite hitting because of the pause.”

“We’re so used to such a quick, upbeat response by people around us that we forget to have patience so they can actually articulate what they’re feeling,” Evers responds. She adds that he’s “the definition of resilience.”

Judy, who is in her 80s, visits most days, helping him when Evers isn’t working. Her husband died almost three years ago, and she moved into a retirement community nearby after selling her house.

Hale has embraced tech to bolster his creativity, using computer-aided design software and his 3D printer. He designed and printed a phone holder for watching shows, creating a matching pink one for Evers.

There’s plenty to look forward to, Hale says. Spending time with family and friends, watching his kids grow up, and, most importantly, seeing the Chargers win the Super Bowl for the first time, he jokes.

“We share a lot of tears,” Evers says. “You’re holding onto every moment. I hate to call it a shift because I enjoy coming here.”