Transcript: Thine AI Companion, Care2U Mobile Urgent Care, Lunalino Home

This is the transcript for the Rethinking Aging Club Podcast episode recorded May 14, 2026.

Episode Title: Thine AI Companion, Care2U Mobile Urgent Care, Lunalino Home

Recorded: May 14, 2026 / Published May 27, 2026

Guests:

Lon Hecht, CEO, Care2U Mobile Urgent Care – Bringing ER & Hospital-Level Care to Your Home

Keolamaikalani (Keola) Dean, CEO, King Lunalilo Trust and Home

Pratyush Rai, Co-Founder and CEO, Thine AI Companion (in beta) and already successful Merlin, both by Foyer.

Co-hosts:

Linda Sherman, Managing Editor, Boomer Tech Talk, Rethinking Aging Club podcasts founder and executive producer.

Ray Gordon, architect, urban planner, futurist, former Pratt Institute grad school professor and avid science reader.

Debbie Howard, caregiver advocate, co-founder, Tokyo-based AgeTech platform Living Best.

Show Notes: Thine AI Companion, Care2U Mobile Urgent Care, Lunalino Home

Linda Sherman 00:05

Welcome to the Rethinking Aging Club show. I am Linda Sherman. Each week, we host presentations and discussion with special guest experts on an important topic in the field of rethinking aging. We’ll be introducing this week’s co-hosts and guests during the show. We’re happy you’ve joined us.

It is May 14, 2026, and we are delighted to be bringing you another episode of the Rethinking Aging Club. Today we have gathered three outstanding speakers to tell us about what they’re working on in a theme we call Project Updates.

We have Pratyush Rai, the co-founder and CEO of Thine, as well as the co-founder and CEO of Merlin AI, and Lon Hecht, the CEO of Care2U, and Keola Dean, the CEO of King Lunalilo Trust and Home.

We are going to start today with Lon Hecht, and for that purpose, I’m going to have Debbie Howard introduce him. But first, I’m going to introduce my co-hosts. I have here with me today Debbie Howard and Ray Gordon.

Debbie Howard co-founded the Tokyo-based AgeTech platform Living Best, which uses consumer insights to guide AgeTech innovation. She’s a caregiver-friendly workplace strategist and author of two related books. Through both Living Best and her company Aging Matters International. She’s a participant in the AgeTech Collaborative from AARP.

Ray Gordon is an architect, urban planner, futurist, and prior graduate school professor at both Pratt Institute and NYU. Ray brings a unique perspective to scientific aging-related topics.

Debbie Howard 03:00

Thank you so much, Linda. This is Debbie. I would like to also introduce Linda Sherman, the founder of the Rethinking Aging Club, which is also a participant in the AgeTech Collaborative from AARP.

Linda is managing editor of Boomer Tech Talk, home to the club’s podcasts. She brings a long-standing interest in healthy longevity, caregiving, age tech, and the future of aging to everything we discuss here.

Linda previously served as CEO and CMO for multinational subsidiaries in Japan and now serves as chief longevity officer for LA-based Miracle of the Sea. She is a champion for healthy longevity and a role model for pursuing it with curiosity, purpose, and community.

Thank you, Linda, for all that you do.

Linda Sherman 03:26

Thank you so much. Can you go ahead and introduce Lon? Thank you.

Debbie Howard 03:32

Big pleasure to introduce our first guest for today, who is Lon Hecht, CEO of Care2U, a physician-led medical group delivering high-acuity care directly into patients’ homes, with more than 25 years of experience across the healthcare ecosystem, Lon has built and scaled innovative care models focused on improving both patient outcomes and the care experience itself.

Prior to Care2U, he held senior leadership roles at Optum Home and Community Care, where he led growth strategies for population health and home-based care solutions. Throughout his career, Lon has championed a simple but powerful idea: people should be able to receive quality care where and how they want it.

We’re looking forward to hearing more about what that means for patients, families, caregivers, and the future of aging. Over to you, Lon.

Lon Hecht 04:37

Well, thank you so much for having me on today. I really appreciate it. Once again, my name is Lon Hecht, CEO of a company called Care2U. We’re actually based out of New York. I reside in New Jersey, out by the coast myself.

And you know, excited to be on here today to just be able to talk a little bit about a new care model, something that’s very different than what folks are probably used to. I think there’s a really big misconception out there that any kind of care that’s higher acuity or higher need than your typical primary care visit needs to be done in the hospital, and I just don’t know that that’s true anymore.

So we’ve really built this innovative care model at Care2U, where we are sending in a clinician into the home, typically within about two to four hours of a referral, closer to two hours typically, and what they do is, if you think about it, we’re replacing ER visits with in-home ER-type visits. And we also are replacing traditional hospitalizations with being able to do that in the home, and we’re doing that at a fraction of the cost of what it would cost in the hospital.

So, our model is pretty simple in a sense. We deploy a clinician into the home, like I said, within two to four hours. Typically, you’re having a physician assistant, a nurse practitioner, a paramedic in the home. They spend on average about 70 minutes with a patient. They work the patient up, and then they bring typically an ER physician or hospitalist physician on telehealth at the same time. So you have two providers in a visit, and they work on the care plan and they execute that care plan together.

We bring a ton of capabilities into the home, so you know, from your typical stat labs to point-of-care testing to oxygen concentrators and imaging and infusions, meds, everything like that. We’re bringing all that fully loaded into the home so we can treat really complex medical needs there.

And I think the really exciting thing is that we’re able to treat patients where they want to be treated. And I think that’s really what’s critical to me. When you get sick, probably the last place you want to be is in a hospital with a bunch of sick people. So what we do is we actually turn that home into a higher-acuity care setting, in a sense, and we treat you very comfortably in the home. And the cool part is we can do this at a fraction of the cost of what it would cost in a hospital. So most people hear this and think it’s going to cost more money. It actually, if you look at it compared to Medicare, it’s about a third of the cost of what hospital utilization would look like, and if you look at your traditional, like, insurance-type plan, it’s actually closer to about a sixth of the cost of that care.

I’ll just mention we’re doing all kinds of cool things, like treating your pneumonias and your congestive heart failure exacerbations and COPD and, you know, infections, cellulitis, all kinds of stuff like that, dehydration. We’re doing all those things in the home, and you know, it’s really kind of flipping the model of healthcare on its head in a sense.

I do want to mention, and then I’ll pause for a minute, that it’s not for everything, and I think it’s really critical. Obviously, if you’re having signs of a heart attack or facial drooping, and it may be a stroke, or you had a traumatic head injury and you’re on blood thinners. Go to the ER. You should go to the hospital. But if it’s non-immediately life-threatening, odds are we can treat that in the home and do it very, very effectively.

So, last thing I’ll mention before I kind of pause for a minute is we are in the New York market right now. We’re actually planning to expand out into other geographies in the not too distant future, but for your listeners, I think one thing that’s really valuable: we may be very innovative in how we’re doing this, but there are services that do some of what we do out there, and you could look for those and look for those before you need them.

Go to Google and search “mobile urgent care” in your geography, and you’ll probably find people that could do 60, 70% of what we can do, and I think that’s like a really good starting point for you. So I’ll pause there, and I’m really excited to hear from the other folks that are going to be on as well. I’ve had a chance to look at both of their organizations, and I think it’s going to be an exciting conversation. So I’ll pause there.

Debbie Howard 08:39

Thank you so much, Lon. I am super excited to learn about your service, and I just want to ask you: When did you get started there?

Lon Hecht 08:48

So, company started about four years ago. I joined about three years ago. Company actually started really more during COVID and started more in that COVID-testing-at-home space, and then realized there was an opportunity, and that opportunity actually came to us, believe it or not, through providers and health plan that had a big issue with all of this ER and hospital utilization that could have been treated in lower-cost, higher-quality kind of settings, and that’s how we got started.

So I joined about three years ago, believe it or not, as the chief growth officer, and within about six months, I took over the CEO role and really had been able to pivot the company more into this really true high-acuity space and really have built a model that’s really different from everything else that’s going on out there. So, I’m really excited about where it’s going.

Debbie Howard 09:35

Yeah, that’s really, really exciting. You may not be able to share this with us specifically, but we’re really interested to understand about your coverage and your expansion plans and how fast that will happen.

I live in Central Texas in one of those rural areas where, you know, we struggle to get all the services that everyone else has. And so I know that’s a big issue in our industry as well. Can you speak a little bit about that?

Lon Hecht 10:05

Yeah, sure. So I have my eyes on several markets very openly. We have contracted with a lot of health plans, so we have health plan partners that would like us in other states already. And I’m talking to other health plans. So what I’m doing is very openly, I’m doing some fundraising right now. I’d like to raise some additional money to maybe be able to move into, I’d say, three markets over the next year or two, and some of those markets.

Texas is actually one we’re highly considering. Florida, obviously, a lot of aging patients down there as well. And there are a couple of other large markets that we’re looking at. Clearly, New Jersey and Connecticut are in play for us as well. Our current partners are kind of begging us to move out there anyway, as we speak. So, those are some of the ones we’re thinking about.

But one thing I’ll say is, if there are folks that are really interested in the service, our website is care2U.com. So it’s C A R E number two letter u dot com. Go on and just put a little form in there and say where you are and what you’re looking for. And the more I hear from folks that they’re interested in our service, the more I’m going to think about that geography and, you know, potentially being able to roll it out.

One last note: you mentioned rural, and one thing I’ll say that’s important for our model is, you know, obviously, as we’re doing these home-based visits. We have to have density of patients to be able to do it effectively at a good cost point, but that doesn’t mean that we couldn’t serve rural geographies very openly. You know, our model is one where if our field staff had to drive rather than 30 minutes between patients, two hours between patients, we would just need more reimbursement from the health plans to be able to cover our costs on that, but it would still come in at a fraction of the cost of what they would be paying for hospital-based services.

And if you’re in a rural geography, you know there are lots of things that are going to happen, right? There’s travel, getting people to those hospitals that aren’t remote. There’s all kinds of costs that get layered in there. So I wouldn’t want to shy away from the idea of doing something in a rural community; I just think it would take an innovative health plan to want to do something and to understand that our costs are going to go up, so their costs are going to have to go up in terms of what they pay us, but overall their costs are going to go down significantly because we’re so much less expensive than the hospital. I hope that makes sense.

Debbie Howard 12:19

Absolutely, it makes so much sense, and I’m really excited. And we’ll be watching your progress. And let me know if you decide to come to Texas, and if I can help you, I will.

Lon Hecht 12:30

Will do. Thank you so much. If you know any health plans or risk-bearing providers that are looking for some help, or hospitals, let us know.

Debbie Howard 12:37

Okay. Thank you so much. I’d like to see if anyone else has questions for Lon?

Linda Sherman 12:43

I do, Lon. When we look for mobile doctors here in Hawaii, I get hits on mobile care, but it’s not covered by insurance. It’s definitely at a lighter level than what you’re doing, and I think they also started during COVID because COVID testing was a big in-home thing. So when people Google, they need to be very specific. I think about what they’re looking for.

Lon Hecht 13:14

Yeah. So I would look for mobile urgent care. I wouldn’t just put mobile doctor. I would put mobile urgent care, because that’s going to automatically get you a higher level of service. A mobile doctor would be more like your primary care doctor coming in with the black bag to come in and check on you and do like, you know, a regular sick kind of visit. We’re talking about something that’s higher acuity than that, so I would definitely look for mobile urgent care.

Now we have done a really nice job in that New York market of getting health plans and others to pay for that service. In some markets, that’s not going to be the case, so there could be some higher out-of-pocket costs. But the one thing I’ll say is, I think this is really important: is you have to evaluate it as an overall cost standpoint.

I’ll give you an example in New York. We have contracts with lots of health plans, right? But there are some that we don’t have an advanced rate with. So what that means is I don’t want to get over technical, but I would have to bill an insurer for a house call, which means I get reimbursed less money than it costs me to actually do the visit. So in a case like that, which are more one-off cases, I may have to ask a patient for an enhanced care coordination fee, right out of pocket, right, which is more money.

But when you look at that enhanced care coordination fee, and you compare that to what it would cost them to go to the hospital and pay their ER copay, right, which is, you know, probably $150 to $250, and then they potentially get admitted and they may have a 20% co-insurance. All of a sudden, that enhanced care coordination fee looks pretty low.

So the thing I would just say for your listeners is, one thing about our service or a service like this mobile urgent care, you’re going to know what your costs are before you even get the care, which is awesome. The difference is when you go to the hospital, you’re not going to know what your costs are for two months. And you’re not going to be happy when you get there, and odds are it’s going to be higher. So weigh that when you have this conversation.

Like all of a sudden, let’s say, you’re looking for somebody that’s mobile urgent care, and you’re like, “Oh my god, it’s going to cost $200 to come out here.” Okay, well, okay, that sounds like a lot of money, but what happens when you go to the hospital and you have a $250 ER copay, and then you get hospitalized for something that could have been done at home, and you pay 20% on a $20,000 visit? Now you’re out of pocket for, you know, $4,000 plus. All of a sudden, that money up front that you knew about looks really good, right? So just be smart and weigh those options when you’re looking at it.

Linda Sherman 15:35

Thank you so much. Keola, how does that fit in with what’s happening on Oahu?

Keola Dean 15:43

Aloha, Linda. That would be an amazing service if we had it in Honolulu. And I actually have a question for Lon. Are you working with assisted living facilities? Because for long-term care facilities that do not have an on-site medical director, we end up relying on emergency rooms. And so, if we’re able to rely instead on a service like this, I think it would work best for the senior who’s needing the care, as well as for the facility.

Lon Hecht 16:11

Yeah, so that’s a great question. I’m glad you asked that. So, assisted livings we’re working with all day long and just very openly; I know Linda knows this from earlier in the week. She was reaching out to me, and I’ve had my hands full with something with my mother. I’m a caregiver. I’m an only child. I’m a caregiver to an elderly parent who’s in assisted living with cognitive impairment, dementia.

So you know, struggling, and we go into assisted livings all the time. And it’s a great thing to be able to keep folks there, especially if you look at things like dementia, Alzheimer’s, things of that nature, where going to the hospital is incredibly confusing. So yes, we do that.

The one thing I’ll say is, if you’re looking at, like, a skilled nursing facility, for a skilled nursing facility, we would probably need to be credentialed with that facility to be able to do a visit there. But I always tell my health plan partners, if there are a couple that they have high needs with, we’d be happy to do the credentialing there to be helpful to them, so I just want to differentiate their assisted livings all day long. We don’t have to be credentialed there; we can go in and see them. It’s like seeing them in their home, but if you look at like a skilled nursing facility, we would probably need some credentialing privileges there.

Linda Sherman 17:15

Can you describe what it takes to get credentialed somewhere? Thank you.

Lon Hecht 17:19

Yeah, honestly, I wish I had my chief operating officer on the call for that because he’s the one that handles that more than I do. But you know, it’s really more of a documentation process of, you know, getting all your licensure and all of your insurance information and everything done and filed appropriately. You have to get credentialed with insurance plans. You would have to get like, I have to get credentialed potentially with facilities. It’s not necessarily a hard process. It’s just not a short process. Just like everything else, it takes some time.

So we’re always more than happy to help our partners out. I think that’s one thing that makes us really attractive to our partners. We’re very entrepreneurial, and at the end of the day, you know, we realize that not everything is going to fit one way of business. Of course, we would like 80-90% of what we do to fit one way because it makes life a whole lot easier and scaling a lot easier. But you have to do one-off things to help people when they need help. So we always try to do that.

Linda Sherman 18:11

Thank you, Lon. And I do hope, I mean, of course, I’d love to see you be national in every state, but I also hope that what you’re doing inspires other people in this field to step up and do what you’re doing because I think it’s a great service.

Lon Hecht 18:30

I agree. I would love for us to be national, and I think that’s the goal. But I want other people to do this. We need to change healthcare and how healthcare is delivered. It doesn’t only have to be Care2U, right? There’s opportunity for many players in a space like this. So, bring it on. Let’s change healthcare together. So, go ahead, Ray.

Ray Gordon 18:47

Hi, I have a couple questions. Is this service 24/7? Like, if someone called at 3 o’clock in the morning and said, “I have an issue.”

Lon Hecht 18:53

Yeah. So, currently in New York, we are taking new patients from 9 a.m. to 9 p.m. So, if we get a referral from either the patient calling or the doctor or whatever at 8:59, we’re going to see them same day.

When they are on our hospital-at-home type of service, they have 24 by seven access to us. So new patients, like new episodes, are from 9 am. to 9 pm.

As I continue to get more and more coverage and more and more patients. I think we’ll continue to push those hours out even further and further. But once again, it’s all density. I just need to make sure I can’t have a, you know, as you can imagine, it’s a business. I can’t have a unit sitting there for one patient overnight. I have to make sure that I’ve got, you know, enough demand to be able to stand it up. So as soon as I have that for 24/7, I’ll do it.

Ray Gordon 19:39
Yeah, and then a corollary to that is you have this telemedical consultation, telemedicine, while someone is there in person. How do you schedule or have those people available to you? I mean, it seems like a daunting task.

Lon Hecht 19:53

No, it’s not. So we employ all of our providers. So we have this queued up. Our dispatch team is constantly monitoring. Where our field providers are, what their timelines are, when they’re getting ready to go into a room and expect that physician to come on there.

So, no, typically the telehealth wait times are very, very, very short, like sub-five minutes. So, what will happen is on-the-ground clinician-that PA, NP, or paramedic-will be in the home. They’ll do a lot of the legwork at first, and when they’re ready, they will kind of put in that they’re ready for telehealth, and then the telehealth physician will pop in and take care of that.

We have typically multiple physicians staffed at any one time, and we have folks that are always standing by to be able to kind of pick up additional cases as needed. But they’re all employed, so we’re pretty effective with that.

Keep in mind, we have to be effective in how we manage this because it’s a costly model to employ. So we can’t have people in the house sitting there waiting 20-30 minutes for a doctor to come on. We need to be able to be quick and be in there. So our dispatch team does a really stand-up job in helping to manage that for us.

Ray Gordon 20:59

And with the crunch in medical professionals. Are you going to have some kind of a limiting factor there in being able to recruit enough people to cover this as you go to a much wider marketplace?

Lon Hecht 21:11

I actually don’t think so. I don’t think we’re going to have a challenge. We have been very fortunate to date. We’ve been staffed very well. We have a really good staffing model. You know, we always staff for an additional 20% capacity. We have to be somewhat inefficient by nature because this is like immediate acute care. So you can’t just be so tight on your scheduling that you don’t have capacity.

But no, I don’t think we’re going to be challenged as we move into other markets because it’s a really innovative model. And look, people get burned out of being in a facility, in a hospital all day long, in a doctor’s office all day long. This is innovative in changing the way healthcare is delivered. People seem to really be leaning into this, and we have a really good bench of folks that are looking to come on. We’ve always got a pipeline of folks that are looking to join us, so I feel pretty good about it.

Don’t get me wrong, staffing is a challenge throughout the industry, but I think because we’re so innovative and we’re kind of, you know, on the cutting edge of what we’re doing, people want to step in and do things like this. People really want to change the model.

Linda Sherman 22:13

I completely agree with that. So often we hear, like Bob Kramer, who is a senior living huge expert with NIC, says the one thing we want to do is keep our residents out of the ER because that’s where people get sick. So I really, really like this model, Lon. And I wanted to ask you: diagnostics is so important in a hospital. You have the hospitalist who is the master of diagnoses. Are you utilizing AI, and is that ramping up in your company?

Lon Hecht 22:52

Absolutely, yes. We’re using AI for more and more, all the way from the beginning in intake to dispatch and making sure logistics are appropriate to, you know, charting summaries, you know, all the way through. So yes, we are using AI. We’re using more and more. I believe we’re going to continue to do that. I don’t think it’s ever going to be a replacement for the clinicians or anything like that. But I think it can help make them more effective in what they do. So yes, we’re definitely doing more and more with that. And I feel like I might have missed a part of your question. Is there something I missed?

Linda Sherman 23:22

Using AI in a number of ways, but specifically for diagnoses.

Lon Hecht 23:26

Yeah. So, oh, what I was going to say is our model is we have ER physicians and hospitalists. So we have the hospitalists on board, and we do have protocols built for this and triaging protocols and everything like that. And I think as we do more and more, we can get those more focused with AI to be able to help with the triage and everything like that.

Yeah, so I do think there’s a point in which we can use more for the diagnosis side. But you know, once again, I think when you look at AI in healthcare, you start with the areas that are low risk to patient care, and then you start looking at areas that are, you know, start to push the boundaries a little bit more. I think we’re kind of working our way through that. I still think there’s a lot of low-hanging fruit that we can do that is not going to, you know, have an impact in that way.

So I think we’ll get there. I just don’t think it’s too immediate. I think it’s the whole, you know, what is it crawl, walk, run. I think we’re starting to walk now.

Linda Sherman 24:21

Got it. And the first thing is to screen on the phone whether they need to actually go to ER, as you said. If it’s a heart attack, that’s not you.

Lon Hecht 24:28

Well, well, not only that, right? So I want to be good by my partners too, right? So I don’t want to tell a health plan that I’ve saved them all this money by going into the home for somebody that has a sore throat that doesn’t help. That’s additive to cost.

So we triage on the front end to make sure are they too low acuity, where I could just take a minute and call their doctor and try to get them into their primary care or get them to an in-network urgent care at a lower cost point. If I can, I will. It doesn’t make us any money. It loses us money, but it’s the right thing to do for the system overall and for our partners. So we triage on the low end and on the high end. If they’re too high acuity, we’re going to get them right to the ER. I don’t want to be additive. I want people to be where they should be, right, to get the right care for their level of need. So it’s really important that we do it on both ends.

Linda Sherman 25:20

Thank you so much.

Lon Hecht 25:21

Sure thing.

Linda Sherman 25:22

Okay, this is very exciting, and thank you so much for what you’re doing, Lon.

Debbie Howard 25:26

You know, this must be a huge, huge boon for family caregivers. I just want Lon to say a couple of words about that because I know, as a caregiver advocate, one of the horrible things, you know is all this management of these types of situations where you find yourself running around in a dither trying to get needs addressed. So, can you just say a few words about that, Lon?

Lon Hecht 25:55

Absolutely. So, a caregiver is front and center for everything we do, and it’s really central to me and kind of my mission, and I think we do a lot really to help the caregiver, right?

So one is it’s not easy to be a caregiver, especially when you have somebody in the ER or the hospital, right? Now your life is completely turned upside down. Being able to make sure that they’re in the right place and they’re comfortable and they’re feeling supported in doing all those things.

So moving that care into the home actually has a big benefit to the caregiver overall in that sense. It puts a little additional burden on them, a little bit in some way, but it takes a lot of additional burden off of them in the, you know, vast majority of senses over there. So I think there’s definitely a huge advantage to that component of it.

Debbie Howard 26:36

That’s great. I just want to remind everyone whenever I can. How important it is to support family caregivers, and your service really does that. So thank you so much.

Lon Hecht 26:47

No, it’s my pleasure. Thanks, everyone.

Debbie Howard 26:49

Okay, thank you.

Linda Sherman 26:50

Thank you so much. Keola Dean just went through five years of caregiving for his mother. She passed in February, and I’m sure that he can very much identify with all of those things that you were talking about, Lon, including, of course, for the care for the company that he works for.

We’re going to bring up Keola next. And Keola Dean is CEO of the King Lunalilo Trust, whose flagship program, Lunalilo Home, has been caring for Hawaii’s kapuna, a Hawaiian word for seniors, in Honolulu since 1883. Founded by King Lunalilo, one of the Kingdom of Hawaii’s most progressive monarchs, the organization today provides long-term care, adult day care, and meal delivery services grounded in Hawaiian culture and values, such as aloha and ʻike kūpuna, honoring the wisdom of elders.

Born and raised in Hawaii, Keola returned home in 2022 to give back to the community that shaped him. He previously served in Washington State, including leadership work with the Washington Health Care Authority, supporting Medicaid programs for tribal communities. Keola is a graduate of Stanford Law School and also holds a master’s degree in health policy and administration.

His commitment to aging and caregiving is deeply personal as well. Keola Dean, please tell us all about what you’re doing, the needs for it in Hawaii, and how you see all of this fitting together. Thank you.

Keola Dean 28:37

Thank you so much, Linda. The needs in Hawaii are, I think, what we are seeing across the country. But with Hawaii being an on-average older state, we are definitely in the middle of the what we call here the silver tsunami. And my organization is, you know, right in the middle of all of that.

One of the other challenges we’re facing that I think the rest of the country is also facing is healthcare professionals are in really short supply. I am constantly trying to recruit healthcare professionals but also ancillary support workers across the spectrum.

And then at the same time, you know, I think many people still don’t understand that Medicare does not cover long-term care services. Medicare is really focused on more traditional healthcare, and so Medicaid is the primary source of assistance. And the reimbursement rates in the Medicaid programs across the country just do not come close to covering the costs of long-term care. You know, and as Lon mentioned, covering those costs of care are critical for sustainability.

On top of that, you know, after COVID and how it ravaged through our nursing homes, I think it did two things: it highlighted just the long-term underfunding of long-term care in this country, and it showed the public health weakness in this country when something like a new communicable disease ravages through our systems. And so the federal government, the Centers for Medicare and Medicaid Services, implemented. They regulated a lot of the skilled nursing facilities in the country and they implemented a host of new requirements for nursing homes without a meaningful increase in financial support.

So, in long-term care, and I think we hear it across the healthcare spectrum. You could definitely hear it in some things that Lon was talking about. We’re just in a bind because the need is growing exponentially, but the finances and the people to provide those services are not there, and what that means on the ground is that everyone is trying to age in place, and you know, honestly, that’s the best model. If you can stay in your home with your family, close to your friends, you’re going to live longer and have a higher quality of living.

And so in that space, the CMS calls that constellation of services that help people age in place. CMS calls that the home and community-based services. That is the area that the federal government has been supporting and trying to emphasize for over two decades when we’re talking about the needs for seniors, and that includes adult daycare that includes delivered meals that are healthy, that includes home care agencies who bring various like CNAs into people’s homes to help them with what are called the activities of daily living. That includes respite, residential care, which is also something we do, and then that includes adult residential care homes like ours.

When I asked my question for Lon, I was talking about I use the term “assisted living.” That’s recognized nationally. And then there’s skilled nursing. That’s also recognized nationally. But in Hawaii, we’ve created this intermediate facility license called adult residential care homes. So you can think of this as just a slightly above assisted living, but not at the high level of care that a skilled nursing facility can offer. And so that’s where we provide adult residential care homes, we provide adult daycare, and we also offer respite residential care, and then we provide delivered meals.

Now, aging in place is really great for seniors who are lucky to have families. That’s the golden standard. But I also want to recognize the fact that there are seniors who don’t have families who can help them, whether it be because the families, you know, don’t live near them and can’t afford to move closer to their loved ones, or it could be that they’ve lost their families, or they don’t have families who can take care of them. So that’s where sometimes I think that the aging-in-place emphasis has left behind folks who need that residential care.

I’ll pause there to see if there are any questions or reactions.

Linda Sherman 33:02

Well, also, Keola, with long-term care, I imagine a large percentage of your residents have dementia. Is that correct? Sometimes that’s hard at home to care for.

Keola Dean 33:16

Yes, and in fact, that’s, you know, when we see families reaching out to us, nine times out of 10, it is because their kupuna has cognitive impairment, some sort of dementia, typically, and they can’t provide safety for them anymore.

And dementia is really an insidious disease because it challenges our most basic understandings of the ability to self-direct and self-restrain. And so that’s where families start running into challenges: is dementia by impairing the executive function in your brain. It removes the what inhibited you before and allows other behaviors to then come forward. And if there is an underlying mental illness, for example, that stayed sort of under wraps, dementia is going to open that up, and now you have a mental illness that is not managed. And so that’s what we see a lot of: is families, their loved ones cannot take care of them anymore because the dementia has impaired that executive function for that kupuna, and they come to us.

And now you know it’s so sad that these families have had to provide this care in such challenging circumstances, where today we are lucky to have a host of pharmacological tools at our disposal, but when those kupuna come to us, then we are working in turn to try to stabilize those kupuna, and that can take many months of working with a psychiatrist and a gerontology expert to figure out what is going to work best for that kupuna, because oftentimes these patients have not. Been diagnosed before, and conducting a diagnosis while the patient has dementia is very difficult.

Linda Sherman 35:06

That’s very interesting. And May is Mental Health Awareness Month, so this is a perfect discussion for that. Thank you very much. I didn’t think about that fact on the challenge of the diagnosis when you have that double hit there. Thank you very much. Debbie.

Debbie Howard 35:25

And Keola, that was really, really interesting. Thank you for all that you’re doing there, Keola. That sounds amazing.

Linda Sherman 35:33

Thank you so much.

Keola Dean 35:33

Thank you so much.

Ray Gordon 35:34

Keola, I have one quick question. Are you able to see the ability to expand and scale up the kinds of services you provide to your communities at this point?

Keola Dean 35:46

That is actually what I’ve been working on for the past four years. As you can imagine, scaling in Hawaii is more expensive and with the lack of healthcare professionals, more challenging. But we are working on expanding our adult daycare facility footprint, and we can only do that through partners. So we do have partners we’re working with on that.

We also expanded our meals program to the opposite end of the island here on Oahu, and that we did through a grant-funded program. But then, of course, grant funding is very challenging. So then we had to scale back that program, and then with regard to adult residential care homes, I’m also looking at expanding that, which is also challenging, though.

Linda Sherman 36:33

I think one thing that is very nice about Lunalilo Home, probably because of the respect of being associated with something like King Lunalilo Trust, is that you have so many people volunteering to come in and provide entertainment for your residents.

Keola Dean 36:56

Yes, entertainment and activities. So I think one thing that makes us unique is because we were founded by King William Charles Lunalilo, the sixth monarch of the Kingdom of Hawaii, and he was a progressive leader. He actually was one of the few monarchs, probably ever, who sought to reduce their power as king and push that power to the people.

So there’s a lot of aloha amongst the Native Hawaiian community for Lunalilo. And you know, various hula troops. We call them halo: they will come to our campus and perform hula, both to honor the king. So that is a way that we give back to our leaders here in Hawaii but also to bring that as a gift to our residents and to our adult daycare clients.

We also have a very vibrant music scene here in Hawaii, and we have performers who come to our campus just to perform for our kupuna. And so almost every day we have the community on campus either performing or spending time with our kupuna.

We do lei making. We do arts and crafts, weaving, lauhala weaving with our kupuna, and that is done with the community and with community partners, and so that’s, I think, one of the key aspects of our program.

Because of the amount of activities that the kupuna experience every day, it actually helps your brain be more healthy because it’s those diverse interactions with strangers as well as laughing with your friends that stimulate the brain and keep your mental capacities healthier for longer, and that’s what I think is one of our strongest aspects is just our community partnerships.

Linda Howard 38:56

Excellent, and you get in that intergenerational connection activity as well because of that.

Keola Dean 39:03

Oh my goodness! One of the most amazing things I’ve ever seen is one kupuna who had dementia and never really participated in much. Would just sit there and watch everyone do the activities. We had a middle school student come in and do painting, and it was an organized activity. So he did painting with the kupuna, with this kupuna, and this kupuna laughed, engaged with this boy, just absolutely had the greatest time that I had never seen him have. And so that is the power of intergenerational activities.

Linda Sherman 39:43

Thank you, thank you so much. And for anybody who forgot, “kapuna” is a Hawaiian word for “senior.” Thank you so much, Keola.

I want to go on to Pratyush Rai. Pratyush Rai is founder and CEO of Thine. A graduate of the Indian Institute of Technology Kanpur, he began his career in management consulting at Boston Consulting Group before moving into the world of AI products and entrepreneurship. Prior to Thine, Pratyush founded and helped build Merlin AI into a platform used by more than 20 million people.

But Thine is a more personal mission, as Pratyush says: Thine wasn’t meant to exist; it came from seeing the world a little differently. His goal is to help AI understand people with far deeper context-not just prompts, but the conversations, tools, and digital patterns that shape how we live and work-so AI can become genuinely personalized and useful.

I met Pratyush at the Uproar Media event during CES in January, and I started using Thine myself on May 1. Please tell us all about Thine, and also we’d like to hear about Merlin AI. Pratyush, thank you.

Pratyush Rai 41:16

Thanks a lot, Linda, for the introduction. Hi everyone, I’m Pratyush. As Linda kind of touched upon, I have previously been running Merlin and scaled it to 20 million users, and now we very recently started working on Thine.

So, just to give you a little bit of background, like with Merlin, when we started, it was technically like the first copilot on browser. We launched Merlin right after ChatGPT got launched and scaled it to 20 million users, and our thesis was simple: that, like, people really do a lot of their work on Chrome on their browser; it can be Chrome, Edge, or Safari, or any of the other browsers, but probably 70 to 80% of their time, which they spend on their laptop, is mostly somewhere around a browser.

And what we thought was that if somehow we are able to give this context of their work, which they do on their browser, to AI, then we can, you know, truly help them build a much better context bank for the AI to learn from their work, and, like, you know, use it to help them in their content creation research and so on. So, this thesis kind of played out very well for us, and we became one of the largest AI extensions in the world and also scaled a lot, even outside our extension space, as a website and a mobile app.

Though, as part of building Merlin, what we realized is that maybe browser itself might not be the only place you would like to kind of, you know, work on in order for AI to truly know you in a much better way, right? Yeah, if you think about it, almost all AI platforms, whether you use ChatGPT, Claude, or anything else, they are only able to understand about your life based on the prompts which you’ve created and based on whatever files and, you know, supplementary materials you feed along with those prompts. They do not have any clarity or any view about you outside of these two things, and they are not ambient; that is, they do not learn about you while you’re not using them.

So what we realize is that given these two insights, one is our learning from Merlin: the more context you give to AI, the better it is for you. And second is this insight that today all these platforms, whether it be ChatGPT, Claude, and so on, they are all requiring you to be proactive, and they are themselves not proactive. Given these two things, if we just work upon something which brings these two insights together and which makes AI proactive and which gives AI more knowledge about you, we can probably build an AI which can help you think better and be an extension of your mind in a much better form, and that’s how kind of Thine came into existence.

So, “Thine” stands for “yours” in Old English, and that’s exactly what our AI intends to be, intends to be extremely personalized to you, understand from your life, be proactive enough to learn about you on the go, and yeah, that’s a broader vision of how we are starting. In terms of the exact product, and as Linda has also used it for almost two weeks now, she can maybe also chip in here.

But yeah, in terms of the exact product, what Thine does is that it starts with learning about you from your conversations, so it’s an iOS app that you can turn on, and like, once you turn it on, it listens to you all the time using your microphone. It does so in an extremely secure manner, with all enterprise-grade compliances being applicable to you as a consumer, offering you SOC 2, GDPR, so all sorts of, you know, our enterprise learnings which we had with Merlin; we offer the same inside Thine.

And based on all your conversations, which you have in person, it forms a viewpoint about you, about who are the people who you interact with, about what are the topics you interact with them around, and tries to, like, you know, build a memory bank for you. So when you then go on to chat with Thine, it has all context about you and your conversations.

And given the fact that conversations are one of the deepest, most insightful, like essentially a memory bank of your life. When you use Thine, it very quickly learns a lot about you and is able to synthesize about the most important things which are happening in your life.

So, let’s say when you’re having this chat with me right now, you can understand that within a matter of like around four to five minutes, I am summarizing my entire life, right from how I started with Merlin and how I moved to Thine and what I am exactly building with, and I’m summarizing all of it in such a short span of time, right? So, if there is an AI which is able to listen to all of it and is able to synthesize and remember it, what it does is that it kind of, like, you know, has a very deep understanding of me and my life in a very, very short span of time, and that’s exactly why we started with a wedge of conversations.

Like, along with conversations, we are now also moving to integrate your emails, your calendar, and some of your other work tools, like Slack and Linear, and so on, so that, like, it can form a much more deeper understanding about you. And when you then go on to chat with Thine, it can, like, respond with all your context, act as a true second brain of thoughts, and, like, give you answers with much better depth than any other AI platform which you might be using.

So, yeah, that’s a little brief about what I have been up to. And Linda, you can maybe also share about your experience using Thine over the last two weeks and how it has shaped your viewpoint of Thine.

Linda Sherman 46:52

Thank you very much, Pratyush. It has been a very interesting experience, for sure. One of the most interesting things was to have Thine send an email. I think that connection is very interesting. In terms of being proactive, for sure, my Thine is sending me reminders and nudges and things. It’s very interesting that way. The thing is, how does that compare to setting up, and I haven’t done this yet, an AI agent? Because agents are proactive, they go out and do things for you without you having to remind them.

Pratyush Rai 47:37

Yep, so we have a viewpoint that for most people the need for maintaining integrations for their agents and maintaining the memory is going to be deep enough that even though they might get started to build their own personal agents, sooner or later they will kind of struggle a little bit to maintain them. And a lot of our team members internally also, and myself as well, we have been trying to build our own personal agents using a lot of these different new frameworks, which are coming across, like there is this OpenCloth framework, then there are Homes Agent Framework, and so on.

But what we all have realized is that, you know, it is good for people who need an insane degree of customization, people who are developers themselves and who would like to build their own stack, but for the normal folks like us, who typically need things out of the box and who do not want to get into maintenance, building our own personal agents do not make as much sense.

Our vision with Thine is to make it as simple as what Mac did to the computing, right? Like before Mac, the mainframe computers and the hobbyist computer builders: they had to literally set up their own, you know, computers at that point in time, and what Mac did was to just standardize things so that these all problems are abstracted away, and everyone now, even if you would ask a computer hobbyist for that matter, would be using a Mac or a PC or some equivalent, right? Like, they are not building their own stack always on the go.

And I think that’s exactly what is also going to happen with personal agents when people are going to build it today because they want that degree of customization, but once there is a standardized personal AI, like Thine, which is good enough for them to, you know, work across all their tools, learn about them, do actions for them, and so on. Maybe the need for building your own personal agent would not be big enough as it is today.

Ray Gordon 49:37

This is Ray. One of the very interesting aspects of Thine is that, I think, what you’re looking at is something that is very useful for older adults, in the sense that it is just going to be passively trying to learn about you. You don’t have to give it a whole bunch of prompts. You don’t have to tell it a lot of leading questions and things that try and train it.

It’s going to learn about you from just normal conversation, and summarizing what’s happening based on those conversations is sort of an interesting aspect of what it provides, especially for someone, you know, you’re getting older, you’re trying to remember what happened; it might be a complex conversation.

You’ll be able to get some kind of a summary from that automatically that gives you a sense of what that conversation, the essence of the conversation was and I think that’s a particularly useful feature.

Pratyush Rai 50:30

Absolutely, and what I also believe is that for a lot of people, we do not realize that how much of our learning and ideas and insights they get lost because there’s no one place where we have actually kind of, you know, stored them. Right? This is something which is not just applicable for the elderly but also applicable for young people, because what we have seen is that a lot of young people these days, specifically those who struggle with ADHD and other attention deficit conditions, we end up like being in a situation where we might have had conversations around the same topic two or four times with different people, but then we still struggle to, you know, link it back that, oh, this is what I had a chat with this person, and what was the feedback they gave me, and like, how can I use that in my next conversation, and in my next iteration, and so on, right?

So I think, in general, the challenges with human memory is more profound than what we realized, and the more you use Thine, and the more you use it for work, you realize how deep and profound it is.

Ray Gordon 51:37

Thank you.

Pratyush Rai 51:38

So yeah, that’s a broader brief about Thine. I’m happy to take up more questions.

Linda Sherman 51:42

I wanted to see if Keola or Lon had any questions, but I really appreciated listening to your explanation after using it, actually. It is true that the ambient capture of what is going on in my life. I took it to a doctor’s office. I took it shopping. I took it to all kinds of things. It has the conversations I’ve had with Lyft drivers, and it gives me a daily digest, and I like those daily digests, and it’s not a transcript, although it’s capturing everything that’s being said.

Thine gets a condensed version of that that it uses to interact. It doesn’t keep the transcript, so if you actually need a transcript, perhaps in the doctor’s office you would want to turn out on something like Plaud or Otter AI, but I think that it can work so well in conjunction with other tools.

But your point about it being really simple, and especially in this month of mental health awareness for ADHD and for aging adults, I really love that simplicity.

Debbie Howard 53:09

Thanks, Linda, for that too, because that helped me understand a little bit, and I really am interested in this practice. I just signed up on your website to get on the mailing list for the app, but I wondered, like, I’ve two questions: one is about cost, and the other is about how far back can it go, or does it start on the day I install it and then go forward, because I know context is so important. Can you speak to those points a little bit?

Pratyush Rai 53:42

Yep, I’ll come to those, Debbie. But before that, I’d like to address the previous point around transcripts, which you were talking about, Linda. We have heard this feedback quite a few times: that people do need, along with the notes of what happened in the daily digest, they do need the transcripts, and we are right now building a version where you can just tap on any specific area of the notes, and once you tap in, you will get the detailed transcripts of that specific time available to you. So, ideally, within next few weeks, it should be out.

Coming back to your questions, Debbie, first is, it can go back a long, long time, so the moment you start recording, for example, I have been using Thine since somewhere around December, and if I ask it a question back to what was the first chat I had about Thine when I just started using Thine. Thine should be able to like literally point out that, oh, I was having a chat with X person on this particular date, and this was the chat I had. And I have actually exactly did this a few times when I have been interacting with journalists, and you know, when I have been demoing Thine to new people who have no context about it, and it works like tremendously well.

So, the memory piece is something which is designed in the manner that it can go a long, long time back. One analogy, using which you can probably understand how it works is that in a day you might not be, you know, speaking more than probably 30 pages’ worth of content. So, if you think about it, Thine is essentially like a very, very big book. It might be a 4000 or 5000 page book if you have been using it for a, you know, few months, and today AI is good enough to be able to read such large books in literally a single prompt to feed an entire book to the entire high portal series to ChatGPT, and you ask it questions; probably it might get, you know, half of the answers right, right? So Thine is able to, like, you know, read, kind of, you know, gather through a lot of context.

In terms of cost, today, the cost is quite a lot, but given we are right now in a beta phase, we are actually not charging, and we are just directly offering it for free to the users who we approve on the wait list. It costs us somewhere around $200 a month a user to currently operate it, and we are directly paying it from our pockets.

But what we believe is that within next nine months the cost is going to go down to somewhere around $20. The reason this cost is high is because the way the memory infrastructure is currently working is very expensive, but over the last six months it has already gone down somewhere around four to five times. When we started, it was around $900 a month, a user. Now it is around $200. Within a month, it might go down to $100, and that’s why what we are expecting is that within nine months it would be dirt cheap, like it might go somewhere around $20 a month. And at that stage, we might be ready for mass adoption.

Right now, we are only working with, like, you know, users who understand, you know, how Frontier Tech works and, like, you know, what it takes to kind of be beta user and constantly give feedback and so on. So, yeah, the cost is a little less of a concern given just the entire AI wave and, like, how the infrastructure is evolving on its own without a lot of effort on our own end to reduce the per-unit cost, which we are, you know, burning on the tokens.

Linda Sherman 57:02

That is amazing, Debbie. I just want to answer your question about history. You can feed to Thine, and Thine is spelled T H I N E. Thank you very much, Rose, for asking us to spell that. There’s a chat function, and I am chatting with Thine constantly, so it picks up ambient conversations at the same time. I can ask it questions in the chat, and it can answer me, and I can paste in huge amounts of text, and I can feed it links, and it will look up links, like when I’m at the club at Kukui’ula, it looked up the link to the club at Kukui’ula for context, so there’s a lot that you can do for history if you want to feed it.

Debbie Howard 57:52

I see. Well, thank you so much. It sounds like a wonderful innovation. Thank you.

Pratyush Rai 57:59

Thanks a lot, Debbie.

Debbie Howard 58:00

So just know that when you’re signing up as a beta user, you’re going to be providing feedback. So there is some time involved with that.

Debbie Howard 58:10

If anyone can help me with my mess, I would put in that time.

Linda Sherman 58:17

Great.

Pratyush Rai 58:18

Thanks a lot, Debbie.

Linda Sherman 58:19

Thank you so much to everyone.

Pratyush Rai 58:23

Thank you so much, Linda, for inviting and really looking forward to all of you, you know, joining Thine. I’ll make sure that everyone who is part of this discussion is approved on the waitlist.

Linda Sherman 58:34

Thank you so much. Okay.

Lon Hecht 58:36

Thank you, everyone.

Pratyush Rai 58:37

Thanks, everyone.

Debbie Howard 58:38

Thank you.

Ray Gordon 58:39

Take care, everyone. See you soon.

Linda Sherman 58:41

Thank you.

Debbie Howard 58:42
Thank you.

Thank you for joining us today. This is Linda Sherman, founder of the Rethinking Aging Club. We appreciate your supporting the Rethinking Aging Club podcast by subscribing to our channel. See you next time.