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I looked at this as a business opportunity years ago. However, it is not possible to do anything without significant changes at the federal level regarding immigration. The US workforce would not take such jobs, especially for an extended period of time. Thus, it would require the employment of large numbers of long-term immigrants AND the creation of small *family* housing facilities for them.

The idea would be to bring in young married immigrant couples to provide significant care in a variety of areas (hence, a young couple). Training is not complex, but things will change over time as the elderly Americans "age in place" (with this help). However, the elderly *will* eventually move to assisted living in an extended medical facility--and the immigrant couple would move to a new elderly person/family to assist. Of course, the immigrant couples would have children in the US, and those would be US citizens. Expectations would be the immigrants would eventually become US citizens.
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