Designing for Caregiver Rest: Building the Strategy Behind Carina's Medicaid Respite Care Expansion

The impact

A state-ready advocacy deck. A Medicaid-aligned feature roadmap. New language and filters shaping how caregivers post jobs and define availability on the platform.

Carina came in with a clear mission, help Washington state caregivers access Medicaid-covered respite care, but no product strategy for making it real. I led early discovery, defined user needs across a tangled policy and emotional landscape, and delivered the artifacts they needed to move forward and advocate for platform investment.

Respite care is not a logistics problem

It looks like one, which is the trap. Treat it as scheduling and you build a calendar nobody uses. The caregivers Carina serves are often unpaid family members caring for medically fragile people, and many have never taken a break. What stops them is not availability. It is guilt, the fear of leaving a loved one with someone unfamiliar, and a platform that treated respite like any other job post. The real problem was relational, and the product was solving for the logistical one.

That reframe changed what mattered. Mapping how respite actually works, and often does not, surfaced gaps a scheduling lens would never flag: caregivers had no way to request fill-in help at all, only care seekers could post jobs; Medicaid rules varied by county with murky reimbursement; provider ghosting on respite roles broke trust; and even internally, "relief" and "respite" had no shared meaning, so the confusion leaked into the UI and into conversations with state partners.

Designing for the person who has never asked for help

I ran discovery with internal teams, union reps (SEIU 775), and caregivers, then built caregiver-first flows for requesting emergency, short-term, and recurring backup care, the first time the platform let a caregiver ask rather than wait. I designed filters and profile flags to surface respite availability and reliability, built a visual Medicaid policy map so internal teams could navigate the regulation, and ran prototype reviews that moved the whole organization from "respite is a workflow edge case" to "respite is a relationship we are mediating." The state-ready advocacy deck gave Carina a clear, evidence-backed case to bring into partnership conversations.

What this built

• A Medicaid-aligned product roadmap. Tied to real regulation and real user pain, with sequencing the team could act on immediately.
• Caregiver-first flows that didn't exist before. For the first time, caregivers could request fill-in help on their terms - urgent, short-term, or recurring - rather than waiting for care seekers to post.
• Platform infrastructure for expanded care modalities. The language, filters, and logic introduced during this work positioned Carina to grow beyond standard home health into a broader respite and backup care offering.