Common Challenges with Home Care

Common Challenges with Home Care

These are the most common challenges with Home Care Providers and how to handle them.

Not knowing your priority for Time or Caregiver

• When there is a short absence with little notice before a visit the Coordinators have to find new caregiver solutions for each impacted visit
• Short absences should be exceptional events, there is seasonality during sick and vacation periods but short absences should not be happening frequently in a well managed operation
• A fundamental concern in the decision making process is whether the specific visit time or caregiver continuity is more important
• Is the specific visit time more important? Then finding a caregiver to come at the right time takes precedent over a caregiver you know at a later time
• If the continuity of the caregivers coming is more important then the visit time may be shifted to find a caregiver you know
• Most Clients prioritize caregiver continuity and prefer to be flexible on visit start time
• Specific timing often becomes the priority for specific medication timing, escorts or scheduled events and sometimes for individuals with high anxiety and time fixation

Too many different visit times

Caregivers showing up too early or too late is frustrating and can result in resistance to further help!

• Starting a service the initial daily visits are typically entered for the same times. Most visits have a degree of time flexibility to accommodate a limited caregiver team. Or they are time firm due to a specific requirement.
• Home care visits may be impacted by last minute absences that require an unavoidable change to a visit time. Home care visits may be shifted ongoing to accommodate preferred caregivers.
• Sometimes Schedulers aren't paying enough attention and a visit with a previous ongoing time change gets moved again and becomes later than it should be!
• Visits for escorts, appointments or time-restricted medication administration receive priority scheduling.
• Caregivers may be delayed for reasons beyond their control including traffic and weather which leads to later start times.
• If your service times are constantly changing for other reasons then the operation most likely has problems with scheduling education. There are very few solutions to poor scheduling knowledge in a home care operation because the industry lacks educators.
• Most services are for whole hours and start on whole-hour times ie 0900. Avoid starting visits on the half hour or the visit will be more susceptible to time changes.
• See also Home Care Basics: Visit Timing vs Team Continuity

Too many different caregivers

When clients receive new caregivers each week it quickly becomes exhausting from the effort of educating new people. Help that isn’t helpful fosters resistance to care.

• Home care visits may be impacted by last minute absences that require a change in your assigned caregiver.
• Service disruption replacements can usually be replaced from within a stable team of caregivers.
• If you receive new caregivers on a regular basis then the operation is likely to have poor scheduling or trouble hiring and retaining caregivers.
• Clients with cognitive decline and dementia are priority for continuity because they often do not cope well with change and will decline help from new caregivers.
• Changing your target visit times may require new caregivers on the team. 
• Changing your service type from hourly to overnight to live-in will result in new caregivers who provide the service requested.
• Agencies should have stated Continuity standards to define good and bad continuity.
• See also Home Care Basics: What is Continuity of Care?

Having a caregiver fail to show up for a scheduled visit kills trust in the service and the peace of mind it should bring. More so if the Admin team doesn't advise you of the problem and you have to find out from the person receiving care!

• The Admin team should have a clock-in and out system in order to receive proactive notifications when a clock-alert does not happen so they can take action to contact the caregiver to ensure their safety, the client or family to advise of the delay and find a replacement if needed.
• Frequent caregiver no shows indicate organization and communication problems within the office, likely combined with systems that don’t support the needs.
• CommunityPlus runs on our Lifespan Unified Care platform with built-in clock-alerts. We don't do much performance management for absenteeism because those folks don't usually stay employed long enough to have a review.

If a visit time is changed by an hour will someone call to let you know? Do you receive responsive replies to your communications within a reasonable timeframe?

• Disorganized, absent and unknowledgeable communication is common. Many agencies use remote on-call teams or 3rd party answering services who know nothing about the local rates and services.
• Frequently missed communications indicate a lack of organization, documentation and missing or broken system functionality.
• CommunityPlus aims to respond to all communications between 0800-1800 within 30 minutes. Our clients always reach one of our three Coordinators or the owner, 7 days a week.

Care Providers should have a way to outline the various duties required for each visit and a way to understand what happened during a visit.

• When the care plan is not setup with adequate detail it is likely to cause problems with tasks not completed correctly or at all.
• Does the care plan mention weekly tasks without giving specific days? This causes problems where each caregiver thinks someone else should be doing the task.
• When in doubt, ask for a copy of the profile and care plan information so you can see what the caregivers are seeing.
• CommunityPlus provides caregivers with detailed online care plans, developed with family input. Clients and their representatives receives an online portal with real-time Visit Notes and Schedules.
• Coming in 2026 is our Lifespan Task Management system which we are very excited for. The new task system reduces caregiver time spent documenting while increasing the accuracy of the reporting. Tasks will also identify any reporting that is exceptional or out of the ordinary including for metrics we may gather such as wake/sleep times, intake and output reporting, weight or height. It is a leap forward from our current functionality. For us home care nerds this qualifies as exciting!

Challenges with privacy can be about a breach of client privacy but that is rare. It is more common to see problems with professional boundaries such as a caregiver oversharing information about their private lives.

• Every organization should provide caregivers with policies and expectations for professional boundaries, client privacy and confidentiality.
• Caregiver oversharing can cause anxiety for clients when they share hardships or events in their life that the client feels empathetic about and worries they may carry with them after the visit.
• If privacy or professional boundary problems are happening with several different caregivers then the operation is likely missing clear policies or adequate supervision.
• Agencies who misclassify Caregivers as "Contract" workers are violating their clients privacy by failing to disclose that their confidential information is being given to parties outside of the organization with no access control.
• CommunityPlus created the Lifespan Unified Care platform which has information access control integrated with the portal functionality to ensure caregivers only have access to Client information when they are scheduled with that person. On the Admin side, the data vault ensures that there is no unlogged access to critical confidential information like birthdates, provincial health numbers or K-numbers for veterans.

Medication errors can have serious health consequences and should always be documented and followed up by the Nursing Team.

• Is the provider giving medications without providing Nurse supervision?
• Is the operation properly documenting the medications given?
• Does the operation have a Nursing Team to support best practice medication administration?
• If there are recurring medication errors then there are problems with the documentation and clinical supervision of the operation.
• CommunityPlus' Nursing Team reviews all medication errors, clinical incidents and provides best practice refreshers to Caregivers.