Patients and families deserve honest information about what home care agencies can and can’t do so they can develop realistic expectations and workable plans. After all, problems we can deal with…what we hate are surprises. The most popular programs paying for home healthcare today have limited budgets that must be divided among a growing number of patients. So the primary goal is often to provide just enough care to keep the patient safe at home and out of the hospital or nursing home. That means family or friends, the family care group, should expect to be regularly involved in the hands on care of the patient.
There should be a back up plan for the inevitable event when the caregiver from the licensed agency can’t make it. The people employed in home healthcare are no different than employees of any business and they are going to have days when they don’t make it to work. The current shortage of staff makes it more difficult for agencies to replace caregivers on short notice so it’s important to be prepared. Or what happens, for example, if the payer source lowers the amount or level of care they will fund for a patient? Is the family care group prepared to deal with that?
Home healthcare agencies try to do their best to accommodate the scheduling wishes and the caregiver choices of the patient and family. But, there is a fine line between flexibility and chaos. Things work best with a routine schedule and consistent staff. As a rule the hardest shift to fill is a short one. Care will be more reliable and consistent when scheduled two, or preferably more, hours at a time especially if the home address is out of the way or hard to get to. Frequent requests for different staff or refusing to accept available staff also makes care less reliable and consistent…and more expensive. You can’t make sound decisions without honest information.