Businesses never want to admit there is an area of significant improvement when it comes to their industry.  All too often people want to act as if nothing goes wrong; there are never service failures and 100% of customer who uses us are always ecstatic with every aspect of the experience with them.

The fact is business can be hard.  It takes it’s toll as it’s tough always to be great.  You strive for being perfect, but mistakes happen.

This is why I wanted to talk about what some of the Achilles heels of private home care are.

No one industry is perfect, we all do something better than others.  So that’s why I want to manage expectation and educate you on what the Achilles heels of private home care are.


Lows Hours

This is always the most significant issue that comes with home care.  It a prime example of an Achilles heel!

Low hour cases are tricky because you have three people involved with different points of view.


The Client

The client is understandably expecting good things when paying for private home care.  Even though it isn’t 12 hours per day of care, we are respectful of the fact that they are still paying out of pocket for care.  It is always expensive, it just how expensive it gets.

So the client is expecting the same caregiver to show up, continuity of care, and that they can make their hours (meaning they pick from 8am-10am every day).

Now there are clients out there that understand the difficulty of the situation with low hours, but there are some that do not.



This is the biggest issue, that dictates the office staff’s concerns.  Most caregivers are looking for 8+ hour shifts.  Anything less than six-hour blocks of time starts to become difficult to fill.

So when you call up the caregivers and offer them a job that is three hours, they decline it as they will wait for us (or another agency) to call with a more extended hour case.

They are working to put food on the table and money in the bank, so it is understandable why they do this.  They are worried about taking a short hour shift job; they will lose out on a more extended hour shift opportunity.


Office Staff/Business Owner

All private home care companies want as many hours as they can get.  I try to fill every case regardless of how big or small it is.

Private home care is a word of mount industry and the more people who have had a positive experience with us, the better and more likely we get more business from the community.

Not all owners see it that way.  They look at short hours as more trouble than it is worth.

They see that their office staff is going to spend 2x – 3x the amount of time to beg caregivers (and I mean beg) to take these low hour cases.  So the ROI isn’t there as they are losing productivity with their office staff for a short hour shift when their team could be working on other tasks.

So going back to caregivers declining jobs, if you do get a caregiver to accept the case, it probably won’t be for long.  As they say, it’s only for a short period or them, will call us one day saying they have received a shift from another agency that has offered more hours.


Wrapping Up Low Hours

So now the client is unhappy that the caregiver they loved is leaving, but they try the next one the agency offers.  The new caregiver can only show up at a specific time that is later than what the client would prefer, but since the office doesn’t have as many caregivers to choose from the client accepts the new time.

Then one week later, the caregiver quits as another agency has offered her a new job.

The cycle then continues until the client is fed up and discontinues services as they keep getting a new caregiver every week or two.

This is why so many agencies have minimum hours because the amount of time and effort that is put into filling the case isn’t worth the money, let alone a customer who is unhappy with the services they received.

It’s an unwelcomed position to be in and is why its an Achilles heel for home care.


Split Shift Hours

Split shift hours are very tough as well.  Split shifts are very similar to low hour cases, but the problem becomes the client’s expectations are even higher.

A split shift case is when a client is looking for a total of six hours a day of care, but three hours in the morning and three in the afternoon.

They are paying for the six hours, which usually would be enticing for a caregiver, but once they find out it is a split shift, caregivers treat it as a low hour case.

This is because (most of the time) caregivers who are working the morning are not available at night and vise-versa.

So the client is looking for continuity of care – expecting the same caregiver each shift, but it is unlikely to happen.

So you go back to what we described before where caregiver A takes the morning shifts and caregiver B takes the evening shifts, and after a week or two, they leave the job.

And the client’s frustration (understandably) starts to increase over time.



Let me make this clear.  We do supervise our staff

I, the owner, drop in on caregivers.

My office manager does.

And my nurse’s primary job description is to do so.

What I mean about supervision being an Achilles heel of private home care is this;

If you have a plywood wholesale company everyone is under one roof.

The forklift driver, the mechanics, truck drivers, salesman, middle and upper management are all there.  All can be checked on in 30 seconds.

With private home care, it just doesn’t work that way.  You can’t be everywhere at all times.

While you have decided nurses or liaisons there to drop in, provide supervisory visits, you can’t hire someone to be everywhere at all times.  Think about it, on a 24/7 case; you have 14 different shifts each week (2×12).  If you have 4 of those going on at one time that is a lot of shifts.

So we talk with the clients, the adult children, the facilities and our caregivers to try and be in the loop on what is going on.  We have care plans with logs in them so we can see what is going on in the home while we are not there.

Of course, there are the unannounced drop-ins, which work great as caregivers have no idea when someone is stopping by, but for this article, we don’t have the type of supervision that an office or warehouse has, which is why I consider it an Achilles heel.


Wrapping It Up

So there you have it folk, the 3 Achilles heels of private home care.  Are there some more?  I’m sure there are, but it’s a start.

Is there some that I have not thought of or mentioned?  Reach on out and let us know your thoughts!