Why Do Caregivers Leave?


Why Do Caregivers Leave?

Caregiver Turnover isn’t only a problem for a home healthcare agency. It’s a problem for patients and their families looking for consistent care.

In the article “40+ Reasons Caregivers Leave and the High Cost of Caregiver Turnover” outlines an impressive number of reasons why a talented caregiver may leave an employer or the industry. They fall into six groups. Company policies, work conditions, job security, personality issues (both supervisors and peers), personal life changes, and discharge.

Here’s a sample of their list and you can read the whole article here: http://rosemarksystem.com/blog/40-reasons-caregivers-leave-and-high-cost-caregiver-turnover

Company policies:

  • No benefits.
  • Vacation time
  • Sick Pay
  • Health insurance
  • Paychecks are wrong.
  • Pay is too low

Work Conditions

  • The client is a hoarder
  • Too far to drive
  • In bad neighborhoods
  • Don’t have clear directives for continuum of care
  • No notes from the previous caregiver

Job security

  • not enough hours
  • not reliable hours

Personality issues

Direct supervisor:

  • Relationship is not good
  • Perceived as a mean person

Relationship with peers

  • not getting along other caregivers
  • they have no opportunity to interact with other caregivers

Personal life changes

  • Moving out of work locality
  • Decided that they just don’t like the work
  • Health issues

Discharged (Fired)

  • No show, no call to a client shift
  • Caught stealing
  • Not following care instructions

Physician’s Choice Private Duty knows these challenges well and our director, Joan Davelis RN, has this to say about how we deal with the challenges of finding and keeping great caregivers.

“We do several things…We try to keep our wages very competitive; we try very hard to treat our caregivers with respect; let them know they are valued; we have several different ways our caregivers can earn extra money if they want; treat each of them as individuals with varying qualities that are necessary to make our company successful.

When you hire an agency, ask them about how they deal with the challenges of turnover because it will affect your care. No agency is perfect and it pays to ask a few more questions to find an agency that fits your family’s needs.

(see full article: http://rosemarksystem.com/blog/40-reasons-caregivers-leave-and-high-cost-caregiver-turnover)




Coping with Changing Caregivers

News to Note

These are some of the best links from our in home assisted living feeds. This month we’re focusing on the most important piece of caregiving – the caregivers. Specifically from the perspective of the patient.



Read this because it addresses changes kids have to deal with in changing caregivers. There is a list of ways to make the change easier including not making a big deal about it, prepping for the new caregiver and letting the child be part of the solution



If you’re hiring caregivers for your parents, this article is interesting because it deals with reasons for caregiver turnover. These include company policies, work conditions, job security, personality issues, personal issues, and scheduling.


The problems with older people developing bonds with caregivers that change. Solutions include using a reputable agency, connecting with caregivers, including family and friends, rotating between caregivers, and getting caregivers support.



Advice for people to ask about caregiver turnover when hiring and getting to the reasons behind turnover. Check staffing levels at different times and ask about how turnover is handled. It sounds like listening to the answers is the best way to tell. If they say no problem, no turnover, it’s not common so beware.

Physician’s Choice Private Duty care solves the problems families face in finding home health care providers they can trust. We focus on strategies that keep seniors in their homes, longer. To learn more about our health care services, visit http://private-duty.pchhc.com


Choosing the Best Caregivers for Your Parents

Choosing the Best Caregivers for Your Parents

A common question from clients is “How can we make sure we get the same caregiver every time? My parents are very particular and dealing with new caregivers is stressful.”

It’s a great question. It reminds me of the story about Helen Keller and her faithful teacher Anne Sullivan. The intimate bond that allowed a deaf and blind girl to overcome her disabilities and go on to graduate from college. It’s inspiring and something all caregivers aspire to, however one of the reasons it’s so inspiring is that it is an extraordinary story. There are countless other success stories that involve teams of people and the consistency of the family, but it’s not easy. Even Anne Sullivan must have wondered if her $25 a month plus room and board was worth it at times.

Turnover is common

Turnover in the caregiver industry is common. There are a few reasons for this. There are company issues like benefits, low pay, and reimbursement. There are work conditions that include hard to handle patients and unclear directives. There are personality issues between management and co-workers and clients. On top of that are personal issues.

Is it any worse than other industries? Statistics say no, these are issues that permeate any service industry, but it’s hard to cite statistics when your parent is struggling with change. Your best bet is to get ahead of the turnover challenge by preparing for it. 

Questions to ask your agency

Start by asking your agency two key questions. If turnover is common in the industry, you want to deal with an agency that acknowledges it.

Question 1: How do you handle turnover amongst your caregivers?

You’re listening for an honest acknowledgement of the issues. If you have the money to invest, you can get a 24/7 care from live in nurses for around $20,000 a month, but if you don’t have that money to spend, make sure the agency you hire knows how to deal with turnover.

Question 2: If the caregiver that my parent loves suddenly quits, what happens?

Their answer here will tell you a lot about how the operation is run. Do they cover 100% of their shifts? Do they have people ready to take over if someone gets sick or can’t work?

Nothing is perfect. Make sure your agency has contingency plans and preventative actions in place to make sure your loved one is cared for.

What to do when turnover happens

And what do you do if turnover happens? Start by getting your parent prepared in case of an emergency. Using a much lower stake example, here’s what psychologists recommend when a child’s caregiver needs to be switched.

  • Acknowledge that it’s happening but don’t make a big deal about it. If you’re happy with the solution, you have a better shot at getting your parent through the change.
  • Prepare for a transition. If your agency doesn’t have a list of the 10 most common questions every new caregiver is going to need answers to (like where is the toilet paper?) then you should have one ready. Welcoming the change makes it go smoother.
  • Prepare for the new caregiver with your parent by involving them in the change. It’s hard to do because they’re your parents, but it pays off with new caregiver acceptance

There will probably be turnover with your caregivers. The more you can do to prepare for it, the easier the transition.


It’s okay to wish for a Helen Keller/Anne Sullivan relationship between your caregivers and your parents. Make sure your caregiver agency is aiming for it, even if it’s a once in a lifetime occurrence. Most agencies will aim for the stars to make sure we hit the moon. For example, to combat turnover, we do several things.

  • We keep our wages very competitive.
  • We try very hard to treat our caregivers with respect and let them know they are valued.
  • In addition we have several different ways our caregivers can earn extra money if they want.

We treat each caregiver as an individual with unique qualities to keep our company successful.

If we can be of assistance as you search for caregivers in Omaha, please give us a call.



Nursing Life Hacks

Here’s a favorite article from http://nurseslabs.com that we love and you’ll find helpful!

Nursing is a tough job and apparently, there are no shortcuts to providing good and quality care. However, this doesn’t mean we can’t make our lives easier while doing our job. Here’s list of nursing life hacks that can show you exactly how.

(we’ll give you the first 6 and if you’re interested, the full list of 30 will appear here: http://nurseslabs.com/30-nursing-life-hacks-probably-didnt-know/)

Go slow when you prime your IV. When you go full blast with the flow, there’s a good chance for tiny air bubbles to form within the tube. To avoid this, you can clamp the tube first, fill the drip chamber and let the fluid flow slowly. See also: 50 IV Therapy Tips and Tricks

Use gauze to prevent hair pulling when using a tourniquet. The friction a tourniquet creates against hair can be painful to patients. To address this, try placing a thin sheet of gauze in between the tourniquet and your patient’s skin.

Prevent pinching. Fold a washcloth and tuck it under the front of the bedside commode seat to prevent pinching.

Use hydrogen peroxide for blood stains. While we technically have no problem seeing blood, having them on our white uniform or your favorite scrub suit is a different story. Instead of wearing blood stains as your battle mark the entire shift, you can apply a few drops of hydrogen peroxide as a stain remover.

Removing blood stains with hydrogen peroxide
You can remove them from patient pillows too. Image via: Pinterest

Didn’t hit the mark? Try double insertion of foley catheters. Missing the mark isn’t only common to new nurses. The truth is, whether you’re a veteran or not, we’ve all had our fair share of the experience. When inserting a foley cath to a female patient and you fail to get a return, leave the first catheter in place and try the same procedure with another Foley catheter, aiming higher this time.

Powder a bedpan. Powder a bedpan before you put a patient on it for easier evacuation; especially useful for obese patients.

Those are the first 6 hints. Pretty great, right? If you’re interested, the full list of 30 appears here: http://nurseslabs.com/30-nursing-life-hacks-probably-didnt-know/

When Less Medicine Means More Health

Less is More

By John Henning Schumann, MD from NPR

Six months ago, an octogenarian patient told me he’d been having light-headedness. For decades, he’d taken a combination pill (two medications in one) to keep his blood pressure below 140/90, numbers proved important in preventing heart attacks, strokes, and kidney failure. Light-headedness is common among older people on blood pressure drugs. “It’s as though I’m going to pass out,” he told me. “My vision fades, and I get wobbly legs.” Fortunately, my patient’s episodes had passed without him actually falling.

He and I agreed that it would make sense to stop his medicine for a month and see what happened – something called a drug holiday. My patient agrees to buy a home blood pressure cuff, use it two or three times a week, and share the results with me. A month went by. His blood pressure, over multiple readings, was fine. And no more light-headedness.

I wrote him back: “Stay off the medication – it’s clear from your readings you no longer need it.” He was thrilled. The decision saved him money and meant he could forget about one of his many daily pills.

Now new research has thrown that decision on to question. A federally funded study was recently stopped early because of evidence that aggressively lowering blood pressure saves lives. The new findings indicate indicate that getting the top (systolic) number to 120 or lower is even better at saving lives than the current standard of 140.

Still, I am satisfied my decision was a good one. I helped my patient avoid a drug-related problem like a fall and maybe a hip fracture – one of the banes of our aging population. What’s more, he and I pushed back against medical inertia the tendency to keep things the way they are because it’s easier than making a change.

My patient’s experience and stories like his have led me to believe that there comes a point in aging when our physiology changes. No doubt there are many factors, such as our senior brains, stiffening blood vessels, and changes in the ratios of our hormones. Sometimes age brings more illness, but in other cases, problems seem to diminish.

Too often, we overlook the option of de-prescribing, or discontinuing medications in older people who take a lot of them. A recent review of more than two dozen studies in which patients discontinued medications (including sedatives like Valium as well as blood pressure drugs) found that people did surprisingly well when they stopped taking them. Adverse symptoms abated, and their health generally improved.

As a doctor looking first to do no harm, I draw the following conclusion: Though I am ready to believe the better low blood pressure outcomes promised by the latest research, I’m also going to look for opportunities to minimize the overuse of drugs in older patients. For many of us, less medicine means more health.

If you have questions or concerns about your medications, contact us today. 402-991-7399

Armbrust Family Testimonial

Armbrust Family Testimonial

Armbrust Family Testimonial

Dear  Staff,

We would like to thank all of you for the loving care shown toward Willis.

Your assistance, thoughtfulness and kindness helped us through this difficult time.

God Bless,

Amy and Armbrust Family

John and Anne Hall Testimonial

John and Anne Hall Testimonial


John and I are so grateful for the extended time and effort you have provided over the past few months. Your insights and strategies were invaluable. This is a journey and your guidance has made it less stressful and manageable. We particularly appreciated your focus on Kay – as a person, not just as a “patient”.

Thank you for doing so much and for doing it so well,

With gratitude,

John and Anne Hall

Wendy Testimonial

Wendy Testimonial

Wendy Testimonial

Dear Encompass “Angels”,

Thank you so much for your efficient and timely help this year!

Blessings Wendi

Monroe Testimonial

Monroe Testimonial

Monroe Testimonial

Please accept my family’s sincere thanks for the care assistance that you and your Encompass Colleagues provided during our Dad’s home hospice care. You, Delra, Brenda, Barbara and Connie, were of immeasurable help to Dad, Melissa and me during a very difficult time.

We appreciated the excelled way that you coordinated with Hospice of Southwest Iowa to make things go as smoothly as possible.

Thank you again for your very caring assistance during a time of great need.


The Family of Norman Monroe

Questions to Ask A Home Health Care Agency Before Hiring Them

Questions To Ask A Home Health Care Agency Before Hiring Them:

Have you ever had the experience of buying a product or service only to realize later that there were questions you wish you knew to ask up front? One of the advantages I have is that I’ve been through this process multiple times over the years and I’ve put together a list of questions you can use to have a shot at eliminating “buyers remorse.”

Who do you send for the initial in-home assessment?

Is it a skilled nurse? Is there a social worker?

Is this a free service? Will you be trying to sell me your services or simply recommending what I need?

How do you make sure your caregivers are nice, trustworthy and that I’ll be safe?

Do you screen your caregivers?

Does your agency conduct statewide police checks?

Is your agency bonded?

How much experience does your average caregiver have?

Does your agency hire experienced caregivers?

What sorts of tests do your employees have to take?

Do you have health and skills testing?

Did they mention Caregiver Code of Conduct™?

What happens if your caregiver doesn’t show up to my home?

Do you have a system for handling caregivers who don’t show up?

Who supervises your caregivers and how do you know they are doing their job?

Are the caregivers supervised?

How do you keep the family informed about what goes on during the day?

Does your agency have a policy for keeping the lines of communication open?

How do your hours and overtime work?

Will your agency accommodate the hours I need?

Does your agency take responsibility for overtime hours that I did not schedule?

What type of services do you provide?

What if I need skilled nursing or therapy?

When are your caregivers available?

Do you have around the clock availability?

Who handles unemployment, Workers Comp and other taxes?

Are you the employer?

All the above questions are very important to have answered before moving forward with a home health care agency.

Feel free to contact me and learn some of the stories behind these questions. My office number is 402-991-7399.