Ending Services

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You may find it useful to agree on the amount of termination notice to give a worker at the time of hiring. You may also want to state how much warning time you will give an employee if you are not pleased with his or her performance. It may also be helpful to ask the worker to give you notice one or two weeks before he or she plans to leave. There are several reasons for a home care situation to end. Here are some of the most common: 

Person Receiving Care has Recovered
Use the Assessment of Needs checklist listed previously to evaluate when to end home care services. You may find that the person using home care services has recovered from illness or surgery and can now be independent. A word of caution: Improved nutrition and having someone around may result in changes that will tempt you to decide that extra care is no longer required when it still is. Resist making a hasty decision to terminate home care services. Recall the situation before the home care worker started. The presence of the worker may facilitate a less stressful, more enjoyable relationship for you, reducing the amount of time you need to spend performing tasks. You can spend this time on enjoyable activities with your relative. Remember your loved one needs you, too, not only the care person you provide.
Job Performance is Unsatisfactory
In spite of your best efforts to explain, teach, and support your home care worker, his or her work performance still may not be satisfactory. Discuss the desired changes in behavior, and set a time period for improvement. Let the worker know that failure to meet these expectations will result in termination. If you are afraid to correct your worker because you do not want to offend him or her, you risk maintaining an unsatisfactory situation. Feeling sorry for an employee who is having personal problems is usually not a good reason to retain someone who is not performing satisfactory work. Flagrant violation of stated rules is a reason for firing without notice; this should be communicated during orientation.
Nursing Home Care is Required
Another reason to end home care services may be the need for residential nursing care. The person may need more physical care than can be comfortably given in the home. You may find that the stress has escalated to a level that is damaging to all concerned, especially to the person receiving the care and his or her family. Some of the behaviors that become most difficult to cope with are: repetitive questions, following the caregiver around the house, sleep disturbances, agitated behavior, being combative, or any combination of the above. Incontinence, difficulties with bathing and dressing, and other physical problems also can be overwhelming for the caregiver.
Financial Concerns
The amount of personal care and medical attention may make it financially impractical to continue to try to maintain the person at home. There may come a point in time when the home care becomes more expensive than a nursing home. In such cases, residential nursing care often becomes the best choice. At this point, many people experience feelings of guilt. Family caregivers should remember that they have done all they can and that the older person’s interests, safety and well-being may be better served through the multiple services and care available in a residential care facility.

Assessment of Needs Checklist


The following sections may assist you in finding help for your loved ones: