When your parent's regular carer changes

The doorbell goes at the usual time, but the face on the step is a new one. By the end of the visit your mum has walked the new carer through how she takes her tea and which mug is hers. The carer she knew has moved on, or is away for a while. This is information, not medical advice. It does not say how a change will land with your parent, and it gives no view on why any carer leaves; neither is for this page to say. What follows is ways to help your parent through the change, and questions the two of you can put to the provider.

Name what the change is like for your parent

Ask your parent what the change is like for them, in their own words, and start from their answer rather than your guess.

NICE guidance in England asks home care providers to make continuity of care a priority; for your parent, that would mean the same carers coming back, and the chance to get to know them. NICE's guidance on adult social care in England also says the same people should support the person where possible. What good care at home can look like looks at continuity more widely.

Ask how you and your parent will hear about a change

NICE's quality standard on home care for older people in England says older people using home care, and their family members or unpaid carers, are told in advance if new staff will be visiting, so ask your parent which of you, if any, they want that notice to reach. If your parent passes on a new carer's name, or the provider rings with it, the family is missing nothing.

With your parent, ask the provider how that notice comes and who it goes to.

Pass on how your parent likes things done, in their words

Two things you and your parent can ask for at a handover come from NICE's adult social care guidance for England: that a new carer, like anyone supporting a person, knows how the person likes their support to be given, and that cover for the usual staff comes with good handover arrangements.

Let your parent lead on what gets passed on: the order of the morning, the tea, the jobs they would rather do themselves. If they would like help putting it into words for the provider, offer it, and keep the wording theirs.

Ask about introductions for a new carer

The Care Quality Commission in England says that at a good home-care agency, a person is introduced to any staff who are going to provide their care. You and your parent can ask whether a new carer will be introduced before they start, even when the arrangement has been running for some time.

The Family Caregiver Alliance in the US lists, among the usual features of hiring through an agency, that the agency can send a substitute when a worker is sick or on holiday. The same fact sheet notes that when an agency sends more than one attendant, each new person has to be shown how the home works. With your parent, ask the provider who comes when the regular carer is away, and how a stand-in learns your parent's way of doing things.

Give a new arrangement a little time

The Family Caregiver Alliance in the US notes that an agency will typically try to match an attendant to the person's needs and requests. It suggests considering giving a new attendant a little time before deciding the match is wrong. Whether a match is working is your parent's to judge.

These sources speak for England and the US, and how providers handle a change of carer differs by where your parent lives. For the day-to-day side of having a carer in the house, there is Bringing a carer into your parent's home.

Take questions about your parent's health to their doctor or care team

Questions about your parent's health are worth bringing to their doctor or care team, and if your parent would like, one of you can help them get those questions ready.