What Causes Caregiver Turnover?

Home Care Office Staff Hiring Tips

We’ve surveyed over 5,000 agencies and conducted over 1 million client/caregiver interviews. Based on the data, here’s why your caregivers might be leaving. 

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As current caregiver turnover rates continue to climb, understanding the root cause of the issue is more important than ever.

Every month, we survey thousands of caregivers (and clients) on behalf of their agencies, focusing on questions about the satisfaction of their experience. To find out exactly what causes dissatisfaction and turnover among caregivers, we took a random sample of 500 survey responses from the last six months from caregivers who would not recommend their agency to another caregiver and categorized those responses according to frequency.

While this list is not exhaustive by any means, it should give you a good understanding of why the majority are leaving.

Running a home care agency is a tough job. While this list might come across as harsh, the truth is that many home care agencies value their caregivers and work hard to provide a great experience for them. With that being said, there’s always room for improvement – this list is to help you understand the general causes of turnover and pinpoint the ones that might be affecting your agency.

Here are some of the top reasons caregivers leave and quotes directly from caregivers themselves.

#1: Lack of communication

By far, the number one issue cited among caregivers was lack of communication. Some of these issues may include:

  • Not being able to get a hold of the office when they need something

  • Not getting any response when they leave a voicemail or send a text

  • Not being notified when schedules change

Make sure you’re keeping your caregivers in the loop. They’re the ones working directly with clients and should be a top priority, especially as client information and schedules change. You don’t want to make them fight for your response and attention. Doing so while only make caregivers more frustrated – and in the long run, more likely to leave your agency for one that provides clear transparency.

Caregiver quote: “Improve their communication! If our schedule changes or something comes up we do not always know about it. Even if we ask it is like pulling teeth to get answers.”

#2: Pay is too low

Home care is notorious for its reputation of being a low-wage industry – and not only that, but when caregivers become aware of how much home care agencies are charging their clients, it’s easy to become discouraged when compared to the amount they’re being paid.

We’ve found that the more competitive home care agencies are in wages, the easier it will be to attract and keep the best caregivers. While not every agency is going to have the budget to allow for sweeping changes, one way you could offset this affordably is to offer benefits that don’t cost a lot out of pocket. For more ideas, read “What Benefits Should You Be Offering Your Home Care Agency’s Employees’?

Caregiver quote: “I would like to be compensated fairly. I do this job because I love doing it. The agencies, however, see us as a paycheck for their business.”

#3: Lack of consistent schedule with enough hours

Caregivers have consistently reported that fluctuating schedules remain a top concern.

Not being able to predict what your hours will look like or how many days you’ll be scheduled to work can be unsettling. Caregivers still want to have a work-life balance, and when their schedule changes drastically from week to week, there is no predictability to ensure this.

Scheduling caregiver shifts is not always easy, especially since your clients’ needs are always changing and you have to adapt as they come, but there are still ways that many agencies can improve their scheduling. One of the simplest is to do whatever it takes to keep a great scheduler with your agency, even if it makes paying a little bit more. The money will come back to you through the effects that good scheduling has on morale for both clients and caregivers.

Caregiver quote: “If they hire you for full time, then they need to accommodate that. I left another job because they said they would give me a guaranteed 40 hours, but I haven’t been getting that.”

#4: Lack of support from office staff

As one of the first points of contact – before and during caregiver employment – office staff play an important role in their satisfaction.

Some caregivers have noted that one of the main reasons they left their agency was because of rude office staff, who didn’t give their concerns the time of day they felt they deserved.

It’s difficult to work in a place where you don’t feel you’re a valued team member.

Caregiver quote: “I don’t feel like I have anybody I can rely on to answer my questions if I have any.”

#5: Management is disorganized and operates last minute

We know it’s difficult to be a home care agency owner, especially with an abundance of new priorities that are popping up left and right, but spending a little extra time to get organized can completely shift how a caregiver views your management team.

When a caregiver can tell that management is disorganized from an outside perspective, you know it’s bad. It’s one thing to be internally disorganized (messy desk, myriad of appointments, etc.), but it’s another when you’re repeatedly missing deadlines that directly affect your caregivers – like payroll, scheduling, and other client information.

Caregiver quote: “They’re super disorganized. I transferred offices and went from working 50-hour weeks to working 10-hour weeks because no one knew that I had transferred.”


They attribute it directly to one specific tool. 
Norwood Seniors - Case Study

#6: Inadequate benefits

Benefits can be a great external motivator for caregivers. Incentivizing employees usually helps them to become more involved in day to day operations while being more invested in their work. However, caregivers have shared that they don’t feel they’re getting enough of these benefits through their current agencies.

One of the most important things we’ve heard is that while most caregivers appreciate those larger health and wellness benefits, the small things matter as well, but a lot of agencies don’t take the time to focus on them.

Caregiver quote: “I wish they provided health benefits. I don’t make much, so I can’t really afford insurance without help.”

#7: Lack of PPE or unsafe working conditions

While important even before the COVID-19 pandemic began, safe working conditions with adequate PPE has become a necessity. Caregivers have reported that their agencies aren’t taking the proper precautions, or giving them the ability to do so, compromising the safety of their health.

Although caregivers want to keep themselves safe, they are also considering the safety of their clients.

Caregiver quote: “They could provide us with gloves. They could provide us with masks. You just don’t feel supported as an employee when they’re not helping with these things.”​

#8: Lack of integrity in management (promises not being kept)

There are certain responsibilities that comes with managing caregivers – and one of those is making sure you’re keeping promises front and center. Inconsistency, but also lack of integrity are disheartening.

Your caregivers need to be able to trust that you’ll keep to your word, because when you don’t, they won’t rely on you in the future and may seek a new place of employment that will.

Caregiver quote: “I haven’t been paid in more than a month.”​

#9: Lack of training

Caregivers who aren’t trained properly from the start tend to be less confident in their roles. This even goes for caregivers who have been working in the industry prior to joining your agency.

You never want your caregivers to feel underqualified or unprepared to do their job. Caregiving is not the type of role where you can just “play it by ear.”

Caregiver quote: “I wouldn’t want anyone to go through what I went through when I started. The training was very unorganized and very rushed. We were left on our own. We didn’t get to ask questions. They need to be able to communicate better and be more organized.” ​

#10: Travel time

It’s important to recognize the role that travel plays in caregiver satisfaction. While it may seem like a very small detail, we’ve heard that caregivers don’t enjoy long commutes to and from the place of care.

On top of that, caregivers have also said that they were unhappy with the way their agency handles travel reimbursement – with some not providing any at all. Combined with the lack of pay, caregivers sometimes feel as though they are getting the short end of the straw.

Caregiver quote: “It’s hard to look to see my pay stub and know that I make two dollars an hour because of the distance I have to drive.”

The true cost of caregiver turnover

Based on data from the Center for American Progress, we’ve estimated that the cost to hire and train caregiver replacements is about $2,600. At this rate, caregiver turnover has quickly become a large expense for many home care agencies.

There are a lot of costly factors that play into onboarding a caregiver replacement – some of which might include sourcing new candidates through online job postings, time spent interviewing and screening, training new recruits, and lost productivity while getting the new hire up to speed.

To get a more detailed look at how caregiver turnover is affecting your business financially, check out our free resource – The Cost of Caregiver Turnover Calculator.

What can you do now?

So, where should you get started? We have a few recommendations.

As you are re-evaluating what is and isn’t driving turnover in your agency, you should be doubling down on the lowest hanging fruit first. Your efforts need to be strategic. Here are a few things to keep in mind:

  • Focus on what you can control

  • Prioritize your next steps based on the frequency of the complaint

  • Address one issue at a time

It’s likely not plausible to make drastic changes all at once, so begin by focusing on a few of these key areas that you are missing.

As always, you’ll want to start by creating a solid retention plan focusing on the feedback you’ve received from your caregivers. What do they like? What don’t they like? What happened prior to a caregiver leaving your agency? Here are a few action items to consider as you’re moving forward:

  • Learn the needs of your care team

  • Embrace negative feedback as a means to improve

  • Prioritize and take action

We could talk all day about the best ways to approach caregiver turnover, but ultimately, it comes down to knowing your agency and your caregivers.

Caregiver turnover is a daily fight for home care agency owners. How are you going to take on the challenge?

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