Photo By: Age Cymru
More than 700 caregiving jobs disappeared in California this September, putting another spotlight on a problem that reaches beyond employment numbers: what happens to continuity of care when the workforce providing it suddenly changes?
El Segundo-based 24 Hour Home Care disclosed plans to lay off 738 employees effective September 15. The company attributed the cuts to Health Net’s decision to discontinue Personal Care and Homemaker Services as an optional Community Support under its Medi-Cal managed care plans.
The company has said it is working with Health Net, California’s Department of Health Care Services, and other stakeholders to mitigate the effects and support continuity of care.
That effort points to a larger challenge facing home care. When workforce conditions change, maintaining coverage is only part of the equation. For older adults and others who depend on assistance at home, replacing a worker does not necessarily replace the relationship that existed with that worker.
Coverage and Continuity Aren’t the Same Thing
Home care happens in one of the most personal environments possible: someone’s home.
Over time, a regular caregiver may become familiar with how a person moves through the house, what they like to eat, how they prefer their morning routine, when they typically become tired, and which activities they can still manage independently.
That knowledge can be difficult to reproduce through a staffing schedule alone.
Continuity therefore involves more than ensuring that someone arrives for a shift. It also involves preserving knowledge, communication, familiarity, and trust when the person providing that care changes.
For Jim Prussak, CEO of New Jersey-based Applause Home Care, that distinction is central to what his company calls Care Partnering. Rather than treating care as something performed for an older adult, the model encourages the individual to participate in and direct their own care as much as possible.
That approach becomes particularly relevant during a staffing transition. A new caregiver may be entering the home, but the older adult should not have to surrender control over how their daily life works.
Workforce Changes Travel Downstream
The California layoffs illustrate how events far outside an individual’s home can eventually affect the systems responsible for providing care.
In this case, the cuts followed a change involving an optional Medi-Cal Community Support. In other circumstances, home care organizations may encounter reimbursement pressures, contract changes, recruitment difficulties, scheduling problems, or caregiver turnover.
Those workforce issues are often discussed as operational challenges. But their effects do not necessarily remain inside an agency.
For a family relying on home care, instability can mean adapting to different schedules or rebuilding relationships with new people. It can also require transferring important knowledge about the person receiving care.
That makes workforce resilience part of the conversation about care quality.
A New Caregiver Shouldn’t Mean Starting Over
Staffing changes cannot always be avoided. Caregivers move, change jobs, experience their own family obligations, or become unavailable. The more useful question is what happens next.
A strong transition should preserve as much knowledge as possible.
That includes an older adult’s daily routines, mobility needs, food preferences, communication style, interests, safety concerns, and the activities they want to continue doing independently.
Families should also know what the backup plan looks like before they need it.
Who will provide care if the regular caregiver becomes unavailable? How will a replacement learn the client’s routines? Who communicates changes to relatives? How quickly can reliable backup support be arranged?
These questions can reveal an important difference between simply filling a shift and maintaining continuity.
Stability Starts With the People Providing Care
Protecting continuity also means looking upstream at the caregiver experience.
Reliable home care depends on organizations being able to recruit qualified workers, prepare them for their responsibilities, communicate effectively with them, and create working conditions that make staying possible.
Compensation matters, but so can predictable scheduling, adequate training, respectful management, communication, and opportunities for caregivers to feel connected to the people and organization they work with.
Applause Home Care’s model places particular emphasis on the relationship between the caregiver, whom the company calls a Care Partner, and the person receiving support. The company describes care as a two-way exchange rather than a purely transactional service.
That philosophy offers a useful lesson during periods of workforce volatility: stability is not only about keeping a position staffed. It is about protecting the human relationships on which personalized care depends.
Older Adults Need a Voice During Change
There is another risk when staffing problems become urgent: solving the schedule can become more important than consulting the person whose life is being scheduled.
Care transitions should preserve the older adult’s agency whenever possible.
That could mean involving them in meeting a replacement caregiver, identifying routines they particularly value, explaining which activities they want help with, and clarifying which things they prefer to continue doing themselves.
For families choosing a home care provider, that also suggests a question worth asking before care ever begins:
What happens if my loved one’s regular caregiver is suddenly unavailable?
No provider can guarantee that the same caregiver will always be there. But agencies can build systems designed to make inevitable changes less disruptive.
The 738 California layoffs demonstrate how quickly the workforce behind home-based care can change. They do not tell us what happened to every individual receiving services, and workforce disruption does not automatically mean care disappears.
They do, however, raise a broader question the industry cannot afford to overlook.
For someone relying on assistance to continue living at home, reliable care is not simply about filling tomorrow’s shift. It is about preserving enough familiarity, communication, and personal control that when change comes, the person receiving care does not have to start over.
