A caregiver’s match with their client can determine whether a home care relationship becomes a stable, long-term arrangement or a source of stress, disruption and potential safety concerns.

As providers contend with high caregiver turnover and labor shortages, effective matching can strengthen employee satisfaction and retention, while a mismatch can have the opposite effect by undermining care continuity.

Home care companies are increasingly using technology to analyze data, including caregiver skill, availability and geography, to make better initial assignments. But providers told Home Health Care News that matching is not a one-time decision: It requires continuous feedback and may occasionally require adjustments.

“For a company like TheKey, where we’re about long-term,” Shadi Gholizadeh, chief quality and innovation officer at TheKey, told HHCN, “We’re looking for these clients who really want to stay with us, age with us. Making sure that it is a strong match works out well for the client [and] also for the caregiver because that’s that steady, stable position they also want.”

Based in Delray, Florida, TheKey provides home care, memory care and other specialized services across 100 locations in the United States, Canada and Australia.

Ensuring a positive caregiver match requires the best possible alignment of experience, personalities, locations and care fit based on the available caregivers, the home care leaders said.

The caregiver’s clinical expertise is perhaps the most important aspect of the match, Michael Slupecki, CEO of Griswold Home Care, told HHCN. This is especially true if a client has neurodegenerative diseases like dementia or another need requiring specialized competence.

“You have to ensure you have the skill-based matching, whether it’s the right certifications, the right experience, the right training for the disease condition,” Slupecki said. “Skill-based matching is really critical.”

Blue Bell, Pennsylvania-based Griswold provides personal home care and specialized care across 32 states and around 200 locations.

External factors also influence whether a caregiver and client match is a good fit. The caregiver’s access to transportation determines their availability, care reliability and how many clients they can serve near them, Slupecki noted.

“Caregivers don’t want to drive an hour to the client,” Slupecki said. “You also have to consider the geographic optimization.”

An optimal care match can not only ensure clients needs are met but can also enrich client-caregiver relationships, John Sneath, CEO of Tribute Home Care, told HHCN.

“The relationship is the most important thing to make home care work,” said Sneath. “This is a loving back-and-forth relationship, [and] obviously that’s harder to do if the team is unstable.”

Framingham, Massachusetts-based Tribute Home Care provides home care, personalized assistance and other services across four states.

Potential for friction

While in the best cases, client-caregiver matches can ensure both client and caregiver retention and satisfaction, unfit matches can cause client uneasiness, Sneath said.

Poor matches can also negatively impact workforce stability.

“If we don’t do the match [well], it does prompt caregiver stress and burnout, reduced job satisfaction and instability,” said Gholizadeh. “You might have caregivers who actually would have been wonderful long-term caregivers had they been matched appropriately with clients.”

Caregiver matches — and mismatches — are shaped by the reality of a persistent caregiver shortage. A 2021 report from Global Coalition on Aging and Home Instead Senior Care found turnover for home care workers ranges between 40% to 60%. Additionally, there will be a national shortage of 151,000 caregivers by 2030, growing to 355,000 by 2040.

Staffing shortages raise the stakes for the caregiver matching process.

“The caregiver shortage definitely makes matching harder, but it’s also what makes matching so much more important and getting it right, because this affects whether older adults can remain safely at home,” Gholizadeh said.

When a match fails and a replacement caregiver is assigned, the rematch process can disrupt a client’s care.

Clients often prefer care routines to be performed consistently, Sneath noted. A team of reliable caregivers will come to understand that routine, while a newly assigned caregiver must learn regimens afresh.

At times, home care providers may assign a caregiver knowing they will not be a long term fit so a client can receive care in a timely manner. While rematches are occasionally necessary, they should be minimized as much as possible, Sneath said.

“The match quality is very, very important,” he added. “People want the smallest possible team, and they want a team that’s consistent.”

Improving the match

TheKey maintains a proprietary matching approach called TheKey Match that pairs caregivers based on more than the client’s diagnosis, Gholizadeh explained. It aims to help improve safety and satisfaction.

For instance, a caregiver could be “exquisitely skilled” in dementia care, but if they cannot physically meet a client’s needs, such as due to back trouble, attempting to assist that client could lead to unsafe conditions. Or, if a client is hard of hearing and the caregiver has a soft voice, requests to speak up could cause the caregiver to feel frustrated.

“They’re just very practical matching issues that are important, and that can certainly support staffers,” Gholizadeh said.

Quality matching depends on precise caregiver and client information. Accuracy is essential both at the time of intake and through continual feedback, such as whether a caregiver was on time, Gholizadeh said. Matching therefore becomes a constantly refined process as opposed to a one-time event.

AI can also help identify the hard-to-quantify soft skills influencing effective matches, Sneath said.

“One of the things that AI is allowing us to do is to really mine all of the data we have now on our caregivers — from all conversations, from their experience, to help in making that kind of match as good as possible,” Sneath added.

Technology can help automate certain tasks in the caregiver matching process, but it cannot replace the human touch required for making meaningful care relationships fit, Slupecki noted.

“The hardest one to solve would be the personality match simply because we’re not going to be doing profiles on every caregiver and client that we run into,” Slupacki said. “That piece is going to be harder to systematize, and there’s going to still be that personal judgment.”

While the matching process is an inexact science, continually refining caregiver matches ultimately serves the older adults who need that care.

“A lot of people are looking at [caregiver matching] like an algorithm, or if we just get this one personality characteristic and this one geographic proximity right, we solve it, we’re done,” Gholizadeh said. “I think that’s a little short-sighted, especially when we’re living in a real caregiver shortage. It’s not just a home care issue. It’s not just a staffing issue. This is a public health issue.”