Top 10 Reasons Caregivers Leave Home Care Agencies

Poor communication, challenging work hours and a lack of recognition are among the top reasons caregivers leave their home care agencies, according to the latest insights from research firm Home Care Pulse. Other prominent reasons include difficult commutes, lackluster training and disappointing compensation.

Undoubtedly, there are several explanations and triggers that cause caregivers to quit their jobs, Home Care Pulse Founder and CEO Aaron Marcum said. Fortunately for employers, though, most of those factors are within their control.

“Focus on [reasons] that are in your control,” Marcum said during a recent presentation. “By doing that, you can make a pretty big impact.”


Marcum, who founded Home Care Pulse in 2008 after running his own home care business, discussed the top 10 reasons caregivers leave while presenting during the 2018 Home Care Association of America Annual Leadership Conference in Washington, D.C.

With a median caregiver turnover rate that’s consistently between 40% and 67% on a yearly basis, recruitment and retention of qualified workers is still seen as one of the biggest threats to home care agencies’ operations. While the typical home care agency keeps its caregivers for about 15 months, many only retain their workers for half a year or less, according to Home Care Pulse data.

To help gauge labor trends, Home Care Pulse conducts more than 14,000 caregiver interviews a month. Marcum’s insights into the top 10 reasons caregivers leave were identified after more than 40,000 interviews spread out throughout 2018.


Figuring out why employees leave is critically important, Marcum said, so home care agencies can improve their hiring operations, figure out major flaws and “nip them in the bud early on.”

The top-10 reasons caregivers leave

These are the top-10 reasons caregivers leave, according to insights from research firm Home Care Pulse. Aaron Marcum, CEO and founder of Home Care Pulse, highlighted the list during a presentation in September at the Home Care Association of America Annual Leadership Conference.
  1. Poor communication
  2. Hours and scheduling
  3. Pay and benefits
  4. Little or not training
  5. Lack of recognition
  6. Lack of expectations with first client
  7. Lack of client compatibility
  8. Rude office staff
  9. Lack of openness to ideas or feedback
  10. Commute or travel

Digging into the reasons

Poor communication is the No. 1 reason caregivers leave their home care agencies, Marcum said. Poor communication pops up in different ways, but it generally means a lack of touch points between an agency office and a caregiver out in the field, especially when problems arise.

“You’re not reaching out enough,” Marcum said. “Over time, when you don’t have a formalized communication process in place, [caregivers] get disenfranchised and become detractors.”

In order, issues related to scheduling, compensation, training and recognition follow communication in the top 10 list. Scheduling flexibility and predictability is particularly important to younger caregivers, Marcum said.

Home care agencies that provide five or more hours of orientation training have been shown to have caregiver turnover rates that are about 27% lower than industry peers, past research has found. Similarly, agencies that provide at least eight hours of ongoing training annually have been shown to have lower turnover rates.

Additionally, caregivers are likelier to recommend employment at their agency if they are satisfied with training.

A lack of recognition isn’t at the top of the list of reasons caregivers leave, but it’s one the the most common pain points cited by caregivers during their interviews with Home Care Pulse, Marcum said. Tactics for fostering recognition include monthly trainings to develop or refine skills, as well as the implementation of award programs.

“This is the pain point for caregivers,” Marcum said. “Figure out how you can better recognize your caregivers and help them feel appreciated.”

Lack of clear expectations prior to working with a client for the first time, problems with client compatibility, rude office staff, issues with openness to ideas and challenging travel requirements round out the top 10 reasons.

Controlling the controllable 

With so many different considerations that play into caregivers leaving, retaining staff may seem like an impossible task for home care agencies. But employers can directly address at least seven of the top 10 reasons highlighted by Marcum, meaning hope exists in an otherwise gloomy labor market.

Indeed, communication, training, recognition, client introductions, client compatibility, office attitude and responsiveness to new ideas or feedback are all points agencies can control, Marcum said.

“How open are you to their feedback?” he said. “Are you listening to them? Do they feel listened to or do they feel talked down to?”

A handful of well-known home care agencies have specifically targeted the training aspect of late to boost their business and assist with employee retention. Interim HealthCare, Right at Home and FirstLight Home Care, for example, have all implemented training programs focused on dementia care and brain health.

Caregiver commute and travel demands are largely outside an agency’s ability to control for because they’re tied to where clients are located. Hours and scheduling is also predominately client-driven.

“This is hard because sometimes our clients are on the other side of town from where our caregivers are,” Marcum said. “There’s sometimes a natural commute, a barrier there that we have to navigate.”

Even so, there are some travel-related solutions. Scott and Lauri Topping, owners of a FirstLight franchise in Hawaii, spoke previously with Home Health Care News about how ridesharing services such as Uber or Lyft can alleviate some transportation burdens for caregiving staff.

In terms of compensation, home care agencies should strive to be in the top 25% of the industry’s employers, Marcum said.

“Do your best as far as pay,” he said.

Home Care Pulse analyzes labor trends and insights annually as part of its Home Care Benchmarking Study.

Written by Robert Holly

Companies featured in this article: