AUTHOR=Bischofberger Iren , Vetter Mary Jo 

TITLE=Family Caregivers Employed by Home Care Agencies: Lessons Learned From Switzerland and the United States

JOURNAL=Public Health Reviews

VOLUME=Volume 44 - 2023

YEAR=2023

URL=https://www.ssph-journal.org/journals/public-health-reviews/articles/10.3389/phrs.2023.1605849

DOI=10.3389/phrs.2023.1605849

ISSN=2107-6952

ABSTRACT=Background
Increasing demands for home care staff has been triggered in the past decades by shorter hospital length of stay, and a shift of responsibility for complex care regimens to private households. Therefore, an innovative model to employ family caregivers in home care agencies is expanding in Switzerland and the USA. This policy brief aims to identify core characteristics of the model and analyze its potential benefits and challenges.

Evidence
The model is expanding on state level without the requisite scientific evidence. Yet, it is based on legal ground for licensed home care agencies. After an initial patient assessment by a registered nurse, and assigned tasks to family caregivers, the salary is derived from payer reimbursement.

Policy options and recommendations
Standards need to be in place to determine the family caregivers qualification that are specific to the client situation of all age groups. Supervision of quality of care, labor law, and blurred roles of biographical relationships remains at the responsibility of home care agency leadership and nursing staff. 

Conclusions
Further research for the data-driven exploration of the model is needed to inform and guide health policy stakeholders. It guarantees the wellbeing of employed family caregivers and home care clients.