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pennsygirl973, I agree with Vegaslady above, fire the Agency and look around for a new one. There are times when an Agency gets short-handed, even the best of Agencies. Check the wording on the contract regarding missed assignments.

If the patient needs around the clock care, or eventually will need such care, the family might start thinking about Independent Living senior facility, if it is within the budget. I was so glad when my Dad moved to such a place, as he had mobility problems.
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It depends on the situation. If caregivers are coming for a few hours a day there would be an expectation that whoever is with them the rest of the time would not leave until they arrive, so the person who lives with them would be the one who neglects to ensure they have a caregiver.
If they have a full time live in caregiver who is not doing their job and is leaving someone unattended then the agency would only be responsible if they were made aware and did nothing about it. Even a live in caregiver gets to have time off, so everyone needs to understand who is covering those shifts when they are absent.
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Fire the agency.
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This lady apparently contracted with and pays an agency. So it is her call whether to stay with this agency in spite of the inconveniences of no-shows, or search for other help. Is she generally satisfied with the care she gets? Are the workers pleasant? Are there some that know her routine well? How often do the no-shows happen? Once a month? Once a week?

This MIGHT be breech of contract, but I doubt it is neglect.

No-shows must be the biggest challenge in the home care world. My cousin had 4 local women (all known to her mother) take shifts around the clock so her mother could stay home. These friendly women tried to cover for each other, but sometimes that wasn't possible. (All 4 of them were going to an out of town wedding, for example.) My cousin said that covering these gaps was her worst nightmare, especially since she traveled a lot. Mother got worse, and cousin placed her in the local care center. That solved that particular problem, at least.
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If anybody has any inside-knowledge about running a home care agency, I'd be interested to hear their perspective on this issue.

I don't imagine that agencies have people sitting around on their payroll just waiting for a no-show call. They probably rely on former employees, employees who are temporarily off while waiting for another assignment, and other people who may or may not be available on short notice. "Gladys, can you cover on the West Side today?" It is to the agency's advantage to find some one. No show, no pay. So they probably check down the list before giving up.

This, of course, assumes they know there is a no-show. The employee should be notifying them. In this case the lady calls them and gets no response. That is troubling. Is it possible she isn't dialing correctly? Doesn't have the right number? Has trouble hearing and misses some phone calls?
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The national Agency I had used for my Dad, if a caregiver couldn't make the shift, the Agency was very good at finding a replacement. The caregivers have an iPhone where the Agency would send out a request. First call back would get the assignment. If it was an evening shift, even the Admin Staff would fill in.

The Agency also had caregivers who just wanted to do emergency placements. My Dad had one who decided to put herself on regular Saturday morning shift just for him. Luckily my Dad was easy going, no trouble at all. If this was for my Mom, it would have been a nightmare.
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She has a agency that she pays for. Her scheduled hours are 8am to 7 pm. But so many times she's left alone due to no shows . She calls EMERGENCY NUMBER and never gets called back. She lives alone, just a dog.
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Well if she lives alone then putting up with no shows is maddening, but it isn't neglect. Neglect would only apply to a vulnerable person who could not be left unattended.
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jeannegibbs, yes she dials the correct phone number, I myself have called the "emergency line" with no result. she has her mind, just her body gave out. and the call outs or no shows happen a lot. she has NO family, just a few chosen friends from church. she is bedridden, while she is getting therapy and working on regaining her legs. so its quite horrible when no one shows and she sits in bed soiled and hungry, lacking her meds etc.. its just her and her little dog. I myself see this as neglect. but I guess im wrong according to the responses. and yes, I have told her to switch agencys, but she is very attached to one care taker she has and doesn't want to lose her...
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If the one caregiver she likes shows up consistently I see no reason she can't fill the other shifts from a different agency.
The real difficulty that I see here is that despite having her mind and the ability to call 911 if she needs help she really is in a vulnerable position and in my opinion needs to make some hard choices about her ability to live on her own.
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