The first week of home care: what to expect and how to prepare

What happens in the first week of home care?

In the first week, a new caregiver learns your parent's home and routine, your parent gets used to having someone there, and the agency checks that the care plan fits real life.

Most first weeks follow the same shape: a consultation and care plan before anything starts, an introduction, a first visit focused on getting to know each other and the most important tasks, a few visits while the routine settles, and a check-in with your family to adjust what is not working.

Nothing about week one is set in stone. Think of it as a trial run for everyone.

What should be in place before the first visit?

A few things should be settled before the caregiver arrives.

• The care plan. At It's Your Home Care, this comes from an in-home consultation, usually within one to two business days of your call in the Harrisburg area and a little longer in outer counties. We walk through the house with you and your parent and write down which tasks the caregiver will do, when, and how your parent likes them done.
• The information packet. Pennsylvania's home care rules require a licensed agency to give your family a written packet before care begins. It lists the services, the caregiver, the hours, the charges, who to call at the Department of Health, the complaint hotline, the local ombudsman's number, how caregivers are hired and trained, and whether the caregiver is an employee. Read it and keep it. Our guide to your rights with a home care agency explains each item.
• The schedule. Days, start and end times, and who to call if the caregiver is running late.
• The match and introduction. We match caregivers on needs, personality, language and location, and introduce the caregiver before the first shift when schedules allow.

How can you get the house ready?

The goal is for a new person to find what they need without asking your parent twenty questions. A quick checklist:

• Getting in. Decide who opens the door, or where a key or lockbox is. Your parent may not hear the bell or may hesitate to let in someone new.
• Parking. Driveway, street or lot, and any permit rules. Row-home blocks in Harrisburg, Lancaster, York and Reading can be tight.
• Bathing supplies in one place: towels, soap, shampoo, lotion and clean clothes. Bathing goes faster and feels less awkward when nothing has to be hunted for.
• Basic safety: night lights, a clear path to the bathroom, and rugs secured or removed. Our home safety checklist has more ideas.
• Groceries for the meals you want made, or a plan for who shops.
• Cleaning supplies and laundry detergent, and where they live.
• Valuables, cash and spare checks put away, and medications not in daily use stored securely. This avoids confusion for everyone, including the caregiver.
• Pets. Let us know how the dog or cat does with strangers, and whether they need to be in another room.

What should you write down for the caregiver?

Write down the things you know that a new person cannot guess. One or two pages on the refrigerator is plenty:

• Daily routine: wake time, breakfast, favorite TV shows, nap, when they like to bathe, bedtime.
• Food: likes, dislikes, allergies, any diet from the doctor, and how they take their coffee.
• Medications: a current list with times, and where the pill organizer is. Caregivers give medication reminders and small help like opening a container; they do not give medications.
• Getting around: cane or walker, which side to stand on, how they get out of bed and off the toilet.
• Communication: hearing or vision limits, the name they like to be called, favorite topics, and topics to avoid.
• If there is memory loss: what calms them, what upsets them, what to say when they ask for someone who has passed away, and whether they try to leave the house.
• Contacts: family phone numbers in order, the doctor, the pharmacy, and any home health or hospice nurse.
• House rules: phone use, the thermostat, the TV, and any rooms that are private.

How do you explain it to a parent who is unsure?

Talk about what the caregiver will do and what your parent gets to keep. "Someone is coming Tuesday and Thursday mornings to help with the shower and get lunch started, so you don't have to wait for me" usually goes over better than "You need a caregiver now."

Some families describe the first visits as help for the house, or as help for a tired spouse. Let your parent make choices where they can: which days, what time, what to have for lunch. If you expect pushback, our page on what to do when a parent refuses help has more ideas.

What happens on the first day?

The first visit is mostly introductions, getting to know the house, and the most important tasks. A good first day often looks like this:

1. Introductions with your parent, and with you if you can be there for the start.
2. A walk-through: where things are, how the stove and shower work, how to get in, where emergency numbers are posted.
3. Going over the care plan and your notes together, and checking anything that has changed.
4. The essential tasks, at your parent's pace. If bathing is on the plan and your parent is not ready, the caregiver can set things out and try next time.
5. Time together: conversation, a walk, a meal. This is where trust begins.
6. A short note before leaving about what was done and anything noticed.

If you can, stay nearby for the first hour, then step out. Your parent and the caregiver need room to find their own rhythm without you translating.

What are the next few days usually like?

The routine settles and the awkwardness fades, though not always evenly. Some parents warm up by the second visit; others are polite but guarded for a couple of weeks. Common first-week patterns:

• Testing: "I already showered," or "I don't need lunch." Caregivers are trained to offer, encourage and respect choices, and to let the office know when an important task keeps being turned down.
• Small mismatches: the eggs are cooked the wrong way, the TV is too loud, the towels are folded wrong. These are easy to fix once someone says so.
• Tiredness: new people and new routines are tiring. A quiet afternoon after a visit is normal.
• Relief: often for the family first. Use the time for yourself.

Try not to add new tasks every day this week. Let the core routine become familiar, then build on it.

How will you know how it is going?

You will hear from three places: your parent, the caregiver's notes, and the agency's check-ins. At It's Your Home Care, caregivers keep daily notes, and we check in with your family after care starts and regularly after that.

Ask your parent open questions ("What did you and Maria talk about?") rather than yes-or-no ones. If you live far away, set a regular time to call your parent right after a visit, and tell us who in the family should get updates. Our page for families who live far away has more ideas.

What if the match is not right?

Say so early. A caregiver who is skilled but not the right personality for your parent is a common and fixable problem, and it is much easier to change in week one than in month three.

Be specific: too quiet or too chatty, too quick with personal care, not confident helping your parent stand, a language barrier. Your parent has the right to help plan their care and to have reasonable preferences respected. Ask what can change: a different caregiver, a different time of day, or a different way of doing a task. In rural parts of our 16 counties, which caregivers are available nearby affects how quickly a change can happen, and we will be honest with you about that.

What does the caregiver not do?

Knowing the limits ahead of time avoids awkward moments. Non-medical caregivers do not provide nursing, wound care, injections or physical therapy, and they do not give medications. Those come from a home health agency or hospice on a doctor's order, and our caregivers work alongside those teams.

Caregivers generally should not handle your parent's bank cards or finances, and no one connected with a licensed agency may serve as your parent's power of attorney or guardian. If you are unsure whether a task is included, ask the office before asking the caregiver.

What should you review at the end of the first week?

At the end of week one, sit down together, or get on the phone, and think through five questions:

1. Are the scheduled hours the right ones, or is the hardest part of the day still uncovered?
2. Is the care plan complete? Add tasks you have noticed, and drop ones that are not needed.
3. Is the caregiver a good match for your parent?
4. Is the family getting the updates it needs, and is everyone clear on who calls whom?
5. Is payment set up correctly, including any long-term care insurance claim, VA benefit or program approval? Our guide to paying for home care in Pennsylvania covers the options.

Share what you found with us. A care plan is meant to change as you learn.

Ready to talk about your parent's first week?

If you have not started yet and would like to talk through what the first week could look like for your parent, call It's Your Home Care at (717) 695-2704 or request an in-home consultation. There is no pressure to decide on the first call. You may also find our questions to ask a home care agency helpful before you call anyone.