Continuity During Workforce Shortages

Ensure key routines are safeguarded by prioritising, informing workers, and planning for realistic backups.

Shortages in the workforce can result in lateness, unfamiliar workers and pressure to accept whatever is available.

Substitutions are especially problematic when there is a need for familiarity, such as in communication, personal care, dementia, and culture, or when there are complex health routines.

Why this matters for care managers

Care managers weigh safety, dignity, continuity, preferences, realities of staff and resources available. The best arrangements make those trade-offs explicit to the older person, and link every service with an outcome that is meaningful in everyday life. The use of clear worker information and planned review ensures consistency and enables the person to have control over their home and routines.

What better coordination looks like

Care managers can detect continuity-critical elements, prepare a short worker brief, and build backups that maintain dignity and safety.

Prioritise essential continuity

Determine the timing, skills, gender, language or familiarity needed for various routines and what is flexible.

Prepare the replacement

Provide the current brief, verify competencies and make an introduction if possible.

Communicate early and honestly

Inform the person and family what has changed, what has been confirmed, and what options they have.

Make the change last

A helpful change is specific enough to practise and small enough to review. Make an agreement about who will take the first step, where they will record the decision and when the person will be asked if it helped. Where more than one service is required, validate each service separately and not presume that a meeting result equates to readiness to perform the service. Keep what is working, change what isn't and eliminate temporary procedures that are no longer working toward the desired end.

Questions for the next review

How would ‘essential continuity' appear from the person's perspective?

Which element(s) of the arrangement is assumed and which is still pending?

What will be observed that will clarify to the person and team whether this strategy is working?

Keep the boundary clear

A shortage is no reason to send an untrained or unsuitable worker. Services have to adhere to the workforce, safety and agreement standards, and emergency pathways should not be used as a routine replacement for the roster.

A practical example

A care manager used a one-page routine and a quick phone introduction when a regular worker's leave was unexpected. The replacement knew the older person's morning routine, and the transition went smoothly.