Photo By: Georg Pflueger
Following hundreds of planned caregiver layoffs in California, Applause Home Care CEO Jim Prussak discusses the importance of trusted relationships, the risks of disrupted care, and what the industry needs to change.
For older adults who rely on regular assistance, a caregiver can become an important part of daily life. Beyond preparing meals or helping with personal care, that person may understand familiar routines, recognize subtle changes, and provide a sense of stability.
When a caregiving relationship ends unexpectedly, replacing the worker may be only part of the challenge.
In September 2026, California-based 24 Hour Home Care reported plans to lay off 738 employees, according to a state employment filing. The company attributed the reductions to Health Net’s planned discontinuation of an optional Personal Care and Homemaker Services benefit under its Medi-Cal managed care plans.
The company said it was coordinating with Health Net and other stakeholders to support continuity of care. The number of clients who experienced service interruptions has not been established.
The situation nevertheless raises questions about the vulnerability of caregiving relationships when funding or staffing arrangements change.
Jim Prussak, CEO of Applause Home Care, discusses what families should watch for and why continuity deserves greater attention across the industry.
When hundreds of caregivers face layoffs, what is at stake for the people who rely on them?
Jim Prussak: “For older adults, a caregiver is often much more than someone who helps with bathing, dressing, meals, or medication reminders. A trusted caregiver becomes part of a senior’s daily routine, provides companionship, recognizes subtle changes in health or behavior, and offers families peace of mind.”
How can losing a familiar caregiver affect an older adult’s well-being?
Prussak: “Missed shifts or unfamiliar replacements can leave seniors without essential assistance, increasing the risk of falls, missed meals, and other preventable problems.”
“Seniors may feel anxious, confused, or isolated when someone they know and trust suddenly disappears from their daily lives.”
“Family members may have to rearrange work schedules, provide care themselves, or scramble to find a reliable replacement.”
Prussak also emphasizes that the value of continuity extends beyond immediate assistance.
Prussak: “A caregiver who knows a senior’s personality, routines, preferences, and changing needs can often recognize concerns that someone new might overlook. Continuity also helps preserve independence. A caregiver who understands a senior’s abilities can encourage them to do what they can for themselves while providing assistance where needed, rather than unintentionally fostering dependence or overlooking important needs.”
When agencies are short-staffed, what is the first thing seniors risk losing?
Prussak: “When there aren’t enough caregivers to meet demand, the first thing that often gets lost is the personal connection that makes care feel human rather than transactional.”
“When staffing is stretched, the immediate priority becomes ensuring that essential tasks get completed: helping seniors get dressed, preparing meals, assisting with mobility, and maintaining basic safety. Those needs are critical, but meaningful care involves much more than checking items off a list.”
What can families do to protect an older adult’s independence during caregiver transitions?
Prussak: “Families can help protect an aging loved one’s voice by making sure that care decisions remain centered on the person receiving care—not simply on filling an open shift.”
“As the caregiver workforce changes, families may not be able to prevent every transition.”
He recommends keeping older adults involved in decisions, creating a personal care profile documenting their preferences and needs, and checking periodically whether they feel comfortable with the people providing assistance.
While these measures cannot prevent every staffing change, they can help families communicate an older adult’s expectations to someone new.
What warning signs might suggest a caregiver change is affecting someone negatively?
Prussak: “The key is to recognize changes from the loved one’s normal baseline rather than dismissing them as a natural part of aging”
Potential warning signs include withdrawal from activities they previously enjoyed, changes in eating or sleeping patterns, declining personal hygiene, mobility or balance difficulties, and unusual agitation or depressive symptoms.
These changes do not necessarily mean a caregiver transition is responsible. Families should investigate potential causes and seek appropriate medical guidance when needed.
What must the home care industry change to provide more reliable, personalized care?
Prussak: “I believe the home care industry needs to fundamentally shift from a model that focuses primarily on filling shifts and completing tasks to one that prioritizes relationships, continuity, and the individual needs of each senior.”
“As the population ages and the demand for care grows, we cannot continue to rely on a workforce model that leaves caregivers stretched thin and seniors vulnerable to frequent disruptions. We need to rethink how we recruit, support, retain, and deploy caregivers—and how we measure quality of care.”
“This means investing in competitive compensation, meaningful training, career development, manageable schedules, and a culture that recognizes the importance of their work. When caregivers feel supported, they are better positioned to build lasting relationships with the people they serve.”
“Moreover, personalized care should be an industry standard. Every senior has a unique history, personality, preferences, and definition of quality of life. Care plans should reflect those individual needs rather than simply outlining a list of required tasks.”
