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Preventing Violence in Home Care: Action Items

Guest Article: Elizabeth E. Hogue, Esq.


According to a recent analysis of Bureau of Labor Statistics data, home healthcare is one of the most dangerous places to work in healthcare.  Homecare field staff members who provide services on behalf of private duty agencies, hospices, Medicare-certified home health agencies and home medical equipment (HME) companies are extremely vulnerable.  Contributing to their vulnerability is the fact that they work alone on territory that may be unfamiliar and over which they have little control.  Staff members certainly need as much protection as possible. 

First, management should develop a written policy of “zero tolerance” for all incidents of violence regardless of source. The policy should include animals! The policy must require employees and contractors to report and document all incidents of violence, no matter how minor.  Emphasis should be placed on both reporting and documenting. Employees must provide as much detail as possible. The policy should also include “zero tolerance” for visible weapons when caregivers are present in patients’ homes. Caregivers must be required to report the presence of visible weapons.

There are also important actions for home care organizations to take including:

  • Develop quality indicators that improve efforts to protect staff. Indicators in quality and safety standards should include patient assault and other instances of violence or threatened violence. The results of these indicators should result in violence prevention plans and training programs in de-escalation of violence.
  • Strengthen data systems to monitor the exposure of staff members to aggression. More resources should be invested in measuring aggressive events and specific factors that resulted in exposure, such as patient type.
  • Encourage and support reports of violence or threatened violence. A “zero tolerance” policy is essential, but such a policy can be neutralized by managers who discourage or ignore reports.
  • Provide ongoing education to protect staff. Education should focus on intentional actions that staff members must take to recognize, document and counter threatened or actual violence.

Every caregiver matters! The home care industry has lost caregivers to violence on the job in the past. Let’s not repeat these terrible events.


©2023 Elizabeth E. Hogue, Esq. All rights reserved.

No portion of this material may be reproduced in any form without the advance written permission of the author.


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