Most problems with a home caregiver do not begin with a dramatic incident. They begin with small omissions that nobody writes down. A shift log is the cheapest early warning you have, but only if you set it up before the first shift and read it every day.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Step 1: Set up the log before the first shift

Put a notebook on the counter, or ask the provider for a written log form. Each entry should include these fields, in this order:

  1. Arrival time and departure time.
  2. Tasks completed, in the order the family listed them.
  3. Things the person said, asked for, or did that were unusual for them.
  4. Tasks not completed, and the reason in a few words.
  5. Questions for the family.
  6. Errands run, with what was bought or picked up.

Write the fields on the first page: ____________________________________________

Step 2: Read the log every day for the first two weeks

Read each entry the same day it is written. Keep a copy or a photo of every page, because the early pages are your baseline. Compare each new entry to the first three entries, not to your memory.

Step 3: Learn the five signs of a thinning log

  • Repeated lines. The same sentence appears five days in a row, word for word, with no change for the weather, mood or meals.
  • Blank 'not completed' field. A task you can see is undone, but the log says everything was done.
  • Blank questions field. A busy home always produces at least one question. Zero questions for a week is a signal, not a success.
  • Errands with no detail. A pickup or purchase with no receipt, no time and no note on what was left behind.
  • Times that drift. Arrival and departure times that never match the agreed shift, or that are all rounded to the same minute.

Write down the first sign you see, with the date you saw it: ____________________________________________

Step 4: Ask one specific question

Do not start with a complaint. Pick one entry and ask a single question about it, such as 'What happened with the grocery list on the third day?' A good provider answers in writing or by phone within the same day. If the answer is vague, or the question is met with a change of subject, write that down too.

What to do with what you find

If the person shows a change in eating, drinking, sleep, or mood, write it in the log exactly as it happened and give that page to the doctor or nurse who sees them. Do not wait for the next appointment to report it. The log does not diagnose anything. It keeps the record clear enough for someone who can judge it.