What Is an In-home Care Manager and Why Are They So Important?

When it comes to in-home care, there are usually two routes you can go – hiring a private caregiver yourself or using an agency. There are some advantages to hiring a private caregiver (read about the pros and cons here), and there are also some unique benefits to going with an agency. One of those benefits is having a care manager. 

A care manager is employed by an in-home agency and has a variety of duties. They will be the main point of contact for your time with the agency, starting from the initial assessment. The care manager also serves as the supervisor for the caregiver. They ensure that the caregiver is carrying out their duties as assigned and that everything runs smoothly

But this is just the beginning of how a care manager contributes to the caregiving experience.  In this article we’ll discuss the role the care manager plays in your loved one’s care and hear from Emily Sloma, an active care manager here at Sequoia Senior Solutions.

Before care begins

Before a caregiver starts to care for your loved one, the care manager is putting in many hours of work to set your loved one and their caregiver up for success.

Perform a needs assessment 

The first time you’ll meet a care manager is when they perform the initial needs assessment to determine if in-home care is right for your family and if Sequoia Senior Solutions would be a good fit. They’ll ask specifics about your loved one’s medical conditions and how they are handling the activities of daily living (ADLs). They’ll want to explore what you and your loved one hope to get out of in-home care and what you’re looking for in a caregiver. 

Evaluate the home

Next, they’ll evaluate the home and ensure the environment is safe for your loved one and set up for a caregiver to perform their duties

Emily shares her process: “I’ve been a caregiver myself for about a decade. So when I go in and do the assessment at the beginning, I also give recommendations For example, if I notice that they need grab bars I’ll tell them that in my experience having a grab bar right here would be perfect.  Or I’ll look at their commode and recommend a different brand because the other one doesn’t seem to be fitting the needs. Oftentimes people that don’t work in home care don’t know those kinds of things.”

Develop a care plan

The care plan is a document used daily by the caregiver once care starts, but a care manager begins developing it as soon they start meeting with you. In essence, it’s the needs assessment, home inspection, and other information gathered during those meetings distilled into an actionable plan and reference guide for the caregiver to follow.

The care plan is a dynamic document that is constantly being updated and evaluated to keep up with changing needs. It contains medical information and general background/history on your loved one as well as emergency contact information. Your caregiver will record notes and reference it to stay on top of the daily schedule, personal care needs, housekeeping and meal prep tasks, and other activities.

Match caregiver to client 

Once the care plan is developed, your care manager will get to work on finding the right caregiver for you and your family. We have a large pool of trained caregivers ready for assignments – each with unique skills, experience, education, and personality.

“I try to match caregiver personalities with client’s personalities to make it a good fit.  Opposites don’t always attract.  I want to make sure I get the right caregiver in there. Some people like the warm and fuzzy caregiver, some people don’t want that.”

The first day care begins, a care manager is there to introduce the caregiver for the smoothest transition possible.

During care

Once the caregiver starts care, the care manager continues to stay involved in your loved one’s care. 

Reassessments and surprise visits 

Every 2-3 months the care manager will reassess your loved one’s care plan. They’ll also drop in on a caregiving shift for a surprise visit every 4-6 weeks to check in on how its going and see if any changes need to be made. It’s not uncommon for the care manager and caregiver to see signs and symptoms that may signal a change in your loved one’s condition:

“Part of my surprise visit is asking the caregiver away from the client, “Have you noticed a change in condition? Is there a mental or physical change?”  Sometimes they will say yes. I check with the care plan and get feedback from any other caregivers involved. I also keep the family informed. I reach out to them and tell them what we’ve been noticing so the family can make an appointment with their doctor. I’ll also make sure the caregivers are comfortable with the change in condition and provide coaching if necessary.”

Support the family

The care manger is there for you, too! It’s a big adjustment to have a someone caring for your loved one, and a care manager can be a great resource during this challenging time.

“Many of the families are going through a lot of stuff so I will often take calls from people that have a specific issue, we address it, and then just need to vent.  I’m there just to be that support, be the reassuring person that says we are getting people in here, things are going to start looking better.  We meet a lot of people that are in the lowest points in their lives.  Having to bring in a caregiver means that they obviously need help, and a lot of people haven’t asked for help before so it’s all brand new.  Oftentimes I am walking people through what it means to get a caregiver, reassuring people that this isn’t the end of the world, that this will bring more stability, more help, and make them feel better.  Families struggle with the fact that their parent is declining.”

Train, develop, and support the caregiver

A care manager is there to make sure the caregiver is giving the best care possible. That means training them, coaching them if they are struggling, and even being there as a cheerleader in tough times.

“I make sure that they know how to interact with a client.  So if they have someone that has a specific device, I go out and do the hands on training with them, I always tell the caregivers that I work with I don’t ever want to put you in a situation that you don’t feel comfortable with. If you don’t feel confident in something that needs to be done please let me know

People take it for granted that caring someone is an easy job.  But the thing that they don’t understand is that we are in it.  We are there sometimes when someone is taking their very last breath.  It can be hard for caregivers.  That is a weight on their mental health. I’m there to support them and acknowledge that this is really hard, and you are doing a great job, and that this is part of life.”  

Be the point person for communications (mediate issues, replacement caregiver if yours is sick, etc.)

The care manager is there to help with situation that might pop up. If your caregiver is sick or can’t make it, they’ll work to find a substitute. They can also mediate any issues and even help if the situation isn’t working out.

“It helps for families to speak to me because they don’t feel comfortable speaking directly to the caregivers.  For example, if I am working with a family and they really don’t like a caregiver and don’t want them back, they can speak to me and say it’s not working and why. I have the conversation with the caregiver, and it relieves that awkwardness.”  


Having a care manager in your corner can make the in-home care process much easier and less stressful. It’s one of the biggest advantages of using an agency rather than hiring a private caregiver yourself. Remember, going the private route means that you as the family caregiver would be taking on all of these duties yourself. Check out our blog for more information about the differences between hiring a private caregiver or using an agency.

Want to learn more about in-home care with an agency? Check out our How it Works page and schedule a time to talk with a client service specialist. A care manager will perform a complimentary needs assessment to determine if in-home care is right for your family.

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