Pain points of dependence on multiple caregivers

Imagine waking up each morning unsure of who will walk through the door—or how they'll care for you. For patients relying on multiple caregivers, this uncertainty isn't just stressful; it can directly impact their physical comfort and safety. Even with tools designed to streamline care, like a well-equipped nursing bed or a reliable patient lift, the human element introduces variables that no manual can control.

Take the nursing bed, for example. A well-designed nursing bed should be a source of stability, with adjustable positions to ease pressure sores, facilitate transfers, or simply let someone sit up to eat. But when Caregiver A prefers keeping the bed in a semi-reclined position "for comfort" and Caregiver B lowers it to the lowest setting "to prevent falls," the patient becomes a passive bystander in their own care. One day, they might struggle to reach their water glass because the bed's too low; the next, they're straining to lift their legs because it's too high. Over time, these small inconsistencies add up to a constant state of adjustment—hardly the restful environment anyone needs.

Then there's the patient lift, a device meant to reduce strain on both caregiver and patient during transfers. But if one caregiver takes the time to adjust the lift's straps for a snug, secure fit and another rushes through, yanking the patient upward without checking alignment, the risk of discomfort or injury skyrockets. "I've had aides who treat the lift like a race car and others who move so slowly I'm sweating through my clothes by the time we're done," one user of a lower limb exoskeleton (who also relies on a patient lift for daily transfers) shared. "Neither feels right. I just want to feel safe, not like a package being tossed around."

These inconsistencies aren't just about preferences. They can have medical consequences. For someone with limited mobility, improper positioning in a nursing bed can worsen contractures or pressure ulcers. Forgetting to lock the wheels on a patient lift mid-transfer could lead to a fall. And when each caregiver brings their own "system"—whether it's how they bathe, dress, or administer medication—the patient is left to adapt, often in silence, rather than receiving care tailored to their unique needs.

Caregiving isn't just about physical tasks—it's about connection. A warm smile, a remembered preference (decaf coffee, not regular), or a listening ear can turn a routine morning into a moment of dignity. But when care is split across multiple people, that emotional bond often gets diluted. Patients may find themselves repeating their life story to each new face, explaining their fears or frustrations to someone who'll be gone in a week. Caregivers, too, can feel like cogs in a machine, rushing through tasks to stay on schedule rather than pausing to ask, "How are you really doing today?"

This fragmentation hits especially hard for those in long-term care. Consider an elderly woman recovering from a hip replacement, working with a rotating team of physical therapists to learn to use a lower limb exoskeleton. One therapist pushes her to "tough it out" through discomfort, while another prioritizes slow, steady progress. "I don't know who to trust," she might think. "Is this pain normal, or am I just not trying hard enough?" Without a consistent guide, doubt creeps in, and motivation wanes. The exoskeleton, meant to empower her, becomes another source of confusion.

For family caregivers caught in the middle, the guilt can be overwhelming. "I feel like I'm letting my dad down by not doing it all myself," one son admitted. "But when I'm at work, I have to trust someone else to notice if he's sad or in pain. Last month, the aide didn't mention he'd stopped eating—by the time I found out, he was dehydrated. She wasn't neglectful; she just didn't know him well enough to see the signs."

The result? A care experience that checks boxes but misses hearts. Patients may withdraw, reluctant to open up, while family caregivers carry the weight of knowing their loved one is lonely—even when "all their needs are met."

It's easy to assume that assistive tools like a patient lift or an electric nursing bed eliminate the physical toll of caregiving. But the reality is, even the best equipment requires skill—and when caregivers are rotated in and out, that skill often gets lost in translation. A new aide might fumble with the nursing bed's remote, taking 10 minutes to adjust it when a seasoned caregiver could do it in 30 seconds. Another might overestimate their strength, skipping the patient lift entirely to "save time," risking a back injury for themselves and a painful fall for the patient.

This isn't laziness—it's lack of familiarity. Most caregivers receive on-the-job training, but with high turnover rates in home health and senior care, that training is often rushed or incomplete. A 2022 study by the National Alliance for Caregiving found that 41% of family caregivers reported that hired help "needed more training" on equipment like patient lifts or specialized beds. "I spent an hour teaching the new aide how to use the lift last week," said a caregiver for her husband, who has ALS. "By the time she got the hang of it, her shift was over. The next aide? I had to start all over."

The strain isn't just physical for the caregivers—it's emotional for patients, too. Watching someone struggle to maneuver a nursing bed or hesitate before using a lift can trigger feelings of guilt: "Am I too much trouble?" "Is this why no one stays?" Over time, patients may even avoid asking for help, worsening their own health to spare their caregivers' discomfort.

Hiring multiple caregivers rarely comes cheap. Even with insurance or Medicaid, co-pays, specialized equipment rentals (like a lower limb exoskeleton for rehabilitation), and overtime fees can add up fast. For families already stretched thin, the "solution" of adding more caregivers often becomes another financial stressor—one that forces impossible choices: cut back on groceries to afford a second aide, or skip a week of physical therapy to pay for a new mattress for the nursing bed.

The math is stark. A single home health aide might cost $25–$35 per hour; hiring two part-time aides to cover 12-hour days can easily top $4,000 per month. Throw in the cost of maintaining equipment—a replacement battery for the electric nursing bed, repairs to a worn patient lift—and the numbers climb higher. "We thought hiring two aides would make things easier," said a father of a teenager with cerebral palsy. "Instead, we're draining our savings just to keep up. Last month, we had to choose between a new patient lift and her speech therapy. No parent should have to pick like that."

Even for those with access to public programs, the red tape can be overwhelming. Eligibility rules for Medicaid-covered nursing beds or exoskeletons vary by state, and navigating the paperwork often falls to family caregivers already swamped with daily responsibilities. "I spent 12 hours on the phone last week just trying to confirm if the new aide's hours would be covered," said a daughter caring for her elderly mother. "By the time I hung up, I was too exhausted to help her with dinner. It's a never-ending cycle."

For the primary family caregiver, coordinating multiple hired helpers often feels like running a small business—without the pay or training. There are schedules to juggle, notes to pass between shifts, medications to track, and endless reminders (don't forget to lower the nursing bed rails at night, use the blue strap on the patient lift, avoid giving citrus before bedtime). It's a second job, and one that rarely gets acknowledged.

Technology can help—apps like CareZone or Cozi let caregivers share updates—but they're only as effective as the people using them. A busy aide might forget to log a medication dose; a new therapist might miss a note about the patient's sensitivity to the lower limb exoskeleton's settings. "I have a binder thicker than a textbook with all my mom's care instructions," said a daughter in California. "Every new aide flips through it like it's a novel, but half the time, they still ask me the same questions. I'm not just her daughter—I'm her secretary, too."

None of this is to say that multiple caregivers can't work—many families thrive with a village of support. But acknowledging the pain points is the first step toward fixing them. Simple changes, like creating a shared digital logbook for caregivers to note adjustments to the nursing bed or patient lift, or scheduling monthly "care team" meetings to align on goals, can reduce friction. For patients, advocating for consistency—asking for the same aide for core tasks, or requesting training for new caregivers on equipment—can restore a sense of control.

At the end of the day, caregiving is about people—and people are messy, imperfect, and deeply capable of growth. By naming these struggles, we don't just highlight the challenges; we open the door to empathy, better training, and systems that prioritize the human side of care. Because no one should have to navigate this alone.