Adult Backup Care Escalations

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Adult Backup CareEscalations

Recognize red-flag keywords and phrases that indicate a high-risk situation.

In an adult backup care setting, certain situations should immediately be escalated to a manager to ensure client safety and proper care.

Key Escalation Triggers & Keywords

Use the Safety Matrix to identify how to handle each escalation

When to escalate:

Keywords to listen for:

• If the adult has fallen or is injured
• If the adult is experiencing difficulty breathing, chest pain, or confusion
• If a caregiver or family member is reporting an emergency

Medical Emergencies or Immediate Danger

"They fell!" "She’s on the floor" "He collapsed." " They are unresponsive." "Not waking up." "Bleeding." "Broken." "Bruised badly." "Choking." "Not breathing right." "Struggling to breathe." "Severe pain." "Can’t move." "9-1-1." "Ambulance."

Use the Safety Matrix to identify how to handle each escalation

When to escalate:

Keywords to listen for:

"No caregiver showed up." "They’re late again." "No one is answering." "I can’t get help." "Medications missing."

• If a scheduled caregiver has not arrived and the adult is alone
• If there are issues with medication management
• If family members are complaining about repeated service failures

Service or Staffing Issues Affecting Safety

Use the Safety Matrix to identify how to handle each escalation

"Not eating." "Not drinking." "Dehydrated" "They left me alone." "No one is helping." "Bruises." "Sores." "Looks bad." "Yelling." "Pushed." "Hitting." "The caregiver is rough with them."

• If there are signs of possible elder abuse or neglect
• If a family member or caregiver is expressing concerns about mistreatment

When to escalate:

Keywords to listen for:

Neglect or Abuse Concerns

Use the Safety Matrix to identify how to handle each escalation

When to escalate:

Keywords to listen for:

"Wandering." "Left the house." "Got lost." "Confused." "Doesn’t recognize me" "Keeps repeating themselves." "Forgetting everything." "Aggressive." "Yelling." "Won’t calm down." "Doesn’t remember taking meds." "Missed medication."

• If the client has wandered away or is at risk of doing so
• If the client is confused or disoriented
• If there are signs of aggression, agitation, or potential self-harm

Dementia-Related Issues

Accurate notes help ensure appropriate follow-up and response.

Notify a manager or supervisor as soon as a red-flag keyword is identified.

If the caller indicates an emergency, ensure they have contacted 911.

Document everything

Escalate promptly

Confirm immediate safety

Escalation Guidelines

Stay calm and gather details – Ask follow-up questions to clarify the situation.