Adult Backup Care Escalations

Adult Backup CareEscalations

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Key Escalation Triggers & Keywords

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

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

Medical Emergencies or Immediate Danger

Keywords to listen for:

When to escalate:

"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."

• 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

Use the Safety Matrix to identify how to handle each escalation

Service or Staffing Issues Affecting Safety

When to escalate:

Keywords to listen for:

• 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

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

Use the Safety Matrix to identify how to handle each escalation

Neglect or Abuse Concerns

Keywords to listen for:

When to escalate:

"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

Use the Safety Matrix to identify how to handle each escalation

Dementia-Related Issues

Keywords to listen for:

When to escalate:

"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

Use the Safety Matrix to identify how to handle each escalation

Escalation Guidelines

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

Confirm immediate safety

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

Escalate promptly

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

Document everything

Accurate notes help ensure appropriate follow-up and response.