Home Care Visits Are Not the Problem. The 22-Hour Gap Is.

Home care is not broken. In most cases, it is working exactly as intended. Care providers are delivering skilled, compassionate support during scheduled visits, helping people remain safely in their homes and maintain independence. For many families, this type of care is essential and deeply valued.

That said, this is not to minimize the real pressures within the sector. Providers, coordinators, and frontline teams are operating under significant strain, often going above and beyond to make the system work. 

Having worked across integrated care models, hospital-to-home transitions, and within both provider organizations and system governance, I have seen this dynamic from multiple vantage points. The challenge is not unique to one part of the system, it shows up consistently across settings.

However, home care was never designed to provide continuous support throughout the entire day. It is structured around defined visit times and specific tasks, not around ongoing visibility into daily life. A personal support worker may be there two hours each day. A nurse may visit a few times each week. These interactions matter, but they only represent a small portion of a person’s day.

What happens in the remaining hours is where caregiving becomes significantly more complex.

For families, especially those balancing careers, children, and other responsibilities, the challenge is not the care itself. It is the uncertainty that exists outside of those scheduled visits. They are left wondering whether their loved one got up that morning, whether they ate, whether they are safe, or whether something has changed that no one has noticed.

This gap becomes especially visible during transitions from hospital to home, where expectations are high but continuous support is limited. In one case, a patient discharged home with appropriate services in place still returned to the hospital within days, not because care wasn’t arranged, but because subtle changes in condition went unnoticed between visits and escalated.

Care is being delivered, but visibility is limited.

This gap creates a persistent mental burden. Over time, it leads to increased stress, feelings of guilt, and ultimately burnout. It is not because care is failing, but because families lack confidence in what is happening when no one is physically present.

From a system perspective, this challenge is compounded by broader pressures across home and community care. Demand continues to grow as more people want to age at home. At the same time, workforce shortages, scheduling complexity, and funding constraints limit the ability to expand services. Even when additional visits are possible, they are often constrained by cost, availability, or both.

The assumption that more care hours will solve this problem does not fully hold. While additional support can help, it does not address the underlying issue of continuity throughout the day. In integrated care environments, we have seen that even well-coordinated increases in service do not eliminate uncertainty between touch points. 

Technology has been introduced in many forms to support caregivers and older adults, but much of it does not align with how people actually live. Many solutions rely on multiple steps, ongoing management, or a level of digital literacy that cannot be assumed. For older adults, this often creates friction rather than reducing it. For families, it does not solve the core problem they are trying to address.

Families are not looking for more tools. They are looking for reassurance.

The opportunity, then, is not to replace home care, but to strengthen it. Care does not break down during visits. It breaks down in the time in-between them. That is where small changes go unnoticed, where communication gaps emerge, and where families are left without clarity.

If we want to meaningfully reduce caregiver burden, we need to think beyond increasing services and instead focus on improving continuity. Families need simple, reliable ways to stay informed and connected throughout the day. Providers need ways to extend the value of care without increasing operational strain.

This is not about adding complexity to the system. It is about addressing a gap that has always existed but is becoming more visible as expectations evolve. This is as much a system design challenge as it is a service delivery one.

The future of caregiving will not be defined solely by the quality of visits. It will be shaped by how well we support the time in-between them. 

Solutions that focus on simple, passive visibility are starting to address this gap in a way that aligns with how people actually live. 👉 Learn how Paige Frame supports families with connection and peace of mind in-between visits. Try Paige risk-free for 30 days with our free in-home trial.

About the Author:

Fraser R. Edward:

Mr Edward is a healthcare and technology executive with 25+ years of experience spanning integrated healthcare systems, home care, digital innovation, and hospital governance. At St. Joseph’s Health System, he co-founded the Centre for Integrated Care and led cross-system initiatives, including EPIC Virtual Care and ED-LTC project AMPLIFY. Previously, Mr Edward held marketing and business development roles at Loblaws (SDM), CellTrak, TELUS Health, Hewlett Packard, Research In Motion (BlackBerry), & various HealthTech start-ups.