We get calls like this more often than you might think.
A family has already called two or three agencies. Maybe four. They’ve been told the case is “too complex,” that they don’t have the right caregivers available, that the hours aren’t a good fit. The family is exhausted and, often, a little desperate. They’ve run out of easy options.
Then they call us.
We can’t always say yes — and we’ll be honest about that in this article. But we say yes more often than most. And we think families deserve to understand why.
What “Declined” Usually Means
When an agency declines a case, it’s rarely because the situation is impossible. It’s usually because it’s inconvenient, unprofitable, or outside the range of what that agency has built its model around.
Large agencies — particularly franchise operations — are built around efficiency. They work best with standard cases: a few hours a day, predictable schedules, clients who are relatively easy to work with. That model works well for a lot of families. But home care needs are not always standard.
Why We Built the Agency This Way
When we started Agape, we made a decision early on that shaped everything that came after: we would not turn away cases simply because they were hard.
This wasn’t idealism. It was a belief — grounded in twelve years of experience — that the families who need help the most are often the ones who have the hardest time finding it. That decision required investing in caregivers who are genuinely skilled at behavioral management, not just task completion. It meant being willing to have longer, harder conversations with families at intake. It meant staying personally involved in difficult cases in ways that a large franchise operation simply can’t.
The Kinds of Cases We Accept
Advanced dementia with behavioral symptoms. Clients with significant agitation, sundowning, resistance to personal care, repetitive or disruptive behaviors. These clients require caregivers specifically trained in dementia care — skilled at redirection, de-escalation, and maintaining dignity.
Clients who are resistant to accepting care. Many older adults — particularly those who have been fiercely independent their whole lives — resist the presence of a caregiver at first, sometimes forcefully. A skilled caregiver can build trust over weeks.
Non-standard or complex schedules. Split shifts, overnight care, weekend-only coverage, care that bridges multiple settings. We build around what the family actually needs.
Care inside assisted living, memory care, or skilled nursing facilities. Some clients in residential facilities need additional one-on-one support that the facility’s staff-to-resident ratio doesn’t allow for. We provide private duty caregivers in these settings.
Hospital-to-home transitions. One of the highest-risk periods for an older adult is the 30 days following a hospital discharge. Families often need coverage quickly — sometimes same-day — and the situation is frequently more complex than baseline.
Clients with complex family dynamics. Sometimes the hardest part of a case isn’t the client — it’s the family. Multiple family members with conflicting opinions. Adult children who are geographically separated. Family members who are grieving and exhausted. We’ve been in these situations many times.
Clients who speak languages other than English. We work to match caregivers to clients based on language and cultural background when at all possible.
What We’re Honest About
We said at the start that we can’t always say yes. There are situations that fall outside the scope of what a non-medical home care agency can safely provide — wound care, injections, IV management, catheter care. If a client’s primary needs are clinical in nature, we’ll tell you that.
There are also situations where, after a thorough assessment, we’ve concluded that a client’s needs cannot be safely met in a home environment. In those situations, we say so. We would rather have that honest conversation than take a case we can’t serve well.
What It Means for Your Family
If you’ve been told by another agency that your situation is “too complex,” or if you’ve had a previous home care experience that didn’t work out — we’d like to talk with you.
Not to promise you that we can solve everything. But to listen carefully, ask the right questions, and give you an honest assessment of what we can do.
Call us anytime at (949) 690-9990. We answer 24 hours a day, seven days a week. Tell us your situation. We’ll listen — and we’ll tell you honestly what we think we can do.