By Thomas A. Parmalee
It was supposed to be a routine visit. A caregiver arrived at a client’s home to assist with morning medications and breakfast preparation — only to find cockroaches scurrying across the counter, the walls and even the bed linens. She called her supervisor immediately, shaken.
The agency’s administrator faced a dilemma familiar to many in home care: How do you protect your employee from unsafe working conditions without abandoning a client who depends on your care?
Situations like this are more common than many agency owners admit. Infestations, hoarding, and other unsafe home environments can arise suddenly, especially when clients are aging in place and no longer have the physical or cognitive ability to maintain their homes. The question is not if you’ll face it — but how you’ll handle it when you do.
Below are practical, ethical, and legal strategies to guide your response when a client’s home becomes unsafe due to a pest infestation.
- Prioritize Employee Safety — Immediately
As an employer, your first obligation is to your staff’s health and safety. Exposure to roaches can trigger allergic reactions and asthma, and in extreme cases, spread bacteria and pathogens. Your employees will also be reasonably concerned with their own homes becoming infested — and if that happens, they will come looking for to you to pay for the remediation of their home … and who could blame them? If you ignore such a problem, it could become quite expensive.
Action Step:
- Suspend in-home visits until the environment is deemed safe.
- Document your findings with photos (if policy allows) or written incident notes to justify your decision internally and to the client’s family or contact person.
- Offer your caregiver an alternate assignment to avoid loss of hours or income, reinforcing that you prioritize their well-being.
- Communicate Transparently and Compassionately with the Client
No one wants to hear that their home is infested, especially older adults who may feel embarrassed, ashamed or fearful of losing services. Compassionate communication is key.
Action Step:
- Speak privately and respectfully with the client (and their family, if applicable).
- Frame the issue as a temporary barrier to providing care safely, not as a personal criticism.
Example: “We want to continue supporting you, but right now, the home environment is unsafe for our caregivers. Once it’s treated and verified pest-free, we can resume services right away.” - Offer written guidance on next steps for pest remediation.
- Determine Responsibility for Pest Control
Generally, the responsibility lies with the client or their landlord to pay for and coordinate extermination. However, some agencies choose to assist with logistics or referrals.
Action Step:
- If the client rents, contact the landlord or property manager — pest control is often legally their obligation.
- If the client owns the home, they (or their family) must hire a licensed pest control professional.
- Provide a list of reputable exterminators, but do not hire one directly unless your agency’s policies and liability coverage explicitly allow it.
- Consider connecting the client to local public health departments, aging services, or community assistance programs that may offer subsidized pest remediation for seniors or low-income residents.
- Set Clear Conditions for Resuming Care
You’ll need proof that the infestation has been professionally addressed before sending a caregiver back into the home.
Action Step:
- Require documentation from a licensed pest control company confirming treatment and outlining follow-up visits.
- If possible, conduct a visual inspection yourself or send a supervisor before reinstating services.
- Add a written clause to your service agreement allowing temporary suspension of care in cases of unsafe environmental conditions, so future situations can be managed without confusion or confrontation.
- Coordinate Interim Support for the Client
A service suspension doesn’t have to mean abandonment. While in-home visits are paused, you can still help your client stay connected.
Action Step:
- Offer check-in calls to ensure they’re safe and that pest control is underway.
- If the client needs meals or medication support, refer them to temporary community services such as Meals on Wheels or visiting nurse programs.
- Once the infestation is resolved, prioritize resuming their care to show commitment and compassion.
- Review Your Policies and Training
This incident is an opportunity to strengthen your agency’s preparedness.
Action Step:
- Develop a “Hazardous Home Environment Policy” that defines unsanitary or unsafe conditions and outlines your response protocol.
- Train staff on how to identify and report infestations or environmental hazards.
- Keep a resource list of local pest control services and public health agencies readily available for case managers and schedulers.
- Document Everything
Thorough documentation protects both your agency and your client relationships.
Action Step:
- Record all communication, inspection notes, and steps taken to resolve the issue.
- If applicable, notify the client’s case manager, social worker, or insurance representative to ensure continuity of care and transparency.
Final Thoughts: Compassion and Professionalism Can Coexist
It’s possible to balance empathy for clients with your duty to maintain safe work conditions for staff. By setting clear boundaries, responding promptly, and communicating with care, you can preserve your professional integrity — and often, your client relationship as well.
When handled correctly, these difficult moments can strengthen trust. Clients see that your agency operates with both compassion and accountability — two traits that define the best in home care.
Thomas Parmalee is vice president of industry insights and content at Senior Care Marketing Max, which publishes Home Care Post.
