Essential questions to ask and criteria for finding the right Spitex for you and your family
“I don’t know where to start, there are so many different services and I don’t understand the differences.”
This is one of the phrases we hear most often when families in Ticino find themselves having to choose a home care service for the first time. The decision can seem complex, especially when you are in an emergency situation or under emotional stress.
The home care landscape in Ticino is indeed complex: from public SACD (Home Care and Assistance Services) to private Spitex providers and specialized services such as CAD Healthcare. Each option has different characteristics in terms of services offered, costs, availability, and approach to care.
How to choose the right home care service in Ticino?
This guide is based on the direct experience of hundreds of families who have turned to us after navigating the complex world of home care in Ticino. The goal is to provide you with the tools to make an informed choice based on your specific needs rather than on the first option available.
In the following sections, we will address the most frequently asked questions we receive, explain the differences between the various types of services, and provide you with a practical checklist to evaluate the different options.
Because choosing the right home care service is not just a matter of cost or availability: it is a decision that can profoundly affect the quality of life of the patient and the peace of mind of the entire family.
The need for home care
“How do I know if I really need home care?”
This is often the first question families ask themselves, especially when the situation is not yet critical but difficulties are beginning to be noticed. Recognizing the right time to request home care can make the difference between effective preventive intervention and more complex emergency management.
Signs that indicate the need for assistance
Home care may be necessary in a variety of situations, ranging from temporary to chronic needs:
Acute temporary situations:
- Hospital discharge after surgery or hospitalization
- Convalescence periods requiring specialized care
- Accidents that temporarily limit independence
- Acute illnesses requiring home monitoring
Progressive chronic conditions:
- Degenerative diseases that gradually reduce independence
- Chronic conditions requiring ongoing management (diabetes, heart failure, COPD)
- Cognitive disorders such as dementia or Alzheimer’s in the early stages
- Disabilities requiring support with daily activities
Warning signs that should not be ignored:
- Increasing difficulty in managing personal hygiene
- Problems preparing meals or eating
- Frequent falls or fear of falling
- Confusion in managing medications
- Progressive social isolation
- Excessive fatigue in daily activities
- Worsening of existing chronic conditions
Professional assessment: when to request it
It is not always easy to assess independently whether and when home care is needed. A professional assessment can be useful in a number of circumstances:
- When you notice changes in a person’s abilities but are unsure of their severity
- Before discharge from hospital to plan the return home
- When the burden of care for family members becomes excessive
- In the presence of complex medical conditions that require specific skills and excellent healthcare coordination
CAD Healthcare offers free assessments that include:
- Analysis of current clinical conditions
- Assessment of the home environment and its safety
- Identification of potential risks
- Definition of the level of care required
- Planning of a possible intervention plan
As Dr. C., a geriatrician who works with CAD, explains: “Families often wait too long before asking for help, thinking they can manage everything on their own. An early assessment allows us to take preventive action, avoiding crisis situations and maintaining the person’s independence for longer.”
The different types of home care
“What is the difference between the various types of service?”
The home care landscape in Ticino can seem confusing to those approaching it for the first time. Understanding the differences between the various types of service is essential for making an informed choice.
Private Spitex services
Main features:
- Greater flexibility in the organization of services
- Possibility of additional services not covered by the public sector
- Variable and often higher rates in the private sector
- Greater attention to detail
Advantages:
- Generally faster activation times
- Greater flexibility in schedules
- Possibility of customizing services
- Often greater weekly coverage
Distinctive features of CAD:
- Integration of advanced technologies (telemedicine, remote monitoring)
- Multidisciplinary approach with specialized teams
- Healthcare Family Office service for coordination
- 24/7 availability
- Specialized management of complex cases
- Continuous staff training
- Proactive emergency management
- Highly tailored services
Factors to consider when choosing a home care service
“How do I choose the right service for my situation?”
Choosing the right home care service depends on many factors. Here is a practical guide to help you make your decision.
Factors to consider when choosing the right SPITEX
Complexity of the clinical situation
- Simple and standardised situations
- Complex or unstable situations: specialised services such as CAD are more appropriate
- Rare or specific conditions: check the service’s experience in that field
Flexibility requirements
- Coverage of weekly hours based on the level of flexibility required
- The degree of availability with the possibility of intervention within 24 hours
Importance of continuity
- If continuity is a priority: avoid services with high turnover
- For complex cognitive situations: continuity is essential
- Always check staff replacement policies
Family support
- Very present family: basic services may be sufficient
- Family not very available: comprehensive services with coordination
- Family far away: services with remote monitoring and constant communication with Healthcare Family Office management
Checklist for evaluating services
Before choosing a service, use this checklist to evaluate the different options.
Organizational aspects:
- Service activation times
- Availability at the requested times
- Coverage on weekends and holidays
- Replacement policies in case of staff absence
- Timeliness of adaptation in case of changes in circumstances
Quality of staff:
- Qualifications and training of operators
- Specific experience with the patient’s condition
- Continuing education policies
- Staff turnover
- Supervision and quality control
Services offered:
- Full range of necessary services
- Additional services available
- Coordination with other professionals
- Emergency management
- Technological support available
Financial aspects:
- Transparency of fees
- Insurance coverage of services
- Possibility of subsidies or discounts
- Billing methods
Communication and relationship:
- Ease of contact with the service
- Quality of communication with families
- Involvement in decisions
- Complaint management and issue resolution
- Regular reporting and updates
Specific questions to ask during the assessment
When you contact a service for an assessment, here are the essential questions to ask:
- “How many different caregivers will I see in a typical month?”
- “What happens if my regular caregiver is unavailable?”
- “How do you handle emergencies outside of business hours?”
- “What specific training does your staff have for my condition?”
- “How do you coordinate with my primary care provider?”
- “Can I change the care plan if my needs change?”
- “What technologies do you use to improve the quality of care?”
- “How do you communicate with family members about the situation?”
- “What guarantees do you offer regarding service continuity?”
- “Can I get references from other families in similar situations?”
Evaluating a Spitex and community care services
“How can I tell if the service I have chosen is working?”
Once home care services have been activated, it is important to monitor their effectiveness on an ongoing basis. Not all problems are immediately apparent, and families often become accustomed to suboptimal situations, thinking that they are normal.
Indicators of a well-functioning service
Positive clinical aspects:
- Stability or improvement in the patient’s condition
- Reduction in unplanned hospital admissions
- Effective management of symptoms and complications
- Correct adherence to prescribed therapies
- Effective prevention of complications
Positive relational aspects:
- The patient is calm and cooperative during visits
- A relationship of trust has been established with the staff
- The family feels supported and informed
- Communication is clear and timely
- Problems are addressed quickly
Positive organizational aspects:
- Punctuality and reliability in planningStaff continuity
- Flexibility in adapting to changing needs
- Effective coordination with other professionals
- Proactive management of situations
Warning signs not to be ignored
There are some signs that indicate that the service is not working as it should:
Clinical warning signs:
- Unexplained worsening of condition
- Increase in hospital admissions
- Errors in treatment management
- Failure to recognize complications
- Poor hygiene or personal care
Problematic relational signs:
- The patient shows anxiety or rejection towards caregivers
- Lack of communication with the family
- Caregivers who always seem to be in a hurry
- Difficulty obtaining information or clarification
- Feeling of being neglected or not listened to
Critical organizational signs:
- Frequent delays or missed appointments
- Constant staff changes
- Difficulty contacting the service
- Lack of coordination with other professionals
- Rigidity in adapting to new needs
When and how to change services
If warning signs persist despite attempts to resolve them, it may be necessary to consider changing services.
Steps to take before switching:
- Direct communication: clearly explain the problems to the service manager
- Time for improvement: allow a reasonable amount of time to see improvements
- Documentation: keep track of problems and communications
- Medical consultation: discuss the situation with your doctor
How to manage the transition:
- Do not abruptly discontinue the current service
- Organize a gradual transition
- Ensure that all clinical information is transferred
- Inform all professionals involved of the change
Conclusions: your roadmap for making the right choice about how to get assistance
Choosing the right home care service is an important decision that requires time and consideration. There is no one-size-fits-all solution: every situation is unique and deserves a personalized approach.
Key points to remember:
- Always assess your specific needs before looking at what is available
- Don’t base your choice solely on cost: value for money is more important than the absolute price
- Continuity of care is essential for quality care
- Good coordination can make the difference between a positive and a frustrating experience
- Don’t be afraid to change if the service does not meet your expectations
The 5-step selection process:
Step 1: Assess your needs
- Analyze the current clinical situation
- Identify the specific needs of the patient and family
- Consider the likely evolution of the situation
Step 2: Research your options
- Find out about the different types of services available
- Gather information about services in your area
- Ask doctors, friends, or other professionals for references
Step 3: Comparative evaluation
- Use the checklist provided in this article
- Request free evaluations from multiple services
- Compare not only costs but also the quality offered
Step 4: Informed decision
- Choose the service that best meets your priority needs
- Don’t delay your decision if the situation requires it
- Make sure you understand all aspects of the service
Step 5: Continuous monitoring
- Regularly evaluate the effectiveness of the service
- Report any problems promptly
- Don’t hesitate to change if necessary
The value of an informed choice
An informed choice of home care service can radically transform the care experience for the patient and the quality of life for the whole family. It is not just about receiving healthcare services, but about building a relationship of trust that accompanies the person throughout their care journey.
As Alessio Branca of CAD Healthcare often says: “Technology and skills are important, but what really makes the difference is attention to the person. Every patient has a unique story, and our job is to respect that uniqueness while providing the best possible care. Technology is enabling, not a substitute.”
Remember: you have the right to receive quality care that is personalized and respectful of your dignity. Don’t settle for less.
For a free, personalized consultation:
CAD Healthcare – Home Care and Assistance in Ticino
The right choice for your family
