How CAD Healthcare solves the most common problems that lead families in Ticino to change their home care service
Critical areas of home care in Ticino
“Every day a different person comes, they don’t even know who I am or what I need. I feel like a number, not a person.” These are the words of M., 78, who after months of frustration with his previous Spitex service decided to turn to CAD Healthcare. His story is not an isolated one: more and more families in Ticino are finding themselves having to change home care services due to dissatisfaction that seems to have become the norm rather than the exception.
But what really drives families to change? What are the most common frustrations? And above all, how can you find a service that truly meets your needs? In this article, we will explore the most frequently asked questions we receive from people who turn to CAD after negative experiences with other services, and explain how our innovative approach can make a difference in the daily lives of patients and families.
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“Why does a different person come to assist me every day?”
This is probably the question we hear most often during our initial interviews with families. The lack of continuity in care has become one of the most serious problems in the home care sector in Ticino.
The problem of continuity in home care
Continuity of care is not just a matter of comfort: it is a fundamental element of quality care. When a different caregiver arrives every day, in-depth knowledge of the patient, their habits, preferences, and, above all, their specific clinical condition is lost. This leads to several negative consequences:
- Loss of crucial information: Each new caregiver has to start from scratch, without knowing the patient’s recent history
- Emotional stress: For many elderly people, having to explain their situation to strangers every time becomes a source of anxiety
- Inefficiency in care: Time is spent getting oriented rather than providing quality care
- Lack of trust: It becomes impossible to build the relationship of trust that is essential for effective care
How CAD manages continuity of care
At CAD Healthcare, we have made continuity of care one of our fundamental pillars. Our approach is based on a few key principles:
- Dedicated teams: After a careful initial assessment, CAD defines a minimum number of staff per function, necessary to ensure proper daily coverage based on the needs, type, and number of daily interventions.
- Personalized case managers: Each family has a dedicated case manager (coordinating nurse) who coordinates all interventions and maintains continuity of information between the various team members and all professionals and institutions involved in the care process.
- Shared digital dossier: We use an advanced digital system that allows all team members to access up-to-date patient information in real time, ensuring that no detail is lost.
As Alessio Branca, founder of CAD, says: “I remember a lady who said to me: ‘Finally, I can call the person who takes care of me by name’. For us, this is true success: when patients feel at home even during their care.”
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“Why are healthcare professionals always in a hurry and looking at their watches?”
Another recurring complaint is the feeling that staff are always in a hurry, constantly looking at their watches, and that visits are timed to the minute. This perception is not unfounded: many traditional services operate with very strict schedules that do not take into account the individual needs of the patient.
The problem of timed home visits
The pressure on response times has several structural causes:
- Patient overload: Operators have to visit too many patients in a day
- Lack of flexibility: Schedules are rigid and do not allow for adjustments
- Staff stress: Operators feel under pressure, and this is reflected in the quality of their relationship with patients
This “industrial” approach to home care transforms what should be a moment of care and attention into a race against time, where the patient feels more like a task to be completed than a person to be cared for.
The CAD approach: the time needed to care for the person
At CAD Healthcare, we have completely reversed this philosophy. Thanks to our years of experience, our principle is to be able to plan each intervention according to a catalog of services, based on actual care and assistance needs.
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- Personalized assessment of time: Before starting care, we conduct a thorough assessment that takes into account not only clinical needs but also the patient’s lifestyle, habits, and preferences.
- Planned flexibility: Our schedules allow for flexibility, enabling our staff to adapt to the needs of the moment without creating stress or delays in subsequent visits.
- Quality before quantity: We guarantee everyone the attention and time they deserve, rather than maximizing the number of daily visits.
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“No one coordinates anything: I have to do everything myself.”
One of the biggest frustrations for families is the feeling of having to personally manage coordination between different professionals and services. Family doctors, specialists, physical therapists, pharmacies, and laboratories: often, each person works in isolation, leaving the patient or family members to act as intermediaries.
Lack of care coordination
The complexity of the healthcare system in Ticino can turn managing care into a real bureaucratic maze:
- Fragmented communication: Each professional has their own information, but there is rarely any effective exchange
- Overlapping appointments: Lack of coordination in schedules creates conflicts and stress
- Contradictory prescriptions: Different doctors may prescribe treatments that are not coordinated with each other
- Diffused responsibility: When something goes wrong, no one takes responsibility for overall coordination
As E., the daughter of a cancer patient, explains: “My father had appointments with his oncologist, cardiologist, physiotherapist, and nurse. Everyone gave me different instructions, the schedules overlapped, and I spent my days on the phone trying to organize everything. It had become a full-time job.”
The Healthcare Family Office (HFO) service: CAD’s organizational response
To meet this need, CAD Healthcare has developed the Healthcare Family Office (HFO) service, an innovative approach that puts coordination at the center of care.
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- A single point of contact: The HFO case manager becomes the sole point of contact for the family, coordinating all aspects of healthcare and drastically simplifying day-to-day management.
- Centralized coordination: All appointments, therapies, tests, and visits are coordinated through a single hub, avoiding overlaps and optimizing time.
- Integrated communication: The case manager maintains contact with all the professionals involved, ensuring that information flows correctly and that decisions are taken in a coordinated manner.
- Proactive management: We don’t just respond to emergencies; we anticipate needs, plan interventions, and constantly monitor the evolution of the situation.
A case in point is that of R., 75, who has diabetes, heart problems, and mobility issues. Before turning to CAD, his wife had to manage:
- Monthly diabetes appointments
- Quarterly cardiology check-ups
- Twice-weekly physical therapy
- Weekly blood tests
- Dressings for diabetic ulcers
- Management of complex drug therapy
With the HFO service, A. has a single number to call. The case manager coordinates everything: they schedule appointments logically, accompany R. to appointments when necessary, monitor vital signs at home, manage prescriptions, and keep all doctors informed of developments. “It’s like having a doctor for a son who takes care of everything,” says Anna. “I can finally be a wife again, not a nurse and a secretary.”
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“The Spitex services I turned to didn’t understand complex situations.”
Many families turn to CAD after experiencing the inadequacy of other services in managing clinically complex situations. Not all patients have standard needs, and when conditions are unique or multiple, a level of expertise and flexibility is required that not all services can offer.
What makes a care situation “complex”
Complex situations in the home can take many forms:
- Multimorbidity: Patients with multiple chronic conditions that interact with each other
- Rare conditions: Uncommon diseases that require specific protocols
- Clinical instability: Situations that can deteriorate rapidly
- Technological requirements: Need for advanced medical devices or continuous monitoring
- Social complexity: Difficult family situations or social isolation
- Resistance to care: Patients who refuse or have difficulty accepting assistance
CAD’s expertise in complex situations
CAD Healthcare specializes in the management of these difficult cases, developing specific skills and protocols:
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- Specialized multidisciplinary team: Our operators receive ongoing training to manage complex situations and always work in teams with different complementary skills.
- Personalized protocols: For each complex situation, we develop specific intervention protocols, which are constantly updated as the case evolves.
- Advanced technologies: We use state-of-the-art monitoring devices that allow us to detect changes in the patient’s condition at an early stage.
- Network of specialists: We have preferential access to a network of specialists and consultants who can intervene quickly when necessary.
- Emergency management: Our team is trained to handle emergencies and can respond 24 hours a day, 365 days a year.
A significant example is the case of F., a 68-year-old woman with progressive multiple sclerosis with episodes of dysphagia (difficulty swallowing) and frequent respiratory infections. The previous Spitex service was unable to manage the complexity of the situation: the operators were not trained to recognize the early signs of deterioration, did not know how to manage safe feeding, and often found themselves unprepared when faced with respiratory crises.
CAD developed a specific protocol for F. that includes:
- Continuous monitoring of respiratory parameters with devices connected to the operations center
- Specific training for operators on dysphagia management
- Emergency protocols for respiratory crises
- Close coordination with a pulmonologist and neurologist
- Specialized nutritional support
The result has been a drastic reduction in hospital admissions (from 6 per year to 1 in the last 18 months) and a significant improvement in quality of life for both F. and his family.
Find out more about the advantages of home care over hospitalisation
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“When I need them, they’re never there.”
Availability is another sore point for many families. Too often, traditional services operate on a rigid schedule that does not take into account the fact that care needs do not follow a set calendar. Emergencies can happen at night, on weekends, or during holidays, when many services are unavailable.
Limited availability and long wait times
Most traditional Spitex services operate according to schedules that prioritize internal organization over the actual needs of patients:
- Office hours: Many services are only available during standard business hours.
- Weekends and holidays not covered: When families are most alone, services are often unavailable
- Long response times: When an emergency arises, waiting times can be unacceptable
- Rigid scheduling: Difficulty in changing times or frequency of visits to meet changing needs
As M., the son of an Alzheimer’s patient, explains: “My father had a behavioral crisis on Sunday evening. I called the Spitex service and they told me to go to the emergency room. But taking someone with dementia to the hospital is traumatic for everyone. I needed someone who understood the situation and knew how to handle it.”
CAD Healthcare’s 24-hour service guarantees rapid availability
CAD Healthcare has made continuous availability one of its hallmarks:
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- 24/7/365 service: we are available 24 hours a day, 7 days a week, 365 days a year. There are no closing times for medical emergencies.
- Always active operations center: Our operations center is constantly staffed by qualified personnel who can assess the situation and activate the most appropriate response.
- Guaranteed response times: We are committed to responding within 2 hours of notification for urgent cases and within 20 minutes for emergencies.
- Flexible scheduling: Our care plans can be quickly modified based on changes in the patient’s condition.
- On-call team: We always have specialized on-call teams who know our patients and can respond even outside of standard hours.
A real-life example: G., 45, cares for his 89-year-old mother who has heart failure. One Saturday evening, the woman began to have difficulty breathing. G. called CAD and within 30 minutes a specialist nurse was at the house, assessed the situation, contacted the cardiologist on call and managed the crisis, avoiding hospitalization. “I don’t know what I would have done without them,” says G. “Knowing that I can call at any time gives me peace of mind that is priceless.”
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“They treat me like a number, not a person.”
Perhaps the most painful criticism we hear concerns the loss of the human dimension in care. Many patients feel reduced to a series of tasks to be performed, rather than being seen as people with a history, emotions, and needs that go beyond the purely clinical.
The dehumanization of care
Several factors contribute to this perception of dehumanization:
- Time pressure: When caregivers are in a hurry, there is no room for listening and empathy
- High turnover: Constant staff changes prevent meaningful relationships from being built
- Standardized approach: Rigid protocols that do not take into account the individuality of the patient
- Lack of interpersonal training: Excessive focus on technical aspects at the expense of human aspects
- Work overload: Stressed caregivers who are unable to devote attention to the person
As A., 83, says: “They come in, do what they have to do, and leave. They never ask me how I am, if I slept well, or if I need anything. I feel invisible in my own home.”
CAD’s human approach: the person at the center of care
At CAD Healthcare, we have made a human and personalized approach our hallmark:
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- Time to listen: Each visit always includes time dedicated to actively listening to the patient, to understand not only their clinical needs but also their emotional and social needs.
- In-depth knowledge: Our staff know our patients’ life stories, their habits, preferences, and fears. This allows us to truly personalize the care we provide.
- Ongoing training in empathy: Our staff receive specific training in interpersonal and communication skills, not just technical skills.
- Flexibility in our approach: We adapt our way of working to the personality and preferences of each patient, respecting their rhythms and habits.
- Active involvement: The patient is not a passive recipient of care but is actively involved in decisions that affect them.
A touching example is that of P., 76, recently widowed, who, in addition to assistance with diabetes, needed above all company and someone to listen to him. With the previous service, the caregiver would arrive, check his blood sugar, prepare his insulin, and leave within 10 minutes. Pietro felt increasingly isolated and depressed.
With CAD, the caregiver spends time with Pietro: she listens to him when he talks about his memories with his wife, involves him in the preparation of his care plan, and encourages him to continue his favorite activities. “She’s not just a nurse,” says Pietro, “she’s become a bit like a daughter. She knows when I need to talk and when I prefer silence. She makes me feel like I’m still an important person.”
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“They don’t know how to handle emergencies.”
A crucial aspect of home care is the ability to recognize and manage emergencies promptly. Many families have had the traumatic experience of facing an emergency with caregivers who were unprepared or unauthorized to intervene.
Limitations in emergency management in local services
The most common problems in emergency management include:
- Lack of specific training: Not all operators are prepared to recognize the signs of an emergency
- Inadequate protocols: Procedures that do not provide for rapid and effective management of emergencies
- Authorization limitations: Operators who cannot make decisions or administer life-saving drugs
- Lack of equipment: Absence of essential medical devices for emergency management
- Ineffective communication: Difficulties in coordinating with local emergency services
Advanced CAD emergency management
CAD Healthcare has developed an integrated system for managing home emergencies:
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- Specialized training: All our operators receive specific training in the early recognition and management of the most common emergencies in the home.
- Advanced emergency kits: Our teams are equipped with first aid kits that include portable diagnostic devices, life-saving drugs, and equipment for stabilizing patients.
- Customized emergency protocols: We develop specific protocols for each patient at risk, enabling rapid and targeted intervention.
- Connection to the operations center: Our operators are always in contact with the operations center, which can provide decision support and coordinate the intervention of specialists.
- Integrated emergency network: Over time, we have built an ecosystem of local emergency services that enable optimal coordination of interventions.
A case in point is that of C., 71, with a history of myocardial infarction. During a routine visit, the CAD operator recognized the early signs of a new cardiac episode: atypical chest pain, sweating, and changes in the portable ECG. He immediately activated the emergency protocol, administered the life-saving therapy prescribed by the cardiologist, alerted the operations center, and coordinated the ambulance response. Thanks to the timely intervention, C. was stabilized before arriving at the hospital, avoiding serious complications.
“If it hadn’t been for the CAD operator’s training,” says the cardiologist who followed the case, “we would probably have had a very different outcome. The difference between a trained operator and one who is not can literally be a matter of life and death.”
Testimonials from those who opted for change and chose CAD
The stories we have told are not isolated cases, but represent the daily experience of many families who have chosen CAD Healthcare after disappointment with other services. Here are some direct testimonials:
The R. family (Lugano) “After two years of hell with the previous Spitex, where a different person arrived every day who didn’t even know why they were there, we discovered CAD. The difference was immediate: my mother finally found peace of mind and we, her family, can sleep soundly knowing that she is in good hands.“
Mrs. E.” My husband has Alzheimer’s, and his condition is very variable. With CAD, we have a team that knows him well and knows how to handle every situation. I no longer have to explain his medical history or habits every time. It’s like having an extended family taking care of him.“
Dr. M., family doctor,” As a doctor, I greatly appreciate CAD’s work. I finally have a partner who understands my prescriptions, keeps me updated on patients’ progress, and knows when to contact me. The quality of care has improved significantly.”
The B. family “When Dad had his stroke, we thought we would have to put him in a nursing home. CAD showed us that even such a complex situation could be managed at home. Today, a year later, Dad has made a lot of progress and, above all, he is happy to be at home.”
Changing Spitex: Are you ready to choose more attentive and responsive home care?
If you recognize yourself in one or more of the situations described in this article, know that you are not alone and that there are alternatives. Changing home care services can seem complicated, but with the right support, the process can be quick and easy.
How to take the first steps
- Free assessment: CAD offers a free consultation to assess your specific situation and identify the most appropriate solutions.
- Gradual transition: There is no need to abruptly discontinue your current service. We can arrange a gradual transition that ensures continuity of care.
- Bureaucratic coordination: We take care of all the bureaucratic aspects, including relations with insurance companies and doctors.
- Personalized plan: Together, we develop a care plan tailored to your specific needs.
When is the right time to change?
Don’t wait until the situation becomes untenable. Here are some signs that it may be time to consider a change:
- You are consistently dissatisfied with the service you receive
- You have to explain the same situation over and over again to different caregivers
- You are unable to get answers to your questions or concerns
- The service is not available when you need it most
- You feel that the patient is treated like a number rather than a person
- The patient’s condition is complex, but does not receive the specialist attention required
What does managing complex cases involve? Find out more about how to deal with advanced home care, even in emergencies
Conclusions: The right to quality home care
Home care is not just a matter of healthcare services: it is also about dignity, respect, and quality of life. Every person has the right to receive care that takes into account their individuality, specific needs, and personal history.
The home care sector in Ticino is transforming, and this transformation is being driven by the needs and expectations of families who are no longer satisfied with standardized and impersonal services.
CAD Healthcare is a concrete response to these needs: a service that puts people at the center, invests in training and technology, guarantees continuity and availability, and is not afraid to tackle the most complex situations.
As Alessio Branca, founder of CAD, says: “Our goal is not only to provide healthcare, but to restore peace of mind to families and dignity to patients. When a family tells us that they can finally sleep peacefully, we know we have made a difference. All this is also possible thanks to a forward-looking vision of continuous proactivity in integrating innovation to support human activity.”
If you are dissatisfied with your current home care service, remember that you have alternatives. You don’t have to compromise on the quality of care for yourself or your loved ones. Change is possible, and it’s often easier than you think.
