It’s written to match your principled, solo-provider model—non-clinical but deeply responsible. It gives you legal clarity, emotional protection, and family-facing reassurance. This should be documented internally, referenced in the client agreement, and included in onboarding with Addendum A.

Purpose

This plan outlines how Cedar & Iron will respond to client incidents, visible decline, safety risks, or emotional distress observed during visits or calls. It ensures a calm, documented, and principle-based response without assuming clinical or legal responsibility.

Escalation Guiding Principles

  1. Preserve Dignity – Act discreetly and respectfully, never panic clients or override them without cause.
  2. Empower, Don’t Enable – Involve the client in decisions whenever possible.
  3. Consistency Builds Trust – Follow the same pattern each time, so clients and families know what to expect.
  4. Support the Ecosystem – Flag issues early to reduce crisis management later.
  5. Be Seen, Not Loud – Intervene quietly, log everything, and never act impulsively.

Trigger Categories & Response Tiers

Trigger Type Examples Immediate Action Follow-Up
Medical Emergency Fall, chest pain, confusion, bleeding Call 911 → Contact emergency contact Complete internal incident log → Send brief written summary to family within 24 hrs
Safety Concern (non-urgent) Loose rugs, clutter, spoiled food, missing handrail Flag in visit notes → Suggest correction to client Include in next monthly family update and safety checklist
Behavioral or Cognitive Change Memory lapse, mood shift, paranoia, disorientation Observe & document → Ask client how they’re doing → Notify family within 48 hrs Recommend care escalation if decline persists
Emotional or Social Crisis Loneliness, crying, anxiety, expressions of grief Gently support → Offer to contact family or clergy Summarize in visit log → Notify family at next summary unless urgent
Client Refuses Care or Escalation Won’t go to doctor, denies fall, won’t eat Respectfully encourage → Document refusal Notify family → “Documented Non-Escalation” tag added to record
Ethical or Legal Concern Elder abuse suspicion, financial exploitation Document → Do not confront Consult legal/reporting guidance within 24 hrs
Family Conflict or Miscommunication Siblings disagree, client feels overruled Do not mediate → Document facts only Send separate update to authorized contact if needed
You Feel Unsafe or Unclear Aggressive behavior, access issues, boundary push Exit politely → Document immediately Notify family and consider pausing visits pending review

Escalation Chain

  1. Client (when safe and conscious)
  2. Primary Emergency Contact (from Addendum A)
  3. Secondary Contact
  4. 911 or Adult Protective Services (if legal duty or emergency requires)

Documentation Requirements