Scope Boundaries & Escalation Policy

Internal Only

Purpose

Define what you do, what you do not do, and how situations are escalated—so clients receive appropriate support while responsibility and risk remain clear.

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In Scope (What You Do)

You provide non-clinical advocacy, stewardship, and coordination to help an aging person get the support they need and help families stay informed and aligned.

In scope includes:

 • Regular presence, visits, and check-ins

 • Observing and reporting changes or patterns

 • Explaining information in plain language

 • Helping the client articulate needs and concerns

 • Advocating with others so the client is heard and supported

 • Helping with small practical tasks when needed

 • Coordinating help the client or family has agreed to

 • Making sure the right people are involved as needs arise

 • Updating family with clear, factual information

Core rule:

You help the client be supported, not be replaced.

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Out of Scope (What You Do Not Do)

Out of scope includes:

 • Medical, legal, or financial decision-making

 • Diagnosis, treatment, or hands-on caregiving

 • Emergency response or crisis care

 • Medication management or administration

 • Acting as power of attorney, guardian, or fiduciary

 • Signing, authorizing, or consenting on the client’s behalf

 • Managing ongoing family conflict

 • Providing constant supervision or guaranteeing safety

Hard line:

If the task requires you to make decisions for the client or carry ongoing risk, it is out of scope.

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Urgent Situations (Immediate Risk)

Urgent situations involve immediate risk to life, safety, or property.

When urgency occurs:

 1. Prioritize safety and contact emergency services if needed

 2. Notify the designated family contact

 3. Document the situation as an Incident

 4. Trigger a Review / Decision

You escalate to the appropriate professionals; you do not attempt to resolve emergencies yourself.

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Escalation (Non-Urgent but Concerning)

Escalation is not a service state. It is a signal that the situation needs reassessment.

Escalation triggers include:

 • Increasing difficulty meeting daily needs

 • Repeated safety concerns

 • Growing reliance beyond agreed scope

 • Boundary pressure or role confusion

 • Signs that additional support is needed

When escalation occurs:

 • Document the concern

 • Set Review Required = Yes

 • Reassess scope, tier, and supports

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Outside Support

Outside professionals are engaged when:

 • Specialized or licensed help is needed

 • Needs exceed non-clinical support

 • Ongoing care or supervision is required

Your role is to:

 • Help identify appropriate support

 • Coordinate and follow up

 • Advocate so the client’s needs are understood

 • Maintain continuity and communication

You ensure help is present; you do not become the help.

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Loss of Fit (When Service Is No Longer Appropriate)

A client is no longer a fit when:

 • Needs require clinical or continuous care

 • Boundaries cannot be maintained

 • The service becomes unsustainable

 • Safety depends on your constant presence

When fit is lost:

 • Conduct Review / Decision

 • Adjust tier or transition out

 • Support a clean handoff

Exiting is a responsible outcome when support needs exceed scope.

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Final Guardrail

If the client’s safety or well-being would depend on you being there all the time, the situation is out of scope.