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Home Health and Personal Care Aides
Nature of the Work | Working Conditions | Employment | Training, Other Qualifications, and Advancement | Job Outlook | Earnings | Related Occupations | Sources of Additional Information
Home health and personal care aides help elderly, disabled, and ill persons live in their own homes instead of in a health facility. Most work with elderly or disabled clients who need more extensive care than family or friends can provide. Some home health and personal care aides work with families in which a parent is incapacitated and small children need care. Others help discharged hospital patients who have relatively short-term needs.
In general, home health aides provide health-related services, such as administering oral medications under physicians orders or direction of a nurse. In contrast, personal care and home care aides provide mainly housekeeping and routine personal care services. However, there can be substantial variation in job titles and overlap of duties.
Most home health and personal care aides provide some housekeeping services, as well as personal care to their clients. They clean clients houses, do laundry, and change bed linens. Some aides plan meals (including special diets), shop for food, and cook. Home health and personal care aides may also help clients move from bed, bathe, dress, and groom. Some accompany clients outside the home, serving as guide, companion, and aide.
Home health and personal care aides also provide instruction and psychological support. For example, they may assist in toilet training a severely mentally handicapped child, or just listen to clients talk about their problems.
Home health aides may check pulse, temperature, and respiration; help with simple prescribed exercises; and assist with medication routines. Occasionally, they change nonsterile dressings, use special equipment such as a hydraulic lift, give massages and alcohol rubs, or assist with braces and artificial limbs.
In home care agencies, it is usually a registered nurse, a physical therapist, or a social worker who assigns specific duties and supervises home health and personal care aides. Aides keep records of services performed and of clients condition and progress. They report changes in the clients condition to the supervisor or case manager. Home health and personal care aides also participate in case reviews, consulting with the team caring for the clientregistered nurses, therapists, and other health professionals.
The home health and personal care aides daily routine may vary. Aides may go to the same home every day for months or even years. However, most aides work with a number of different clients, each job lasting a few hours, days, or weeks. Aides often visit four or five clients on the same day.
Surroundings differ from case to case. Some homes are neat and pleasant, while others are untidy or depressing. Some clients are angry, abusive, depressed, or otherwise difficult; others are pleasant and cooperative.
Home health and personal care aides generally work on their own, with periodic visits by their supervisor. They receive detailed instructions explaining when to visit clients and what services to perform. Many aides work part time, and weekend hours are common.
Aides are individually responsible for getting to the clients home. They may spend a good portion of the working day traveling from one client to another; motor vehicle accidents are always a danger. They are particularly susceptible to injuries resulting from all types of overexertion when assisting patients, and falls inside and outside their homes. Mechanical lifting devices that are available in institutional settings are seldom available in patients homes.
Home health and personal care aides held about 746,000 jobs in 1998. Most aides are employed by home health and personal care agencies, visiting nurse associations, residential care facilities with home health departments, hospitals, public health and welfare departments, community volunteer agencies, nursing and personal care facilities, and temporary help firms. Self-employed aides have no agency affiliation or supervision, and accept clients, set fees, and arrange work schedules on their own.
In some States, this occupation is open to individuals with no formal training. On-the-job training is generally provided. Other States may require formal training, depending on Federal or State law.
The Federal Government has enacted guidelines for home health aides whose employers receive reimbursement from Medicare. Federal law requires home health aides to pass a competency test covering 12 areas: Communication skills; observation, reporting, and documentation of patient status and the care or services furnished; reading and recording vital signs; basic infection control procedures; basic elements of body function and changes; maintenance of a clean, safe, and healthy environment; recognition of, and procedures for, emergencies; the physical, emotional, and developmental characteristics of the patients served; personal hygiene and grooming; safe transfer techniques; normal range of motion and positioning; and basic nutrition.
A home health aide may take training before taking the competency test. Federal law suggests at least 75 hours of classroom and practical training supervised by a registered nurse. Training and testing programs may be offered by the employing agency, but must meet the standards of the Health Care Financing Administration. Training programs vary depending upon State regulations.
The National Association for Home Care offers national certification for home health and personal care aides. The certification is a voluntary demonstration that the individual has met industry standards.
Successful home health and personal care aides like to help people and do not mind hard work. They should be responsible, compassionate, emotionally stable, and cheerful. Aides should also be tactful, honest, and discreet because they work in private homes.
Home health and personal care aides must be in good health. A physical examination including State regulated tests such as those for tuberculosis may be required.
Advancement is limited. In some agencies, workers start out performing homemaker duties, such as cleaning. With experience and training, they may take on personal care duties. The most experienced home health aides assist with medical equipment such as ventilators, which help patients breathe.
A large number of job openings are expected for home health and personal care aides, due to substantial growth and very high turnover. Home health and personal care aides is expected to be one of the fastest growing occupations through the year 2008.
The number of people in their seventies and older is projected to rise substantially. This age group is characterized by mounting health problems requiring some assistance. Also, there will be an increasing reliance on home care for patients of all ages. This trend reflects several developments: Efforts to contain costs by moving patients out of hospitals and nursing facilities as quickly as possible, the realization that treatment can be more effective in familiar surroundings rather than clinical surroundings, and the development and improvement of medical technologies for in-home treatment.
In addition to jobs created by the increase in demand for these workers, replacement needs are expected to produce numerous openings. Turnover is high, a reflection of the relatively low skill requirements, low pay, and high emotional demands of the work. For these same reasons, many people are unwilling to perform this kind of work. Therefore, persons who are interested in this work and suited for it should have excellent job opportunities, particularly those with experience or training as home health, personal care, or nursing aides.
Median hourly earnings of home health and personal care aides were $7.58 in 1998. The middle 50 percent earned between $6.41 and $8.81 an hour. The lowest 10 percent earned less than $5.73 and the highest 10 percent earned more than $10.51 an hour. Median hourly earnings in the industries employing the largest number of home health aides in 1997 were as follows:
Median hourly earnings in the industries employing the largest number of personal and home care aides in 1997 are shown below:
Most employers give slight pay increases with experience and added responsibility. Aides are usually paid only for the time worked in the home. They normally are not paid for travel time between jobs. Most employers hire only "on-call" hourly workers and provide no benefits.
Home health and personal care aide is a service occupation combining duties of health workers and social service workers. Workers in related occupations that involve personal contact to help or instruct others include attendants in childrens institutions, childcare attendants in schools, child monitors, companions, nursing aides, nursery school attendants, occupational therapy aides, nursing aides, physical therapy aides, playroom attendants, and psychiatric aides.
Disclaimer: Links to non-BLS Internet sites are provided for your convenience and do not constitute an endorsement.
General information about training and referrals to State and local agencies about opportunities for home health and personal care aides, a list of relevant publications, and information on national certification are available from:
For information about a career as a home health aide and schools offering training, contact:
Selected industries employing home health and personal care aides that appear in the 2000-01 Career Guide to Industries:
Last Updated: March 30, 2000
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