Home Health Aides and Personal and Home Care Aides

There are roughly 1.7 million home health aides and personal and home care aides in the United States. Job-growth indicators suggest that over the next ten years, the job will grow by an amazing 50 percent, far beyond the average growth for all jobs combined and making it among the fastest-growing occupations.
Home health, personal and home care aides help individuals who need assistance because of age, disability, chronic illness, or cognitive impairment. Clients live in residential facilities or their own homes, as well as in hospice facilities or day programs. Seniors, physically or mentally incapacitated clients who require care beyond what family or volunteers can offer, and newly discharged patients with short-term needs are among the populations these aides serve.

Aides assist with housekeeping chores and meal preparation. Some help clients bathe, wash their hair, get dressed, and groom themselves. Others go with clients to run errands or visit the doctor. Home health, personal and home care aides share information about cleanliness, nutrition, household chores, paying bills, and etiquette. Some aides visit the same clients daily or weekly over an extended period, serving several clients a day. Others work with a single client who needs focused attention.
Home health aides work for certified agencies that receive government funding, such as hospices and home health agencies. Aides working for these institutions are supervised by a medical professional and must document services given, client progress, and client condition.

Home health aides check a client’s temperature, pulse, and blood pressure and respiration rates, support clients as they complete prescribed exercises, and assist clients with medication dispensation. If the situation requires it, they can change dressings, massage sore muscles, clean skin, apply lotions or medicated creams, or help clients attach or remove braces or artificial limbs. Some home health aides undergo special training to learn how to assist with medical devices like ventilators.
Personal and home care aides are employed by agencies providing home care services. These aides, under the supervision of a licensed nurse or a nonmedical manager, are given detailed assignments containing information on when to visit and what services to provide. Although they work under supervision, they meet with their managers only occasionally; for the most part, personal and home care aides work independently. Schedules can vary. Some aides visit a single client in a day; others are responsible for several. Personal and home care aides can also be employed by families or the client. Direct-support professionals are personal and home care aides who specialize in working with developmentally delayed or intellectually disabled clients. Their tasks include instruction in self-care skills and employment support.

Aides spend a great deal of their time on their feet. They must have the strength to lift or support clients, help them into and out of beds and bathtubs, or walk; these activities can lead to skeletal or muscular distress unless the aide follows safety protocol. Aides may be exposed to infectious diseases within clients’ homes and in larger settings. Other drawbacks to this occupation include unpleasant tasks such as emptying bedpans and cleaning client accidents when they fail to reach the bathroom. Some clients will be uncooperative or angry; a few may become violent. Aides must have stamina, remain calm regardless of the situation, and multitask. Empathy and understanding are required for this type of work.

Aides who make home visits may find themselves in unclean, cluttered, dim surroundings or in clean, brightly lit homes. Those who work in hospices or care facilities have clean, well lit surroundings. Hours can be irregular and include evening, weekend, and holiday hours.

Certified hospice and home health agencies require home health aides to be formally trained and pass a competency exam in order for the agency to receive Medicare or Medicaid reimbursement. Hospice and home health agency aides must complete a 75-hour training session and pass either a state certification program or undergo a competency assessment.

Sixteen supervised training hours are required before an aide works directly with a resident. The competency exam can be taken prior to any formal training. In addition to these federal requirements, some states require additional hours for certification.

National voluntary certification is offered by the National Association for Home Care and Hospice (NAHC), which documents competency in 17 skills and requires passing a written exam. This may help in obtaining a position. In terms of advancement, aides can undergo additional training to become nursing aides or licensed practical nurses. Aides with business experience might start their own agency.
The median hourly pay for personal and home care aides is around $10. Those in the midrange earn between $8 and $11 per hour. Those at the high end make more than $12 per hour.
The median hourly pay for home health aides is around $10. Those in the midrange earn between approximately $9 and $12 per hour. The highest paid earn just over $14 per hour.