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Home Care Aide
Employment | Training | Other Qualifications
Advancement | Job Outlook | Earnings | Related Occupations
Sources of Additional Information
Excellent job opportunities are expected, due to rapid employment growth and high replacement needs. Almost a third of personal and home care aides work part time; most aides work with a number of different clients, each job lasting a few hours, days, or weeks.
Occupational characteristics include low skill requirements, low pay, and high emotional demands.
Nature of the Work
Personal and home care aides help elderly, disabled, and ill persons live in their own homes or in residential care facilities instead of in a health facility. Most personal and home care aides work with elderly or disabled clients who need more extensive personal and home care than family or friends can provide. Some 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. (Home health aides—who provide health-related services, rather than mainly housekeeping and routine personal care—are discussed in the statement on nursing, psychiatric, and home health aides, elsewhere in the Handbook.)
Personal and home care aides—also called homemakers, caregivers, companions, and personal attendants—provide housekeeping and routine personal care services. They clean clients’ houses, do laundry, and change bed linens. Aides may plan meals (including special diets), shop for food, and cook. Aides also may help clients move from bed, bathe, dress, and groom. Some accompany clients outside the home, serving as a guide and companion.
Personal and home care aides provide instruction and psychological support to their patients. They may advise families and patients on such things as nutrition, cleanliness, and household tasks. Aides also may assist in toilet training a severely mentally handicapped child, or they may just listen to clients talk about their problems.
In home healthcare agencies, a registered nurse, physical therapist, or social worker assigns specific duties and supervises personal and home care aides. Aides keep records of services performed and of clients’ condition and progress. They report changes in the client’s condition to the supervisor or case manager. In carrying out their work, aides cooperate with other healthcare professionals, including registered nurses, therapists, and other medical staff.
The personal and home care aide’s 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, whereas others are untidy or depressing. Some clients are pleasant and cooperative; others are angry, abusive, depressed, or otherwise difficult.
Personal and home 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 for them. Almost a third of aides work part time, and some work weekends or evenings to suit the needs of their clients.
Aides are individually responsible for getting to the client’s home. They may spend a good portion of the working day traveling from one client to another. Because mechanical lifting devices that are available in institutional settings are seldom available in patients’ homes, aides must be careful to avoid overexertion or injury when they assist clients.
Personal and home care aides held about 608,000 jobs in 2002. The majority of jobs were in home healthcare services, individual and family services, private households, and residential mental retardation, mental health, and substance abuse facilities. 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 who have no formal training. On-the-job training is then generally provided. Other States may require formal training. The National Association for Home Care offers national certification for personal and home care aides. Certification is a voluntary demonstration that the individual has met industry standards.
Successful personal and home care aides like to help people and do not mind hard work. They should be responsible, compassionate, emotionally stable, and cheerful. In addition, aides should be tactful, honest, and discreet, because they work in private homes. Aides also must be in good health. A physical examination, including State-mandated tests, such as those for tuberculosis, may be required.
Advancement for personal and home care aides 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.
Excellent job opportunities are expected for this occupation, as rapid employment growth and high replacement needs produce a large number of job openings.
Employment of personal and home care aides is projected to grow much faster than the average for all occupations through the year 2012. The number of elderly people, an age group characterized by mounting health problems and requiring some assistance, is projected to rise substantially. In addition to the elderly, however, patients in other age groups will increasingly rely on home care, a trend that reflects several developments, including efforts to contain costs by moving patients out of hospitals and nursing care facilities as quickly as possible, the realization that treatment can be more effective in familiar rather than clinical surroundings, and the development and improvement of medical technologies for in-home treatment.
In addition to job openings created by the increase in demand for these workers, replacement needs are expected to produce numerous openings. The relatively low skill requirements, low pay, and high emotional demands of the work result in high replacement needs. For these same reasons, many people are reluctant to seek jobs in the occupation. Therefore, persons who are interested in and suited for this work—particularly those with experience or training as personal care, home health, or nursing aides—should have excellent job opportunities.
Median hourly earnings of personal and home care aides were $7.81 in 2002. The middle 50 percent earned between $6.65 and $9.06 an hour. The lowest 10 percent earned less than $5.90, and the highest 10 percent earned more than $10.67 an hour. Median hourly earnings in the industries employing the largest numbers of personal and home care aides in 2002 were as follows:
Residential mental retardation, mental health and substance abuse facilities $8.63
Vocational rehabilitation services 8.40
Community care facilities for the elderly 8.14
Individual and family services 8.12
Home health care services 6.72
Most employers give slight pay increases with experience and added responsibility. Aides usually are paid only for the time they work in the home and normally are not paid for travel time between jobs. Employers often hire on-call hourly workers and provide no benefits.
Personal and home care aide is a service occupation combining the duties of caregivers and social service workers. Workers in related occupations that involve personal contact to help others include childcare workers; nursing, psychiatric, and home health aides; occupational therapist assistants and aides; and physical therapist assistants and aides.
Sources of Additional Information
General information about training, referrals to State and local agencies about job opportunities, a list of relevant publications, and information on certification for personal and home care aides are available from:
National Association for Home Care, 228 7th St. SE., Washington, DC 20003. Internet: http://www.nahc.org
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