Home Health Aides: Schools and Careers

About Home Health Aides

Home Health Aides

A Home Health Aide (HHA) may also be known as a Home Caregiver, Certified Nursing Assistant (CNA), or Residential Assistant (RA). An HHA provides basic, personal care and health-related services to a variety of individuals (patients) who require more assistance than family and/or friends are able to provide. HHAs are part of a category of occupations that is commonly referred to as "direct care workers." The services/care that a Home Health Aide provides depends upon their specialty area.

A Registered Nurse (RN), Physical Therapist (PT), other health professional, Social Worker, or home health agency generally gives assignments and duties to a Home Health Aide. For each patient, an HHA is responsible for recording services performed, as well as the patient's condition and progress. They also record and report any changes in a patient's condition to the case manager or supervisor and also discuss observations with them.

The types of patients with whom a Home Health Aide may work include:

• the elderly
• physically disabled
• terminally ill
• convalescent persons
• hospice patients
• individuals with long-term illness
• adults with mental disabilities (e.g., Alzheimer's disease)
• children with mental illness

An HHA generally works in a patient's private home or residential care facility by assisting with, and performing, a variety of duties that include:

• checking temperature, pulse, and respiration rates
• changing (surgical) dressings
• assisting with prescribed exercises
• helping to move patients in and out of bed, chairs, baths, wheelchairs, and autos
• administering prescribed medications
• providing psychological and emotional support
• reading aloud to, or conversing with, patients (for mental health maintenance)
• purchasing and preparing meals (at times following a prescribed diet)
• dressing
• grooming
• personal hygiene (e.g., bathing)
• changing bed linens

Home Health Aides also perform a variety of housekeeping chores such as cleaning, laundry, and grocery shopping. Also, depending on their assignment, an HHA may be responsible for picking up prescriptions and/or transporting a patient to scheduled doctors' appointments, or any other venue the patient wishes to go.

Home Health Aide Job Characteristics

While some HHAs work part-time, the majority work a full-time, 40-hour workweek. Many may also work nights, evenings, weekends, and holidays for patients who require round-the-clock care. If not self-employed, Home Health Aides are typically employed by state or county welfare agencies, or private home health agencies.

More often than not, Home Health Aides have heavy workloads that include physical demands such as walking and standing for long periods of time. Also, because an HHA may be required to move clients from one spot to another and assist in standing and walking, it is very important that they learn and practice correct procedures for lifting and moving patients. Other hazards that an HHA may encounter in this occupation include minor infections and major diseases (e.g., hepatitis). It is important to note, however, that infections can be avoided by adhering to proper procedures. There are also duties performed by an HHA that most individuals would consider unpleasant, such as changing soiled bed linens and emptying bedpans.

Most Home Health Aides simultaneously work with a variety of patients where the duration of each assignment may last anywhere from a few hours, days, or weeks. During a given day, many will drive from one patient to another. There are also HHAs who work with the same patient at their residence for many months or years.

While physical and emotional demands are part of this occupation, most HHAs find it gratifying to enhance the lives and help those in need.

Individuals in this profession must possess and exude the following characteristics, attributes, and abilities:

• patience
• dependability
• precision and accuracy
• emotional stability
• sensitivity
• honesty
• discretion
• strong communications abilities
• good physical health (including strength to lift, carry, push, pull)
• service oriented
• socially perceptive
• problem recognition/sensitivity/solving
• ability to work as part of a team

Employment Outlook

The U.S. Department of Labor Bureau of Labor Statistics (USDL BLS), which combines employment forecasting for Home Health Aides with Nursing and Psychiatric Aides, projects that overall employment is anticipated "to grow 28 percent between 2006 and 2016, much faster than the average for all occupations." Growth will vary between these individual occupations. Furthermore, according to the USDL BLS, for Home Health Aides specifically, the following factors will contribute to the "much-faster-than-average employment growth:"

• increasing demand from the aging population for in-home services
• cost containment efforts focused on moving patients (as quickly as possible) out of nursing care facilities and hospitals
• preference by consumers for in-home care services
• medical technology advancements for in-home treatment

Home Health Aide Training, Certification, and Licensing

While neither a high school diploma nor formal education is a requirement in this profession, it is advantageous for an individual to have at least achieved a high school diploma or equivalent. Some employers provide classroom training for new hires, but most individuals receive on-the-job training under the tutelage of RNs, Licensed Practical Nurses (LPNs), or other seasoned/experienced HHAs. The latter form of Home Health Aide training may take anywhere from several days to a few months to complete. Other training available to Home Health Aides includes workshops, lectures, and in-service training. Once a Home Health Aide completes training, it is not uncommon that they be required to go through a competency evaluation to ensure that they can properly perform required tasks.

It is important to note that HHAs, who work for employers who receive Medicare reimbursement, must adhere to specific Federal Government guidelines. As such, HHAs are required by Federal law to pass a competency test that covers a wide range of disciplines; training may be obtained beforehand. Furthermore, a Home Health Aide may seek voluntary certification from the National Association for Home Care and Hospice (NAHC). Licensing as a Certified Nursing Assistant (CNA) may be required by some states.

When it comes to advancement, opportunities are limited. Moving on to health occupations generally requires formal education or training. Most HHAs move on to become RNs, Medical Assistants, or LPNs.

Resource for Home Health Aides

• National Association for Home Care and Hospice (NAHC)

Major Employers of Home Health Aides

Schools for Home Health Aides are listed in the column to the left.

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