At the forefront of home healthcare care are aides and assistants. These people are given various titles, much of which depends on their training program and certification. A caregiver may be referred to as a Home Health Aide (HHA), Certified Nursing Assistant (CNA), Personal Care Attendant (PCA), or Companion (though in most cases a companion will be assigned to those cases requiring more basic levels of care). They are considered “non-medical” caregivers.
Certified caregivers may be considered “non-medical” caregivers, but they are an integral part of home healthcare services. Certification and training do allow for some levels of care and assistance that you might consider medical; in the language of the medical world, it is not generally considered skilled medical care, and therefore is categorized as “non-medical”. To the lay person this may seem like semantic hair-splitting, but it is helpful to know and understand the level at which your caregiver works so that you can better understand what they are and are not allowed to do for you or your loved one.
Without these caregivers, there would be little to no home care. It would be fair to say that often (too often) home health aides, companions, and caregivers are the unsung heroes of private care services. They allow people with catastrophic injuries and chronic conditions to come home (where the best healing takes place) and they allow elders to age in place, with dignity, safely.
It’s Important to Understand Caregiver Roles and Responsibilities
Home health aides often look the part of other healthcare providers. It is easy to mistake them for nurses or those providing higher-level medical services. They may even exhibit a higher level of knowledge gleaned from their years in the field, beyond what their job description describes.
Legally speaking, these providers, for their own protection and for yours/your loved one’s, must adhere to the limits set forth by their employer, their certification, and the state in which they work. This is called “scope of practice.” Expecting care providers to exceed that scope of practice and provide services that do not fall under their purview would be a risk to them and their job; it could potentially be a risk to the care recipient. And so, it is important to understand what does and does not fall under the responsibilities of your caregiver.
An understanding of what a home health aide (such as a CNA, HHA, or PCA) does and doesn’t do will also ensure a more positive experience for you and/or your loved one. When all parties understand the roles that different providers are responsible for, the expectations are much more in line. There is less potential for misunderstanding, stress, and disagreements. You set the stage for mutual respect, quality care, and the best possible outcome for the care recipient.
Types of Care Provided by CNA’s and HHA’s
The list of care and activities performed by home health aides is long and varied. The types of care provided by aides and caregivers can include:
- Perform and assist “Activities of Daily Living” (those things you could normally do to take care of yourself, that are often taken for granted, but which become difficult or impossible for some people)
- Carry out care plans developed by clinical and nursing staff
- Meal preparation, feeding or serving, diet, and nutritional support
- Observe and monitor condition and progress
- Assist and ensure exercise and activity
- Movement and transfer (such as turning for bedridden clients, or transfer from bed to chair, wheelchair, etc.)
- Assist sample collection for laboratory testing
- Take and report vital signs
- Medication reminders
- Assistance with bathing and personal care
- Grooming (hair, nails, shaving)
- Housekeeping and cleaning including sweeping, vacuuming, mopping, cleaning bathrooms, kitchens, and showers
- Household sanitation and sterilization of surfaces
- Shopping and errands
- Supply fulfillment (such as communicating and initiating the ordering of durable medical goods and other care supplies via agency clinical staff and administration)
- Conversation and companionship
- Communicate with supervisors, nurses, agency administration, and other care staff
- Be a second set of “eyes and ears” and work closely with Clinical Directors and staff to ensure all are updated and that the level of care and services remains appropriate
- Speak in general terms with family members who are present in the home about the client’s day, appetite, observations, etc. Note that most direct communication with family will come through the administration and clinical staff, though certainly caregivers will communicate with family if they are in the home together. For example, at the end of a shift or during a visit. Caregivers should not be expected or asked to discuss issues that fall under the responsibility of medical care providers, administration, or clinical staff.
Each Case Its Own
These are the services that fall under the responsibility of a caregiver, but that does not mean that your caregiver will necessarily do all of them—at least not without an agreement or understanding. Each case can be different. The terms of your contract may differ from another’s, even when services are provided by the same home care agency.
For example, if you have contracted for full-time care every day of the week, it is reasonable to expect that more from the list of services will be rendered. More limited contracts mean less time, though, and so in that case the responsibilities may be shared with the care receiver (dependent on their needs and abilities) or with other members of the recipient’s family.
In some situations, a caregiver may run errands and go grocery shopping. In others, this may be a responsibility of members of the family. Much of this will depend on the situation—is your mother or father able to be left alone for long periods of time for a caregiver to run out for shopping and errands? Or do they always need a caregiver present? In which case, sending your caregiver out for outside tasks would not be possible; at least not without the addition of a second care provider.
The point is, that for the best outcome and the most seamless experience, it is important to work with your caregiver and the agency by which they are employed to arrange the services that you need the most. Prioritize the care.
When people operate on assumptions and take it for granted that certain tasks are being performed, they are setting the stage for tension and misunderstanding. Clarity and communication are key to a positive home care experience. The first step in achieving that is understanding the scope of care and what that looks like in terms of daily tasks—the step you have just taken here today.
Can we help answer questions or arrange care for you or your loved one? Contact or Call PHCS–all inquiries welcome without obligation.