Personal and Home Care Aides
- Job opportunities are expected to be excellent because of
rapid growth in home health care and high replacement needs.
- Skill requirements are low, as is the pay.
- About 33 percent 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.
Personal and home care aides help elderly, disabled, ill, and
mentally disabled persons live in their own homes or in residential
care facilities instead of in health facilities. Most personal
and home care aides work with elderly or physically or mentally
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
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
get out of bed, bathe, dress, and groom. Some accompany clients
to doctors’ appointments or on other errands.
Personal and home care aides provide instruction and psychological
support to their patients. They may advise families and patients
on 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 health care 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 health care 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 and 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. About one-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.
|Training, Other Qualifications, and Advancement
In some States, the only requirement for employment is on-the-job
training, which generally is provided by most employers. Other
States may require formal training, which is available from community
colleges, vocational schools, elder care programs, and home health
care agencies. The National Association for Home Care and Hospice
(NAHC) offers national certification for personal and home care
aides. Certification is a voluntary demonstration that the individual
has met industry standards. Certification requires the completion
of a standard 75-hour course and written exam developed by NAHC.
Home care aides seeking certification are evaluated on 17 different
skills by a registered nurse.
Personal and home care aides should have a desire to help people
and 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.
A criminal background check also may be required for employment.
Additionally, personal and home care aides are responsible for
their own transportation to reach patients’ homes.
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. Some aides choose to receive additional training
to become nursing and home health aides, licensed practical nurses,
or registered nurses. Some experienced personal and home care
aides may start their own home care agency.
Personal and home care aides held about 701,000 jobs in 2004.
The majority of jobs were in home health care services; individual
and family services; residential care facilities; and private
households. Self-employed aides have no agency affiliation or
supervision and accept clients, set fees, and arrange work schedules
on their own.
Excellent job opportunities are expected for this occupation,
because rapid employment growth and high replacement needs are
projected to produce a large number of job openings.
Employment of personal and home care aides is projected to grow
much faster than average for all occupations through the year
2014. The number of elderly people, an age group characterized
by mounting health problems and requiring some assistance with
daily activities, is projected to rise substantially. In addition
to the elderly, other patients, such as the mentally disabled,
will increasingly rely on home care. This trend 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 lead to many
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 prospects.
Median hourly earnings of personal and home care aides were $8.12
in May 2004. The middle 50 percent earned between $6.83 and $9.70
an hour. The lowest 10 percent earned less than $5.93, and the
highest 10 percent earned more than $10.87 an hour. Median hourly
earnings in the industries employing the largest numbers of personal
and home care aides in May 2004 were as follows:
|Residential mental retardation, mental health
and substance abuse facilities
|Vocational rehabilitation services
|Community care facilities for the elderly
|Individual and family services
|Home health care services
Most employers give slight pay increases with experience and
added responsibility. Aides usually are paid only for the time
they work in the home, not for travel time between jobs. Employers
often hire on-call hourly workers and provide no benefits.
Personal and home care aides combine 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; physical therapist assistants and aides;
and social and human service assistants.
Sources of Additional Information
Information about employment opportunities may be obtained from
local hospitals, nursing care facilities, home health care agencies,
psychiatric facilities, residential mental health facilities,
social assistance agencies, and local offices of the State employment
Source: Bureau of Labor
Statistics, U.S. Department of Labor, Occupational Outlook
Handbook, 2006-07 Edition