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Personal and Home Care Aides

Significant Points
  • 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.
Nature of the Work

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 needs.

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.

Working Conditions

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.

Job Outlook

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.

Earnings [About this section] Back to Top Back to Top

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 $9.09
Vocational rehabilitation services 8.76
Community care facilities for the elderly 8.49
Individual and family services 8.48
Home health care services 6.99

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.

Related Occupations

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 service.

  • Source: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2006-07 Edition

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