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Considering Work as a Home Health Aide or Personal and Home Care Aide?

Nature of Work

Health care is a modern necessity. Nursing and health care technician jobs are often unglamorous, but have the potential to be vastly rewarding in personal, financial, and intellectual ways, providing interesting challenges and opportunities for enthusiastic people. There are numerous degrees available for different types of work in the medical field. One job that is in high demand is for home health aides and personal and home care aides.

Job opportunities for such a career are expected to be in very high demand in the future due to the rapid growth of the home healthcare market. There are many different ways to pursue such a career and the requirements will vary from state to state and based on the type of services provided and what form of payment is given. Flexible schedules are a necessity for anyone looking to become a home health aide or personal or home care aide as the client’s scheduling needs must be met.

Home health aides and personal and home care aides treat both old and young patients who are disabled, chronically ill, or cognitively impaired and in need of assistance but do not live in a residential medical facility or institution. Aides often work to improve the quality of life of their patients when family and friends cannot provide their full care. Aides also work for patients who have been discharged from hospitals and have relatively short-term needs.

Aides give instruction and psychological support to their clients and advise on nutrition, cleanliness, and other household tasks. Aides may help clients out of bed and assist them in bathing, dressing and grooming. Additionally, aides may be required to provide light housekeeping and homemaking tasks such as washing laundry, changing bed linens, shopping for food, and planning and preparing meals. Aides often accompany patients to doctors appointments and other errands.

Such work is often tailorable to the individual’s particular wants. An aide may work solely with one client for many years or they may visit four or five clients each day. They may work in a patient’s home, at their place of work, their school, or some combination of these locations.

There are small differences between home health aides and personal and home care aides. Home health aides usually work for certified home health or hospice agencies. Such agencies receive government funding and must comply with regulations, which means an aide must work under the direct supervision of a medical professional (generally a nurse). Home health aides keep records of a patient’s performance, condition, and progress, work with therapists and other medical staff, provide some basic health-related services such as checking patients' pulse rate, temperature, and respiration rate. They also may help with simple prescribed exercises and assist with medications administration. Occasionally, they change simple dressings, give massages, provide skin care, or assist with braces and artificial limbs. With special training, experienced home health aides also may assist with medical equipment such as ventilators, which help patients breathe.

Personal and home care aides work for either public or private agencies and will likely be supervised by a licensed nurse, social worker, or other non-medical manager. They are given detailed instructions about client care, but often work independently with only periodic visits by their supervisors. They may be hired directly by the patient or his family in which case the employer will supervise work done and give assignments.

Work Environment

The work can be physically taxing as aides often have to move patients into or out of bed, and help them stand or walk. Care must be taken not to contract communicable diseases that patients may expose them to. Home health aides and personal and home care aides experience a higher than average number of work-related injuries and illnesses.

This work is not for everyone. It involves unpleasant duties such as emptying bedpans and changing soiled linens, and home environments may be distasteful, and patients may be disoriented, irritable, uncooperative, angry, abusive, or depressed.

Training and Other Qualifications

To work for certified home health or hospice agencies, home health aides must obtain formal training and pass a competency test. They must complete a training program of a minimum of 75 hours and a competency evaluation or state certification program. The exam may also be taken without any of the training, but 16 hours of supervised practical training are required before an aide has direct contact with a patient. Different states may require additional training before certification.

Personal and home care aides may face a diversity of requirements which vary by state. They are not necessarily required to be certified.

Workers are not generally required to have a high school diploma and are often trained on the job by registered nurses, licensed practical nurses, experienced aides, or their supervisor. Clients who prefer things done in a certain way will teach their aide.

Good health is a must for aides, so as not to contract or transmit infection or illness. A good temperament is also required. Employers will look for responsible, compassionate, patient, emotionally stable, and cheerful workers. A criminal background check and a good driving record also may be required.


Becoming a home health aide or personal and home care aide can be a good first step to becoming a nursing aide, licensed practical nurse, or registered nurse. Some may start their own home care agency or work as a self-employed aide. Self-employed aides have no agency affiliation or supervision and accept clients, set fees, and arrange work schedules on their own.

Job Outlook

In 2008, home health aides and personal and home care aides held about 1.7 million jobs in the U.S., mostly in home healthcare services, individual and family services, residential care facilities, and private households. Job outlook is good for such occupations and employment is projected to grow by 50 percent between 2008 and 2018. Employment of personal and home care aides is expected to grow by 46 percent from 2008 to 2018.


Median hourly wages of wage-and-salary personal and home care aides were $9.22 in May 2008 with the lowest 10 percent earning less than $6.84, and the highest 10 percent earning more than $12.33 an hour.

Median hourly wages of home health aides were $9.84 in May 2008 with the lowest 10 percent earning less than $7.65, and the highest 10 percent earning more than $13.93 an hour.

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