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- 191
- Homemaker-Home Health Aides
- D.O.T. 309.354-010 and 354.377-014)
-
- Nature of the Work
-
- Homemaker-home health aides help elderly, disabled, and ill persons
- live in their own homes instead of in a health facility. Most work
- with elderly or disabled clients who require more extensive care
- than spouse, family, or friends can provide. Some homemaker-home
- health 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. These workers are
- sometimes called home care aides and personal care attendants.
-
- Homemaker-home health aides provide housekeeping services, personal
- care, and emotional support for their clients. They clean clients'
- houses, do laundry, and change bed linens. Aides may also plan
- meals (including special diets), shop for food, and cook.
-
- Home health aides provide personal care services, also known as
- hands on care because they physically touch the patient. These
- aides may help clients move from bed, bathe, dress, and groom. They
- may also check pulse, temperature, and respiration; help with simple
- prescribed exercises; and assist with medication routines.
- Occasionally, they may change nonsterile dressings, use special
- equipment such as a hydraulic lift, give massages and alcohol rubs,
- or assist with braces and artificial limbs. Some accompany clients
- outside the home, serving as guide, companion, and aide.
-
- Homemaker-home health aides also provide instruction and
- psychological support. For example, they may assist in toilet
- training a severely mentally handicapped child or just listen to
- clients talk about their problems. Aides keep records of services
- performed and of the client's condition and progress.
-
- In home care agencies, homemaker-home health aides are supervised by
- a registered nurse, a physical therapist, or a social worker, who
- assigns them specific duties. Aides report changes in the client's
- condition to the supervisor or case manager. Homemaker-home health
- aides also participate in case reviews, consulting with the team
- caring for the client registered nurses, therapists, and other
- health professionals.
-
- Job prospects are excellent for people seeking work as
- homemaker-home health aides.
-
- Working Conditions
-
- The homemaker-home health aide's daily routine may vary. Aides may
- go to the same home every day for months or even years. More
- commonly, however, aides work with a number of different clients,
- each job lasting a few hours, days, or weeks. Aides often go to
- four or five clients on the same day.
-
- Surroundings differ from case to case. Some homes are neat and
- pleasant, while others are untidy or depressing. Some clients are
- angry, abusive, depressed, or otherwise difficult; others are
- pleasant and cooperative.
-
- Homemaker-home health aides generally work on their own with
- periodic visits by their supervisor. They have detailed
- instructions explaining when to visit clients and what services to
- perform. Many aides work part time, and weekend hours are common.
-
- Most aides generally travel by public transportation, but some need
- an automobile. In any event, they are responsible for getting to
- the client's home. Aides may spend a good portion of the working
- day traveling from one client to another.
-
- Employment
-
- Homemaker-home health aides held about 475,000 jobs in 1992. Most
- aides are employed by homemaker-home health agencies, home health
- agencies, visiting nurse associations, residential care facilities
- with home health departments, hospitals, public health and welfare
- departments, community volunteer agencies, and temporary help firms.
- Self-employed aides have no agency affiliation or supervision, and
- accordingly accept clients, set fees, and arrange work schedules on
- their own.
-
- Training, Other Qualifications, and Advancement
-
- The Federal Goverment has enacted guidelines for home health aides
- whose employers receive reimbursement from Medicare. The Federal
- law requires home health aides to pass a competency test covering 12
- areas: Communication skills; observation, reporting, and
- documentation of patient status and the care or services furnished;
- reading and recording vital signs; basic infection control
- procedures; basic elements of body function and changes; maintenance
- of a clean, safe, and healthy environment; recognition of and
- procedures for emergencies; the physical, emotional, and
- developmental characteristics of the patients served; personal
- hygiene and grooming; safe transfer techniques; normal range of
- motion and positioning; and basic nutrition. A home aide may also
- take training before taking the competency test. The Federal law
- requires at least 75 hours of classroom and practical training
- supervised by a registered nurse. Training and testing programs may
- be offered by the employing agency, but they must meet the standards
- of the Health Care Financing Administration. Training programs may
- vary depending upon State regulations. Thirteen States have
- specific laws on personal care services.
-
- The Foundation for Hospice and Home Care offers a National
- Homemaker-Home Health Aide certification. The certification is a
- voluntary demonstration that the individual has met industry
- standards.
-
- Successful homemaker-home health aides like to help people and do
- not mind hard work. They have a sense of responsibility,
- compassion, emotional stability, and a cheerful disposition. Aides
- should be tactful, honest, and discreet since they work in private
- homes.
-
- Homemaker-home health aides must be in good health. A physical
- examination including State regulated tests like those for
- tuberculosis may be required.
-
- Advancement 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. The most
- experienced aides may assist with medical equipment such as
- ventilators, which help patients breathe.
-
- Job Outlook
-
- A large number of job openings is expected for homemaker-home health
- aides, due to very rapid growth and very high turnover.
- Homemaker-home health aides is expected to be one of the fastest
- growing occupations through the year 2005 more than doubling in
- employment size.
-
- The number of people in their seventies and beyond is projected to
- rise substantially. This age group is characterized by mounting
- health problems that require some assistance. Also, there will be
- an increasing reliance on home care for patients of all ages. This
- trend reflects several developments: Efforts to contain costs by
- moving patients out of hospitals and nursing facilities as quickly
- as possible; the realization that treatment can be more effective in
- familiar surroundings rather than clinical surroundings; and the
- development of portable medical equipment for in-home treatment.
-
- In addition to jobs created by the increase in demand for these
- workers, replacement needs are expected to produce numerous
- openings. Turnover is high, a reflection of the relatively low
- skill requirements, low pay, and high emotional demands of the work.
- For these same reasons, many people are unwilling to do this kind of
- work. Therefore, persons who are interested in this work and suited
- for it should have excellent job opportunities, particularly those
- with experience or training as homemaker-home health aides or
- nursing aides.
-
- Earnings
-
- Earnings for homemaker-home health aides vary considerably.
- According to the National Association for Home Care, home health
- aides' average starting hourly wage in July 1992 was $6.31, and the
- average maximum hourly wage was $8.28. Wages were somewhat higher
- than these national averages in the Northeast and West and somewhat
- lower in the Midwest and South. Some aides were paid on a salary or
- per-visit basis.
-
- Most employers give slight pay increases with experience and added
- responsibility. Aides usually are paid only for the time worked in
- the home. They normally are not paid for travel time between jobs.
-
- Some employers offer a full package of vacation and sick leave,
- health and life insurance, and a retirement plan. Others hire only
- on-call hourly workers, with no benefits.
-
- Related Occupations
-
- Homemaker-home health aide is a service occupation that combines
- duties of health workers and social service workers. Workers in
- related occupations that involve personal contact to help or
- instruct others include attendants in children's institutions,
- childcare attendants in schools, child monitors, companions, nursing
- aides, nursery school attendants, occupational therapy aides,
- nursing aides, physical therapy aides, playroom attendants, and
- psychiatric aides.
-
- Sources of Additional Information
-
- General information about training and referrals to State and local
- agencies about opportunities for homemaker-home health aides, a list
- of relevant publications, and information on national certification
- are available from:
-
- Foundation for Hospice and Homecare/National Certification Program,
- 519 C St. NE., Washington, DC 20002.
-