How to Become a Home Care Assistant

How to Become a Home Care Assistant

How to Become a HomeCare Aide/Assistant


By Kelli Hansen, RN

Personal care aide helping an elderly woman get used to her walker

Home care assistants serve a vital role in providing much-needed
assistance to the elderly, disabled, and chronically ill populations
within our communities. They care for patients who independently are
unable to maintain good hygiene, proper nutrition, and a clean living
space. They may also assist with daily activities and recreation if
needed by the patient.

“Home care assistant” is often a generalized term used to refer
collectively to two different branches of assistants: personal care
aides and home health aides. Each branch varies in job function and

Home health aides (HHAs) help
patients with personal necessities like dressing, bathing, and hygiene
needs. By assisting with housekeeping and other IADLs (instrumental
activities of daily life) like cooking and laundry, HHAs enable clients
to live safely in their own homes, greatly improving their quality of
life in the process. Aides may have to document the patient’s condition
and the care that they provide, along with any problems encountered
during care, submitting this report to a supervisor. In some cases, HHAs
also facilitate transportation and leisure activities for clients.
Depending on the state regulations, they may be able to take vital
signs, give medications, and perform basic wound dressing changes as

Personal care aides assist patients with
self-care and everyday tasks as well as provide some clients with much
needed companionship. Personal care aides are sometimes known by other
titles, including caregiver, companion, and personal attendant. They
often perform tasks similar to those of home health aides; however, they
cannot provide any type of medical-related services, whereas home
health aides may be able to provide basic medical services depending on
state regulations.



The word “home” within the title of home care assistant would
suggest that the environment is primarily within an individual’s home,
but this is not necessarily true. While most home care assistants do
work in homes, their job functions may also be performed in a variety of
provider settings such as retirement homes, community centers,
residential group homes, and even nursing care facilities. An assistant
may care for one individual or many, depending on the provider setting
in which he or she works. The length of time during which a home care
assistant may work with a client or clients varies from one day to
multiple years. Work may include nights, weekends, and holidays
depending on the requirements of the employer or the private client with
whom the assistant is working.

Because of their work environments, home care assistants have a
higher rate of injury than the national average. The work provided in
this role can at times be very emotionally and physically demanding.
Injury can occur when lifting a client, helping a client ambulate
(walk), or simply helping a client to get in and out of a bed, chair, or
shower. Clients may suffer from Alzheimer’s or other cognitive
impairments that prove very challenging at times; the client may even
become violent and aggressive. In some instances, personal care aides
may be exposed to communicable diseases or infections when working with
clients, depending on the nature of a client’s health issues.



No formal education is required to become a home care assistant. But
according to the Bureau of Labor Statistics (2014), most home health
aides have earned a high school diploma. This is true for personal care
aides as well.

HHAs who aim to work in a certified home health or hospice agency are
required to get formal training. In anticipation of this, preparatory
classes are offered at some community colleges or through
vocational/technical schools. To enroll in classes, students typically
must be at least 18 years of age.


Training requirements for home care assistants vary from state to
state. Broadly, for both HHAs and personal care aides, there are
circumstances in which no formal training programs are required and the
budding professional receives all necessary training while on the job.
This is often the case for personal care aides, who may be trained by a
nurse, social worker or other aide to meet the specific needs of a
particular client – for instance, if a client has cognitive impairment
issues or has very specific dietary requirements.

However, formal training programs are required in some states and are
available from vocational schools, community colleges, agencies and
elder care programs. The duration of these programs varies based on
varying state requirements.

An HHA who wishes to work with a home health agency will need to
obtain formal training and pass a competency exam before becoming
employed. Some states include additional required training above the
nationally mandated minimum for working within an agency.

Furthermore, if a home health aide wishes to become certified, which
can definitely improve job prospects, he or she must obtain a minimum of
75 hours of training in order to become eligible for certification.




Home health aides are not licensed, but many employers prefer or require that HHAs, Care Givers, obtain certification. The National Certification Coucil of Activity Professionals
(NCCAP) ( oversees a HHC certification. Minimally, in
order to become certified, the candidate must complete 75 hours of
training. In some states, the required amount of time is greater than 75
hours. You can refer to this map
for HHA training requirements in your state. Upon completing the
training, HHAs will have to take a standardized written test and
correctly demonstrate the skills they learned during training.

Necessary Skills and Qualities

Because they focus on direct patient care, home care assistants must
possess patience, dependability, good interpersonal skills, and
effective time management skills. They must be detail-oriented to follow
specific rules and protocols. Home care assistants will be working
closely with patients who may have severe pain or who may be
experiencing emotional distress; they must be able to show sensitivity
to patients’ emotions. It is important for the aide to be warm,
compassionate, and emotionally stable. This role involves performing
physical tasks such as lifting, turning and repositioning patients; an
aide must possess a higher level of physical stamina and strength in
order to be comfortable and safe performing those required tasks.

Opportunities for Advancement

Personal care aides may start within their role and progress into the
role of a home health aide by receiving additional health training.
Once they advance into the HHA role, they may have more opportunities to
advance even further into medical assisting, nursing or both. Many home
care assistants with experience and a higher level of training seek out
available opportunities to teach students or supervise new home care

Salary and Job Outlook Interactive Map of Salary and Job Growth


The annual mean wage reported by the Bureau of Labor Statistics (BLS) is $21,380 for home health aides. Salaries range from a low of $17,040 up to a high of $29,560.

Meanwhile, the median annual wage for a personal care aide is $20,440, according to the BLS. The lowest 10% of wage earners make around $16,580 and the highest 10% earn closer to $27,910.

Job opportunities for home care assistants will be numerous from now
well into the future; based on its statistic, the U.S. Bureau of Labor
Statistics anticipates a 48% employment increase for HHAs and a 49% increase
in jobs for personal care aides between 2012 and 2022. This job growth
is due mostly to more elderly people needing care and choosing to stay
in their homes as long as possible. Some clients don’t require medical
related assistance as much as additional assistance with household tasks
or minor personal hygiene assistance. Hiring a home care assistant may
be a cheaper option for many clients who wish to stay in their homes to
avoid the increased expenses that occur with moving to a higher level of
care, such as an assisted living facility or retirement home.

Visit for Home Care Certification Classes Online

Enjoy a bit of Memorial Day Humor from the Adventures in Activities 
 artist Bradey Sooter

Theme for the Day is Super Heroes..

download a copy at Download MemorialDay Comic

Activity Director Needed Cedarbrook Memory Care, Fresno California

  Posted by CedarbrookEDFresno, California, United States

Job Description

Cedarbrook Memory Care is looking for an experienced Director of Activities for their 68 bed community.
We will be accepting applications through April 18th.
  • 1 year or more experience in planning activities
  • must be able to conduct and lead group activities
  • provide person centered care with seniors in the memory care setting
  • have experience managing employees
  • experience creating calendars
  • must work with a team and mentoring staff
  • must be able to drive our bus
  • must be able pass criminal backgound check and health screening

How to Apply

You may apply in person at    1425 E Nees, Fresno, CA 

Email your inquiry or resume to


For more details or to list a job opening please visit

Learning About Adult Day Care

Many Americans who care for an older adult feel overwhelmed and trapped by the situation. Adult day care programs can help caregivers and the people they care for.

"Adult day centers are the best thing you never heard of," says Burton V. Reifler, MD, director of Geriatric Psychiatry Outreach Program and professor at Wake Forest University School of Medicine. "It gives people their lives back."

Relief for Caregivers
Caregivers Sue Coleman and Pam Buenaventura agree. Coleman began caring for her father, Harry, about eight years ago and ended up losing two jobs because her father, who was home alone and frightened, called her every 30 minutes.

"I would have to leave and come home to try to figure out what was real," Coleman explains. "As he was aging and had more health problems, it was more difficult to hold down a job."

With her father's care her top priority, Coleman realized she had to come up with a solution, but did not want to move him out of her home. A nurse told Coleman about Day Break at Winter Park, Florida, an adult day center where her father could socialize while Coleman worked. Once enrolled, the phone calls stopped. Her father is happy, and Coleman does not know what she would do without day services.

"Caregiving was much more difficult than I had anticipated," says Buenaventura, whose grandmother, Myrtle, attends Eastside Adult Day Services in Bellevue, Washington. "Adult day care gives me time to go and do something I want to do. When she first came to live with us, I could not leave her. I could not go anywhere unless somebody was here."

Taking a Break
Caregiving often leads to feelings of entrapment, depression, and hopelessness. Researchers from Pennsylvania State University conducted a study to evaluate whether adult day services affected caregiver stress and psychological well-being. They found that three months after sending a loved one to adult day care twice a week, caregivers experienced fewer feelings of overload and strain and significantly less depression and anger.

"You are no longer a 24/7 caregiver," explains Steven H. Zarit, PhD, lead author of the study and professor of human development. "We had reports by family members that their relatives looked forward to going, that their behavior was better when they came home. They were more alert, less agitated."

Day Services Benefit Participants
Like many caregivers, Buenaventura and Coleman have seen an improvement in their older relative's conditions. Elders who participate in adult day care make friends, and day programs provide structure and remind some attendees of going to work. Meaningful activities fill the hours and give participants something to talk about over dinner.

"The biggest benefit for clients is having a reason to put their shoes on, a place to show up for life," says Jan Nestler, past chairperson of the National Adult Day Services Association and executive director of Eastside Adult Day Services in Washington. "It is a place where someone feels not only that they belong, but it is safe and they have dignity and are allowed a level of independence and choice."

Leaving her father, with tears in his eyes on the first day, tugged at Coleman's heart. But he agreed to give it a try and ended up loving it. He plays the piano again, something he had given up after his wife died, entertaining Day Break members and staff with upbeat renditions of big band tunes.

"His dementia has lessened, and he is more active," Coleman says. "He loved going out to get pumpkins and to the university to see how new classrooms were set up and what the students were working on. Those are things a caregiver does not have time to do."

Comprehensive Care
Participants enjoy music, dancing, exercising, and other activities. Many allow clients time to themselves to read, work on a craft item, or visit with someone. Some programs may provide transportation to and from the center.

Many centers also offer medical services. In adult day health programs, nurses check members' blood pressure and blood sugar, administer medicines, and monitor chronic health conditions. Some centers provide bathing and personal care services. Social workers or nurses provide caregivers with suggestions for other community resources and sometimes facilitate support groups.

Day Centers May Not Be for Everyone
While most older adults enjoy the day out, the programs may not suit every potential client. Programs are tailored and paced to benefit adults with physical or cognitive limitations. An active senior, who still drives and handles the checkbook, potentially functions too well for an adult day center and might find a senior center more suitable.

Someone who has always been a loner may resist an adult day center's socialization. Patients with dementia may be fearful of going to a new location. Some centers will not accept clients who hit, kick, or punch other people. Some caregivers worry that staff will not correctly interpret a loved one's needs.

"We asked families about their satisfaction with day care, and they were overwhelmingly positive about all aspects except the cost. For many people, cost is a problem," Dr. Zarit says. Fees vary depending on the program. Long-term insurance might cover some of the expenses. Many nonprofit facilities offer a sliding scale, and some states provide financial assistance to eligible clients.

What to Look For
The National Adult Day Services Association recommends that caregivers considering a day program assess their and their loved one's needs before visiting a center. Keep the following questions in mind when looking for a program:

  • Can participants with certain conditions be admitted? Under what circumstances would someone not be allowed to attend?

  • Is help available for using the bathroom, cutting up food, taking medicines, or walking or pushing a wheelchair?

  • What happens if a participant has an incontinence episode? (Some centers keep clean, spare clothing available and will wash the soiled garments.)

  • Can the center provide a special diet, a bath, or transportation?

  • What type of exercise program is offered?

  • How long has the center been open? Is it licensed by the state?

  • What is the cost?

  • What is the ratio of clients to staff?

  • Who owns the center?

  • Has the center received accreditation by CARF (the Rehabilitation Accreditation Commission)?

  • Do clients and staff seem happy about being there?

  • Is the furniture comfortable?

  • Is the center clean? Are there odors?

  • Is the building secure? Could someone wander away?

  • How are outings supervised?

  • Are activities tailored to the individual or is everything done as a group?

Nestler suggests that families select facilities where they feel comfortable and accepted—a facility that feels like home.

"I would urge [anybody caring for someone with dementia ] as strongly as I can to go visit an adult day center," says Dr. Reifler. "People do not realize how good they are until they see one. They are places where there is a lot of vigor and vitality."

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Senior Facility offers "Come Stay for the Winter" Residency trials are a huge success!


Posted By: Cambridge Realty Capital
January 17, 2014

Senior Housing Providers Can Benefit from Residency Trials

In an effort to improve occupancy, senior housing communities should consider offering short-term trial stays to potential residents. When a trial-stay is successful and the resident decides to move in permanently, the community increases its occupancy, revenue, and net operating income. Thereby improving its financial position and its ability to obtain financing for future growth.

 Many assisted living communities offer short-term stays for people that are recovering from surgery, but there are other opportunities to offer trial-stays as well. Because of the cold weather, increased potential for power outages, and feelings of isolation and loneliness that are often more common during the winter, some communities have found that this time of year is an ideal time to offer trial-stays to potential residents. 

Furthermore, trial-stays are an excellent marketing tool because they allow residents to “test drive” a community and they also give the adult children who are typically instrumental in their parents’ transition to senior housing, another way to broach the subject with their parents and to get them comfortable with the idea of moving into a senior housing community.  While it’s currently not a widespread practice, an increasing number of senior housing communities are beginning to offer trial-stays to potential residents. For example, Epoch Assisted Living at Brewster Place in Massachusetts began unofficially offering winter trial-stays at someone’s suggestion five years ago, and because it was a success, it made the program official last year. 

Now every year Epoch sends invitations to potential residents inviting them to “spend the winter” at Brewster. The winter stay lasts for three months (a fourth month is offered for free) costs $5,000, and comes with a large room with a kitchen and sitting area, three meals a day, exercise and entertainment activities, cable TV, a phone, linen service, housekeeping, transportation, and shopping trips as well. Last year seven people took advantage of the program and 5 of them ended up moving in permanently after their trial stay ended. This year, residents like Ann Golini, who spent the night without utilities at her home last year when the power went out, were quick to accept Epoch’s invitation to spend the winter there. Losing utilities aren’t a concern at Epoch due to the presence of a generator.

In addition to the many benefits that trial-stays offer residents, communities also benefit from the arrangement. Trial-stays help communities maintain occupancy, generate revenue, and improve their financial position. This in turn increases their ability to obtain financing for future growth. Accordingly, before interest rates increase this year, senior housing communities should consider offering trial-stays to generate additional revenue and enhance their ability to obtain additional financing from companies like Cambridge Realty Capital.

Mom with Alzheimer's marries, her eyes now sparkle and her smile is genuine

Mom with Alzheimer’s Marries and Finds New Joy

Although the future is unknown, I believe that there can be new life after Alzheimer’s and that falling in love can renew anyone’s brain.

By Sandy Balli
+Alzheimer's Reading Room

My 89 year-old mother, deeply forgetful for eight years, improved significantly since meeting a kind 93 year-old man in the assisted living center where they each had lived for six months.

Note: Sandy writes that the look on her mother's face changed dramatically, and for the positive. As can be seen in the pictures above.

Does she look younger and more aware?

This reminded me of the change that came over Dotty's face from 2005 to 2012. As we moved from burden to Joy.

Subscribe to the Alzheimer's Reading Room

After playing pool together every day and eating meals together in the dining room, the couple decided that they wanted to marry.

His mind is quite good, but my mom is challenged with short term memory loss and other issues related to Alzheimer’s.

Although his daughter and I explained to him what could lie ahead, he ultimately decided he still wanted to marry her and spend their last few years together.

He had been married 72 years and mom 66 years before each being widowed. They joke that they had 138 years of combined marital experience at the time of their December 22, 2013 wedding.

Mom has been “glowing” since she fell in love with this man. Her eyes now sparkle and her smile is genuine.

Her husband has a witty sense of humor and he makes mom laugh. He is patient and tenderhearted in relating to her forgetfulness.

As for Mom, she has a purpose in life now. She folds his clothes and walks his dog.

It has made a difference for her and for me, her caregiver.

Just Married
Although the future is unknown, I believe that there can be new life after Alzheimer’s and that falling in love can renew anyone’s brain.

*Sandy Balli, Ph.D. is a professor at La Sierra University in Riverside, California. She teaches research methods courses in the School of Education and mentors doctoral students through their dissertations. She has written for scholarly education journals and published a book, Making a Difference in the Classroom, in 2009. Sandy is an only child who has been the primary caregiver for her 89 year-old mother for three years.