Home Health Care Aide work with clients in their homes to help them with basic tasks like bathing and grooming, and to prepare meals. Aides also monitor their clients’ conditions and medications. In some cases, home health aides are trained to provide more hands-on medical care under the supervision of a licensed home health care therapist or nurse.
The demand for home health aides has increased significantly, driven in part by the aging of the population and by a preference among many clients to receive health care at home rather than in a nursing home or hospital. In addition, home health aides are often less expensive than other types of health care professionals.
For aides, however, the job is demanding and stressful. The physical nature of the work means that aides are frequently on their feet and moving around, often in difficult-to-navigate homes. It is often difficult to establish a trusting relationship with clients, especially when their cognitive and physical abilities decline. And a number of aides report high levels of stress, including burnout and depression.
Those challenges were intensified during the COVID-19 pandemic, when aides were working around the clock, and often without pay, to care for ill clients. Aides and agency representatives described the need to increase visibility and appreciation for their role as well as for policies that would support aides during the pandemic.
Aides also struggled to deal with the irascible behavior of some of their clients, particularly those with dementia. As one aide put it, “Some of them just don’t like you and cuss at you and say nasty things.” Other aides were worried about infection, reporting that they had seen or heard of cases of MRSA, methicillin-resistant Staphylococcus aureus, and bed bugs.
Aides may work for an agency or independently. Some are trained in-home, and others attend formal training programs, with some completing as many as 75 hours of health training, which is more than the minimum federal requirement. Unlike personal care aides, home health aides must be licensed to assist with medication and other basic healthcare needs. Some HHAs continue their education, pursuing training in areas such as nursing and physical therapy. Others are simply dedicated to making a difference in their clients’ lives. Dashia, who works for an agency, has already taken classes to learn more about the medical side of home health aide work, and she hopes to move up to a registered nurse role someday. Clear pathways to higher-level roles are essential for attracting and keeping more aides, experts say. But they are not always available, with some states only requiring that aides receive training from an approved program.