Home Health Aide: Job Duties, Skills, Salary & Education

What is a Home Health Aide?

A home health aide, abbreviated HHA, is a health-care professional who provides care to elderly adults and patients living with chronic illnesses, cognitive impairments, and other disabilities. More often than not, home health aides provide this assistance in the patient’s home, but they also deliver care to patients in day services programs, patient homes, and group homes. Employed by hospice and other home health agencies, the home health aide provides these day-to-day services as ordered by optometrists, podiatrists, chiropractors, and other licensed physicians.

Home health aides are qualified through training, certification, and other competency evaluations established and administered by the agency or organization for which they work. However, qualification requirements vary from state to state. For example, some home health aides are required to have a high school diploma while others are not. Some states even permit health aides to administer medication and check patient vital signs.

What Does a Home Health Aide Do?

A home health aide is someone who takes care of an individual in the patient’s home or at an assisted living facility. The patient is often someone who is elderly or has a physical or mental illness that requires they receive special care. This can be anyone from an elderly individual with Alzheimer’s to a person with a spinal cord injury. The care provided involves assisting in daily routines such as bathing, feeding, and dressing. Their tasks can also involve taking the individual outside the home to a park or buying groceries for the patient, dependent on what is desired.

A home health aide is an important individual as they will likely have the most contact with the patient. If they notice any behavioral or mental changes, they can contact the patient’s nurse or doctor. They are also responsible for following the directions provided by a doctor, including visually examining wounds or administering medicine. Unless they have special training, their job would not involve any special tasks like physical therapy or diagnosing new problems.

While a home health aide’s job often involves routine tasks and is repetitive, it can also be rewarding. The relationship they create with the patient is important, and long-term aides can create lasting bonds with those that they care for. The aide is spending long hours with the patient, so it is important that they trust one another and enjoy spending time with one another. Understanding the benefits of home health aides are important, as the number of elderly requiring in-home care is expected to grow substantially over the next two decades, particularly in the US.

Why Do We Need Home Health Aides?

Home health aides fill a number of society’s most important needs. First, hiring a home health aide and the assistance they provide to disabled and/or elderly loved ones is much more affordable than the high costs of hospitalization and institutionalization. As most states only require these healthcare workers to have earned no more than a high school diploma, and some states do not require even that, home health agencies can maintain relatively low hourly rates for their in-home health aide services. Furthermore, in most cases, these patients do not require institutionalization in the first place, but merely a little extra help keeping track of their medications and doctor appointments.

Third, home health aides are important because they deliver much-needed companionship to those who are otherwise socially isolated due to their limited mobility. Research has shown that even just an hour of the kind of social interaction provided by a home health aide can lower patient blood pressure, and reduce their risk of developing Alzheimer’s disease and other mental health issues. Finally, the need for home health aides has been on the rise as the second largest generation, the baby boomers, are approaching their elderly years. Society needs home health aides to prevent the baby boomer generation from overcrowding nursing homes and other healthcare institutions.

What are the Educational and Certification Requirements to Become a Home Health Aide?

There are no universal educational or certification requirements to become a home health aide as these vary from state to state. For the most part, however, the minimum educational prerequisite is a high school diploma or GED, but there are many states in which even this is not a requirement. On the other hand, in stricter states, home health aides must complete some type of recognized certification provided by either a community college, vocational school, or through the agency for which they will be employed. While there are also home health aide certification courses available online, the majority of states and employers require at least 16 hours of training on-site working with actual patients under the supervision of a doctor or nurse.

While there are some less-comprehensive home health aide certification programs that only take a few weeks to complete, typical programs are the full length of one academic semester. In the courses provided, aspiring home health aides learn the fundamentals of patient care such as household maintenance, bathing and dressing, how to dispense and keep track of medications, patient charting and basic medical terminology, and how to accurately check a patient’s pulse and take their blood pressure.

As many patients eat according to strict dietary needs, there are also meal preparation courses to teach home health aides how to cook nutritious and allergy-avoidant meals. Furthermore, some states and healthcare agencies require that home health aides become CPR certified and receive training for other types of emergency responses. There are also courses a home health aide can take if they prefer to work with a specific category of patient needs. Finally, most states and employers that require certification will require that each home health aide also pass a competency exam.

What Skills are Needed for a Home Health Aide?

Interpersonal Skills – A home health aide must exhibit an advanced set of interpersonal skills as the care they provide takes place inside the individual homes of their patients. Furthermore, HHAs perform highly personal tasks such as bathing and dressing, and as these were tasks that their patients had once performed on their own and in private, HHAs must be able to establish a profound level of trust and rapport.
Patience – More often than not, home health aides provide care on a daily basis to one single patient. Such prolonged and repetitive interaction can be trying and challenging for anyone, thus a home health aide must be skilled at remaining calm and exercising patience regardless of inevitable aggravation or feeling irritable.
Authoritative – As it is not uncommon for patients to become difficult by challenging boundaries and refusing the recommendations made by their doctors, a home health aide must be able to establish boundaries, ensure guidelines are followed, and remain reasonably authoritative at all times.
Physical Strength – A home health aide should possess an appropriate amount of physical strength and stamina as they will be performing a wide variety of tasks, some of which may require moving furniture and other heavy objects, and lifting their patients from bed and/or into vehicles.
Initiative – While most healthcare professionals are supervised throughout the day by doctors, nurses, and hospital administrators, a home health aide provides care without such daily direction. Ultimately, they do regularly supply their patients’ physicians with wellness reports, but this is usually given on a weekly or need-to-know basis.
Detail-oriented – A home health aide must keep detailed records, be skilled at drawing meaning from body language and making inferences from physical cues, and precisely following instructions as prescribed by their patients’ doctors and/or nurses.
Compassion – Perhaps the most important skill a home health aide must possess is the ability to empathize with their patients and treat them with compassion on a daily basis.

What are the Advantages and Disadvantages of Being a Home Health Aide?

Advantages

Schedule Flexibility – The schedule of a home health aide is based upon the availability that they provide. HHAs can work 40 hours or more a week, part-time, or even less than that as a means of additional income. Although home health aides ultimately report to their patients’ physicians, the majority of the time they work autonomously and without day-to-day supervision.
Minimal Requirements – Many states do not even require home health aides to have earned a high school diploma or GED. HHA training is usually provided through relatively brief on-site job training, and at its most extensive, HHAs are required to earn specific certification through a single short-term course provided by a community college or vocational school.
Fulfilling – The majority of home health aides say the career’s greatest advantage lies within the sense of satisfaction that the job itself delivers. HHAs are profoundly fulfilled by helping others in need.
Live-in opportunities – Some patients require the services of a home health aide 24 hours a day, 7 days a week. Many HHAs find these type of live-in opportunities incredibly advantageous.
Work Environment – While sometimes home health aides must care for patients who are difficult and defiant, the majority of HHAs describe their daily work environment as a quiet and calm one.

Disadvantages

No coworkers – Although home health aides appreciate that the job is overall an autonomous one, it can nevertheless feel lonely, too, as they do not encounter the everyday social interactions that come with having coworkers.
Unskilled labor tasks – Many people do not succeed as a home health aide due to the various tasks they are asked to perform. Not only can the work be physically strenuous due to the moving of patients, lifting heavy objects, and various housework chores, the work of a home health aide can be emotionally demanding, too, as oftentimes they provide care for terminally ill patients.
Driving – Home health aides often complain about the amount of driving required of them. From transporting patients to doctor appointments, grocery shopping, and other errands, the job can take a toll on one’s car and gasoline expenses.

How Much Does a Home Health Aide Make?

According to the U.S. Bureau of Labor Statistics, as of 2016, the national average for the yearly salary of a home health aide is $23,600. Of course, when examining these averages on a state-to-state basis, the average salary for a home health aide is higher in some states than it is in others. For example, the state with the highest average salary is Alaska, paying its home health aides an average of $33, 290 a year.

A close second, the average home health aide in North Dakota will take home a yearly salary of $33,170. Furthermore, home health aide salaries become particularly interesting when examining their averages from city to city. The United States’ highest average salary for a home health aide is found in Sioux City, Iowa, at an astonishing $40,410 a year. The Californian cities of Santa Rosa, Sacramento, and Santa Cruz make the list, too, paying home health aides $39,210, $36,550, and $32,590, respectively, per year. Likewise, some states pay home health aides a much lower salary than the overall national average. West Virginia ranks as the country’s worst offender, paying its home health aides an average salary of $19,385 per year at an hourly rate of just over $9.00.

What is the Difference Between a Home Health Aide (HHA) and a Certified Nursing Assistant (CNA)?

The first difference between a home health aide (HHA) and a certified nursing assistant (CNA) is in the amount of training and education that each requires for licensure. It is not mandatory to have earned a high school diploma or GED for either profession, but a CNA is required to undergo more extensive preparation. While an HHA is expected to receive job training for a brief period of time, CNA candidates must attend a training program provided by either a vocational school or community college. A CNA is then required to complete a certain number of on-site clinical hours under the supervision of a recognized healthcare facility or hospital. And finally, they must pass the appropriate CNA licensure exam mandated by the state in which they reside.

The disparity in training requirements leads to the second key difference between an HHA and CNA; i.e., the kinds of care they are authorized to provide. An HHA meets only the simplest of patient needs such as running errands, shopping, meal preparation, feeding, and helping patients to bathe and dress. A CNA will also fill such fundamental roles, but all CNAs they are certified to provide various kinds of minimal medical care such as checking vital signs, charting patient conditions and symptoms, and dispensing medication. Meanwhile, most HHAs are not permitted to provide any type of care that would be considered medical.

The third difference between an HHA and a CNA is where they provide their services and to whom. For example, an HHA will almost always work with one, single patient each and every day inside of that patient’s home. While some CNAs also work one-on-one with patients within the home, it is more common that a CNA will see numerous patients on any given day. As CNA training is more extensive than that of an HHA, they are qualified to provide care inside nursing homes, hospitals, doctor offices, and other clinics.

What Professions Are Similar to Home Health Aide?

Physical Therapist Assistant

A physical therapist assistant is similar to a home health aide in that they work one-on-one with patients under the guidance of a much more qualified healthcare professional. For example, where home health aides provide care according to the directions prescribed by their patients’ physician or nurse, physical therapist assistants provide care as prescribed by a licensed physical therapist. However, while most home health aides work inside the individual homes of their patients’, a physical therapist assistant typically works in a hospital or physical therapy office.

Medical Assistant

A medical assistant is similar to a home health aide in that they, too, work under the direct supervision of a licensed physician or nurse. However, where home health aides primarily work inside patient homes or sometimes less frequently in nursing homes, medical assistants can work in a much wider variety of settings such as hospitals, doctor’s offices, immediate care clinics, and even in ambulatory services. Additionally, becoming a certified medical assistant requires more training and education than what is necessary to become a home health aide. It usually takes medical assistants at least one year, sometimes two, to complete the certification program mandated by their state.

Personal Care Aide

A personal care aide is similar to a home health aide in that they also work inside a patient’s home under the guidance of that patient’s physician or nurse. However, where a home health aide can provide basic types of medical care, a personal care aide does not. They provide services strictly in regards to bathing, dressing patients, and household maintenance such as doing laundry, cooking, and carrying out other various chores. Like a home health aide, a personal care aide will also run errands and grocery shop for their patients. But unlike a home health aide, personal care aides do not transport or drive their patients around. As many patients are characterized by various types of limited mobility and may even require the use of a wheelchair, moving these patients without the proper knowledge and training can be dangerous and even result in further serious injuries.

Home Health Aide Career