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Home Health Aides and Personal and Home Care Aides - What They Do

How to Advance (Advancement)
The National Association for Home Care and Hospice (NAHC) offers national certification for aides. Certification is a voluntary demonstration that the individual has met industry standards. Certification requires the completion of 75 hours of training; observation and documentation of 17 skills for competency, assessed by a registered nurse; and the passing of a written exam developed by NAHC.

Advancement for home health aides and personal and home care aides is limited. In some agencies, workers start out performing homemaker duties, such as cleaning. With experience and training, they may take on more personal care duties. Some aides choose to receive additional training to become nursing aides, licensed practical nurses, or registered nurses. 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.

Home health aides and personal and home care aides held about 1.7 million jobs in 2008. The majority of jobs were in home healthcare services, individual and family services, residential care facilities, and private households.

Job Outlook
Excellent job opportunities are expected for this occupation because rapid employment growth and high replacement needs are projected to produce a large number of job openings.

Job Growth
Employment of home health aides is projected to grow by 50 percent between 2008 and 2018, which is much faster than the average for all occupations. Employment of personal and home care aides is expected to grow by 46 percent from 2008 to 2018, which is much faster than the average for all occupations. For both occupations, the expected growth is due, in large part, to the projected rise in the number of elderly people, an age group that often has mounting health problems and that needs some assistance with daily activities. The elderly and other clients, such as the mentally disabled, increasingly rely on home care.

This trend reflects several developments. Inpatient care in hospitals and nursing homes can be extremely expensive, so more patients return to their homes from these facilities as quickly as possible in order to contain costs. Patients, who need assistance with everyday tasks and household chores rather than medical care, can reduce medical expenses by returning to their homes. Furthermore, most patients—particularly the elderly—prefer care in their homes rather than in nursing homes or other in-patient facilities. This development is aided by the realization that treatment can be more effective in familiar surroundings.

In addition to job openings created by the increased demand for these workers, replacement needs are expected to lead to many openings. The relatively low skill requirements, low pay, and high emotional demands of the work result in high replacement needs. For these same reasons, many people are reluctant to seek jobs in the occupation. Therefore, persons who are interested in and suited for this work—particularly those with experience or training as personal care, home health, or nursing aides—should have excellent job prospects.

Median hourly wages of wage-and-salary personal and home care aides were $9.22 in May 2008. The middle 50 percent earned between $7.81 and $10.98 an hour. The lowest 10 percent earned less than $6.84, and the highest 10 percent earned more than $12.33 an hour.

Median hourly wages of home health aides were $9.84 in May 2008. The middle 50 percent earned between $8.52 and $11.69 an hour. The lowest 10 percent earned less than $7.65, and the highest 10 percent earned more than $13.93 an hour.

Aides receive slight pay increases with experience and added responsibility. Usually, they are paid only for the time worked in the home, not for travel time between jobs, and must pay for their travel costs from their earnings. Most employers hire only on-call hourly workers.

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