Everything You Need to Know About Home Health Aides (HHAs)

Every profession uses their own terminology to identify particular roles. But it can be difficult to understand exactly what a title signifies if you are not a part of that environment, or it is not entrenched in popular culture. We have a general idea (although exaggerated) of what forensics involves because of the show CSI and its spinoffs. Home health care has yet to make the same splash. To remove much of that uncertainty, we are going to focus on one particular role in home care—the home health aide.

What is a Home Health Aide and what do they do?

A home health aide provides basic care for a person that needs assistance. This is typically for an elderly person, but there are younger people who have disabilities or conditions with medication requirements that also require support.

Basic care includes the activities of daily living:

  • Personal hygiene
  • Companionship
  • Dressing
  • Grooming
  • Helping with mobility
  • Assistance with eating
  • Providing medication reminders
  • Light housekeeping

Providing companionship is another important role they fulfil. The deteriorating health of an aging person can lead to them becoming very socially isolated. This in turn can greatly exacerbate symptoms and worsen their condition. Having someone who cares visit regularly has a tremendous effect on an isolated person’s mental and physical wellbeing.

Home health aides are limited to this type of basic care because of the low training requirements to become qualified. 

The state of New York has recently passed legislation that allows home health aides to administer medication if they receive additional training. They will have had to be working for one year to be eligible, and the training will be given over a period of two weeks. This will even include insulin injections to diabetic patients.

How does one become a Home Health Aide?

There is a federally mandated requirement that an aide receive 75 hours of training. 40 hours of this must be devoted to the home care curriculum, and the remaining 35 hours must be home care related. 16 hours must also be fulfilled in a clinical setting. Every 12 months, an aide will need to complete a further 12 hours of continuing education training.

The curriculum that a training institution must abide by includes modules on:

  • Food nutrition and meal preparation
  • Safety and injury prevention
  • Personal care skills (i.e. bathing, urinary system, proper movement techniques)

There are concerns that the current amount of required training is not sufficient to prepare home health aides for their challenging tasks. To address this, some states have their own requirements. For example, Maine requires 180 hours of training, more than double the minimum. The state of New York only requires the federal minimum. 

This is why it is so important to choose a reputable agency when you are looking for a home health aide. You want to make sure that in addition to the minimum training, the person has been vetted using strict guidelines. 

One benefit of such a minimal barrier to entry is that it allows a person to see if they want to work in the healthcare industry without forcing them to make a large commitment. This allows many people to try the field out that may have otherwise been scared off.

Those that choose to remain should have a passion for the role. Taking care of the sick and elderly is not easy. Both the aide and the one being looked after will enjoy their time much more when passion is involved. 

Average Salary of a Home Health Aide

In 2015, the median salary across the country for a home health aide was $21,920. This range started at $17,480 on the low-end, and ended at $29,950 on the high-end.  In the state of New York, the average salary is $23,370. Hourly rates in the state range from $15 to $35. A major determining factor of rate of pay is location. Aides in Rochester tend to make more than those in New York City.

Live-in care can also offer additional benefits to the hourly rate you charge. Some arrangements include room and board, which significantly cuts your personal costs.

There is room for growth in the field, as there are many positions that require more training, and pay more as a result. See the discussion below on certified nursing assistants and nurses.

Did you know Mavencare Home Health Aides make over $150 a day on live in shifts? Click here to apply if you are interested in doing live in shifts. 

Working as a Home Health Aide: Private vs Agency vs Assisted Living Facility

If you are a home health aide or planning to become one, you may be having a hard time deciding if you would like to operate privately or through an agency. 

An obvious benefit of working privately is that it allows you to remain in control and be your own boss. As a result, you may be able to charge more for your services. But there are some important caveats to be aware of. 

It will be very difficult for you to establish a reputation without the backing of a reputable agency. Many choose this career path because they enjoy the work and rewards of taking care of others. Then there are others who try to take advantage of the incredibly vulnerable people they service. Reassuring your client’s families that you can be trusted with their loved ones will be challenging.

Charging higher rates may also not be easy because of the tax burden that your clients may face when hiring you privately. Social security, unemployment, and payroll taxes become the responsibility of the private employer. This is an obligation that many may not wish to deal with, which is another barrier to finding clients.

Operating through an agency gives you access to support when issues arise. It also facilitates the relationship between the client and yourself so you do not have to do the groundwork. A good agency will do their best to match you with clients that you are the most suited to work with. Your level of training, culture, language skills, and hobbies will be taken into account so that you are matched with ideal clients. 

Working for an assisted living facility has its own issues. Some home health aides will operate in such a facility, but only be responsible for one resident, as if they were going to that person’s home. Others work for the facility directly and become responsible for a large number of patients.

This can easily include residents who have health concerns that you have not been trained to handle. Dementia care is very different than caring for someone who has arthritis. Many of these aides also find that they are overworked. This lowers the quality of care you are able to provide, and thus your job satisfaction. Such an environment makes it difficult to develop a meaningful bond with your client, which is one of the most rewarding aspects of the role.

Differences between a Home Health Aide (HHA), Certified Nursing Assistant (CNA), and Nurse

What separates home health aides and other healthcare professionals is their level of training. This has a direct effect on the activities that they are permitted to engage in.

A certified nursing assistant (CNA) is the next level above the home health aide. Their training requirements are 25 hours longer, and must be completed at a state-approved training program. They are then required to pass a certification exam. The other major difference is that CNAs typically work in assisted living facilities.

Nurses are next up the hierarchy. There are two types of nurses: licensed practical nurse (LPN) and registered nurse (RN). 

An LPN requires significantly more training than a CNA, but is still limited in the tasks they can perform. They must have an RN available who can help with supervision if necessary. There are certain tasks that they can only perform under that supervision, and some tasks that they cannot perform at all, which an RN must do.

An RN thus has more opportunities because they do not need to be supervised. Their education requirements are higher than an LPN, but they get paid higher than any of the other care providers already discussed.

What to look for in a Home Health Aide (HHA)

So how should you determine if someone is an appropriate person to take care of your loved one? There are key things to be aware of.

First, the most important qualities for a home health aide to have are:

  • Dependable
  • Sociable
  • Honest
  • Objective
  • Caring
  • Patient
  • Respectful
  • Knowledgeable

How much experience the caregiver has in caring for others should also be carefully considered. In particular, how much experience providing the type of care that your loved one needs. A caregiver could be amazing in providing all of the basic care needs a person has, but may have never handled the intricacies involved in caring for someone with dementia. An agency that takes all of these factors into account will alleviate much of this uncertainty.

You also want to be absolutely certain that your aide has the proper certification they need. It is very risky to hire someone who has not been properly trained. Moving your loved one from place to place is particularly dangerous. An accident could result in very serious health concerns, even death.

Take time to choose your home health aide and agency so that you can be confident your loved one is receiving the care they deserve. There should be no doubt that who you hire has passion for their role. You want your loved one to easily build a connection with their caregiver, and finding the right person is crucial.


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