Education, certification, training and employment of Personal Care Aides
Around the world, demand for Personal Care Aide (PCA) and Certified Personal Care Aides (CPCA) services are expected to rise sharply over the next three decades due to the exponential growth of the frail elderly population and rapid increases in the number of persons reaching formerly unheard of age groups. The vast majority of these elderly persons will be in need of personal care assistance whether they choose to remain at home or opt to go to a long-term care environment.
Personal care assistants provide routine health and personal care support and assistance with activities of daily living to patients with physical impairments or disabilities in private homes, nursing care facilities, and other residential settings. According to the International Standard Classification of Occupations, they usually do not require extensive health care knowledge or training to practice their profession, but typically require a high level of manual dexterity, physical strength, psychological balance and good interpersonal communication skills.
The work they do is physically demanding. Emotional and social maturity is a must.
A PCA may be either independently contracted on a freelance basis directly by the person needing the assistance or their family, or be employed by aprivate type of care provider, such as in a home health agency, personal care agency or assisted living facility, or employed by a public, government-operated or community-based organization that routinely dispatches providers of personal care to persons in need. The PCA might work exclusively with one client, or have any number of clients. Some PCAs only work for temporary or respite clients, while others prefer to establish long term relationships with persons who need ongoing cares, while still others primarily help discharged hospital patients who have one-time (hopefully), short-term needs.
Traditionally, PCAs were almost always self-employed and only worked for clients who could pay their fees. these type of direct care workers still exist, but are finding more options for employment through the growing home health care industry.
Today there are many ways that a PCA (Personal Care Aide) is employed or paid. The services of a PCA are either paid directly out of pocket for some clients and under a a public or private health insurance system for others.
Financial assistance programs for the disabled or elderly exist in most county or state social welfare systems, with private ‘supplement’ plans meant to provide individuals with funds to support PCA level care.
Education and Training
Non-certified PCAs perform routine personal care, assist with ADLs, and provide home making services such as light house work and meal prep.
Certified Personal Care Aides, much like licensed home health aides, are trained in cooking for clients who have special dietary needs. They learn basic safety and emergency techniques, how to protect and respect patients, how to communicate with other members of the healthcare team, how to organize and manage a domestic care environment, cope with caregiver stress, family conflict, wellness activities and appropriate companionship behavior, assist with basic wellness regimes, and much more.
Although a high school diploma or the equivalent is not generally required, most personal care aides have one before entering the occupation. They usually are trained on the job by nurses, or supervisors and more recently (and increasingly) by online personal care aide courses. A competency evaluation or exam may be required to ensure that the aides have and understanding of their duties and can perform required tasks at a more professional level of skill.
In some countries, and increasingly in the United States, PCAs must receive formal education, pass a competency test and be certified: competency areas typically include communication, personal hygiene, safe transfer techniques, safety and emergency training, infection control, and population specific nutrition, and more in order to qualify to work for certified personal care service agencies that receive reimbursement from social insurance programs, such as Medicare or Medicaid.
In a few states, the only requirement for employment is on-the-job training, which employers generally provide, though the trend is for much more pre-employment preparation. Most states require some type of formal education and training, which is available from online programs, community colleges, vocational schools, and home health care agencies. In addition, most states require criminal background checks on prospective aides.
Increasingly, without additional education and certification advancement in this growing career field is very limited.
Personal Care Aides who work for agencies that receive reimbursement from Medicare or Medicaid must get a minimum level of training and pass a competency evaluation or receive certification. Aides must take a competency exam to become certified without taking any training. These are the minimum requirements by law; additional requirements for certification vary by state.
Aides can be certified by CertifiedCare.org in most states throughout the USA and internationally. Although certification is not always required, employers prefer to hire certified aides because they are able to provide services to a wider variety of clients and are better educated. Certification can require 10-over 80 hours of education and passing an exam. Most agencies or states require additional in-house orientation, observation and documentation of 17 skills demonstrating competency before being assigned to patients/clients.
- World Health Organization: Classifying health workers. Geneva, WHO, 2010.
- “DEFINITION OF CARING FOR ELDERLY”. LiveStrong.com. Retrieved 15 June 2012.
- International Labour Organization: International Standard Classification of Occupations, ISCO-2008: Minor group 532-Personal care workers in health services. Geneva, ILO, 2010.
- US Bureau of Labor Statistics: Occupational Outlook Handbook, 2010-11 Edition: Home Health Aides and Personal and Home Care Aides
- OECD: Long-term Care for Older People. Paris, OECD