Types of Caregivers

Non-Certified Aides / Home Helper / Personal Care Aides / Homemakers / Companions
The non-certified aide or assistant provides custodial, supportive, long-term personal care services which may also include housekeeping, meal preparation, and companionship. However, this can be very confusing depending on which state you live in as there are many variations in job titles, duties and costs. As a general rule these types of non-certified aides usually work as either private-duty hires for families OR as employees of non-medical home care agencies.

Services are privately paid for and not reimbursable under Medicare and private health insurance regardless of whether they are employed with a non-medical home care agency or hired privately. Some long-term care insurance plans may cover these services but need to check with insurance carrier first. Non-certified aides can provide general routine personal care services that often is what is needed most to help care for a loved one at home.

Homemakers and chore-workers fall under this non-certified category also and usually perform light household duties, meal preparation, laundry and other similar tasks. Chore workers sometimes do heavier types of cleaning such as washing windows. Both of these workers are supervised and they do not provide direct personal care as a rule. Companions also without formal training do not perform direct personal care but instead are more limited to providing comfort and companionship to those people who cannot be left alone and unsupervised.

Certified Nurse's Aides (CNA) / Home Health Aides (HHA)
Certified Nurse's Aides (or Assistants) and Home Health Aides work as an essential part of the home health care team under the supervision of other health care professionals such as nurses and rehab therapists. Both CNAs and HHAs are certified with similar required training that varies from state to state. CNAs and HHAs have successfully completed a training course, passed both a written and practical exam and placed on a state registry. In some states the HHA has additional training in the homecare field while in other states the CNA has broader healthcare training including but not limited to homecare.
Certified nurse's aides and home health aides are employed at both medical home health agencies and non-medical home care agencies. CNA's and HHA's services when employed with Medicare / Medicaid home health agencies may be reimbursed when certain requirements are met. These requirements include working under supervision of licensed professionals and a physician approved plan of care authorizing supplemental aide services to skilled care. In contrast aide services are usually not covered by Medicare and private insurance when provided through a non-medical home care agency or private hiring. However privately paying for CNAs and HHAs for needed personal care assistance might be the best or only option when skilled care is not necessary.

CNAs and HHAs both assist patients with activities of daily living (ADLs) including personal care, ambulation, nutritional, medications, toileting, health monitoring (i.e. blood pressure) and sometimes light housekeeping. The certified assistant must be skilled in actual procedures and also make competent observations of a patient's condition for reporting to professionals.

CNAs and HHAs are CPR certified and based on level of training again varying from state to state, may provide additional bedside care. Such care might include wound / bedsore treatments and dressing changes, tube feedings, catheter care, ostomy changes, and diabetic monitoring under the supervision of a Registered Nurse (RN) or Licensed Practical Nurse (LPN).

Licensed Practical Nurse (LPN) / Licensed Vocational Nurses (LVN)
LPNs sometimes known LVNs or practical nurses must pass rigorous specific state curriculum requirements and a standardized national exam after completion of their college program to obtain their nursing license. They are qualified to perform certain skilled nursing procedures and must work under the supervision of a Registered Nurse (RN) or a physician.
Registered Nurses (RN)


Registered Nurses (RNs) have more extensive education and must pass rigorous state curriculum requirements and a standardized national exam after completion of their college program to obtain their nursing license. They are competent to perform all aspects of skilled nursing care in addition to supervising other members of the health team including LPNs/ LVNs, CNAs, and / or HHAs.
Physical Therapists (PT) / Occupational Therapists (OT) / Speech Therapists (ST)
Therapists including physical therapists, speech therapists and occupational therapists assist in the rehab of those with physical injuries or disease. Restoration of mobility, strength, dexterity, balance, communication skills is often the purpose for therapy. Helping individuals who are disabled by physical injuries or disease to regain maximum function with activities of daily living is always a main priority.


Social Workers (SW) / Medical Social Workers (MSW)
Social Workers assist in the evaluation of social, emotional and environmental factors affecting the ill and disabled. They may provide family or individual counseling for those in need or a crisis situation. Medical social workers offer support and often help identify and locate appropriate community resources.

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"Wandering" in Dementia Patients: the Home Care Perspective

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Private Duty Caregivers

Serving Seniors and the Special Needs Child in the home, hospital, nursing home, assisted living, respite, retirement and hospice facilities. We come where you are.

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Mission and Philosophy

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*To maintain quality of life for your loved ones and providing quality service to make life easier for you.

We are here for you when you need us. Services can be arranged from a minimum of 4 hours to 24 hours per day, seven days a week, including holidays.

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Caregivers

When is the right time for a Caregiver?

Do you or someone you know been recently diagnosed?
Dementia
Alzheimer's
Diabetes
Parkinson's
Road to Recovery from Surgery
Transition from Hospital
Risk for Falls
Confusion
Difficulty with independence
Loneliness
Loss of Spouse
Paralysis
Depression
Special Needs Child

Do you find yourself taking off to care for your loved one, and you are not ready for a nursing home? Help is one click away.

What you need to know about Grieving

1. Grief is a normal reaction to loss. A common question you may have is: Am I okay?
Be assured that your experience of grief is normal. You’re not going crazy; you are
grieving. Each of us is aDected by grief in our own way.

2. There may be danger signs with grief. When we behave in self-destructive ways—
if we're suicidal, if we're abusing substances such as drugs or alcohol, or we are
being destructive to others—it is important to seek professional help. Many hospices have support groups or provide referral to resources. Physicians,clergy and even funeral directors can be excellent resources as well.

3 Grief is not a predictable set of stages. Most of us experience grief like a
roller-coaster: there are ups and downs, good days and bad days. And like a roller-coaster, the beginning of the ride is not the worst part. There are no universal stages of grief; each of us has our own personal pathway as we experience loss. Grief can affect us now and years from now.

4. We continue a bond. For most people, the pain of grief does lessen over time. But
we never forget about the person who died.We continue a bond that always lasts.
Sometimes we're afraid that if we let go of grief we'll let go of that connection. But death can never end that; we stay connected.

5 Grief a&ects us inmany ways. We may experience grief physically, emotionally, and
spiritually. If grief physically hurts, talk to a doctor and remind him or her of your loss. Emotions like sadness, loneliness, guilt, or worry are normal parts of
grief. Spiritually, we may be angry at God or alienated from our beliefs. Conversely, we may grow more dependent on our faith.

6. Rituals can help. Funerals, memorials, and other rituals can be important ways to
acknowledge loss and experience our emotions. Some may be helped by freely talking about the loss in a support group or with trusted friends. Some of us may need to say a Final goodbye or a Final “I love you.”


7 A person’s death can bring about other losses. One mother found that as she dealt with the death of her 19-year-old son, she also felt that she lost a connection with many of his friends. After a long caregiving experience, some people need to redefine who they are, as they have lost that role as caregiver and partner.

8. Planning ahead can help. Some days like birthdays, anniversaries, and holidays
may be especially diEcult.We may need a plan to cope. The “three C’s” can be
useful: Choose how you want to spend the day. Communicate those choices to the people around you. Compromise if necessary, especially if the plans involve other family members who may also be grieving.

9 Choose how to adjust to life after loss. While you didn’t have any choice about
losing your loved one, you do have choices: What do you wish to take from your old life into your new life? What memories do you want to take with you? What do you wish to leave behind? As you live your now-changed life, what new skills and insights do you need to add?

10. You don’t have to do this alone. Grief is hard work, but we don’t need to do it
alone. Libraries and bookstores oDer a range of self-help books. Support groups may be helpful. Activities such as journaling, drawing, or making a video montage or photo book can offer comfort. Professional counselors can also offer great support.

We can emerge from this journey and end a life with new satisfactions and joys, while
always keeping a connection to the person we loved.


For more information on hospice, grief and bereavement, or caregiving and end-of-life issues, please visit our website at www.hospicefoundation.org/hfacares or call us at: 800-854-3402.

This Fact Sheet is provided through the support of a grant from the Centers for Medicare and Medicaid Services (CMS) to support hospice and end-of-life care outreach and education. CMS funds of $571,000 with HFA in-kind services of $5,710 are funding a variety of outreach and educational programs, including this Fact Sheet.