7.2.2: Role of the Home Health Aide/Personal Care Aide

The role of a Home Health Aide/Personal Care Aide will vary depending on the needs of the patient with a physical disability and their family. The Care Plan will direct them as to what their patient’s needs are and the tasks they are required to perform. Whenever in doubt about what they should be doing for their patient, they should seek guidance from their supervisor and ask for clarification. Remember that the patient’s needs and goals always come first. Help promote self-determination by encouraging them to set goals and helping them to achieve those goals.

For many patients, Home Health Aides/Personal Care Aides will assist with providing or assisting to provide self-care. The personal care skills learned in previous modules and in future modules in this course will all be used when working with a patient with a physical disability. This includes bathing, skin care and dressing, toileting, feeding, and assisting with ambulation or use of adaptive equipment.

Part of the job of a HHA/PCA while working with a person with a physical disability may be to help them learn to safely use adaptive equipment such as eating utensils and transfer devices such as wheelchairs or canes. This will help promote independence for the patient. Home Health Aides/Personal Care Aides should always keep in mind safety risks and work to provide a safe and clean environment for their patient. Ensure there are accessible routes for the patient in case of an emergency. If a patient’s home requires special adaptations to provide for the patient’s safety and independence, such as wheelchair ramps or safety bars in showers, speak with a supervisor about these needs.

Home Health Aides/Personal Care Aides will monitor their patient’s health as directed by the Care Plan. They may be asked to measure intake and output. They may assist with shopping, housekeeping and meal preparation for their patient. They may provide respite for the family or assist with child care. Using good communication skills is important and essential in doing the job well and meeting the needs of a patient. It will also be part of the job of Home Health Aides/Personal Care Aides to help teach patients who need help learning effective coping skills. Remember skills learned in how to be a good listener and demonstrate empathy for all patients and their families. Never assume you understand their individual experience. Allow them the space and time to express themselves.

As with all patients, an important part of the job of Home Health Aides/Personal Care Aides is to always be observing and documenting changes in physical, mental, emotional, or social health. Report any issues of concern to a supervisor immediately. Always document all observations and tasks completed. Be watchful of issues of concern in the home such as domestic violence, substance abuse, or child abuse. Report any concerns to a supervisor immediately.

Social, Cultural, and Environmental Influences in Caring for People with Disabilities

As we have discussed throughout this course, all people have different views of family, come from different cultures, and have different beliefs and values. Everyone has their own unique identities and we all have many parts to what makes us who we are. Regardless of whether the person has a physical disability, it is important to remember that all of these differences should be respected and valued. It is also important to keep in mind the unique physical limitations that a patient may have and what they mean to them. Home Health Aides/Personal Care Aides should never be judgmental about what a person can or can’t do. Remember to always see the person, and not the disability. Use terms the patient and family prefers when discussing physical disability and limitations. Don’t say things such as “He/she is crippled” or “He/she is disabled.” The patient is a person with a disability. Their disability does not define who they are. All it means is that the patient and the HHA/PCA may need to be creative in learning to adapt with any physical limitations. Focus on the word ability in the term disability.

Keep in mind that it may be more difficult for a person with a physical disability to access community resources due to physical limitations, and opportunities for socialization may be limited. They may also be concerned about going out in public with their disability and perhaps may be embarrassed by their physical limitations. While many people in our society are supportive of differences in others, there are some people who may make the patient uncomfortable with asking personal and intrusive questions about their disability, staring at them, or exclude them because of physical limitations. Home Health Aides/Personal Care Aides should provide support to their patient as they deal with their many emotions and help to teach others to accept differences we all have. Provide as many opportunities as possible for the person to interact with others and to remain an active member of their community.

Situations in Which People with Physical Disabilities May Require Home Care

A person with any type of physical disability, whether it is temporary or permanent, may benefit from home care. Home care services for a person with a physical disability are directed at helping the person meet their physical, emotional, and social needs. A person may have trouble performing activities of daily living (ADLs) independently. They may be unable to perform tasks such as bathing, dressing, toileting, or feeding themselves. They may be unable to transfer from a bed to a toilet or to safely get into the bath tub. A person with a physical disability may have difficulties with maintaining a clean home or shopping for and preparing food. A parent who has a physical disability may need assistance with child care for their children.

While some people may only need home care for a short time, such as while recuperating from an injury or surgery, other people may need home care throughout their lives to help them remain in their home rather than a long-term care facility. Dealing with the many stressors of everyday life, and as a result of their physical limitations, a person with a physical disability may require home care to provide the support they need. Home Health Aides/Personal Care Aides can help provide the emotional support the patient and family needs in addition to providing assistance with physical tasks such as transfers, meal preparation, household cleaning, and bathing.