Anyone working as CNA Home Health Aide?

Nurses General Nursing

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Hi everyone, I'm new and I'm not sure if this post belongs to the write thread but I have some questions about CNAs working at people's homes.

I just had my CNA license and I thought of starting as home health aide since CNA jobs at hospitals and nursing homes in my area require experience.

To those working as home health aide:

How many homes do you go to in a day and how long do you provide service in a home?

Do you drive patients to their doctor's appointments?

Do you prepare their meals too?

Thanks.

I'm not a HHA but have worked in HH a long time. I think typically HHA's would see about 6 pts a day, probably spending anywhere from 45 mins to 1 1/2 hours at each home. Care would include checking VS, assistance with bathing, dressing, and grooming, and possibly simple dressing changes or exercise programs, under the direction of a nurse or therapist. You would not be responsible for transportation, shopping, meal preparation, or housekeeping (except as pertains to the care you're providing, like linen changes, cleaning up after a bath, etc).

You should check out the home health threads, I'm sure you can find a lot more info there.

Specializes in NICU.
Hi everyone, I'm new and I'm not sure if this post belongs to the write thread but I have some questions about CNAs working at people's homes.

I just had my CNA license and I thought of starting as home health aide since CNA jobs at hospitals and nursing homes in my area require experience.

To those working as home health aide:

How many homes do you go to in a day and how long do you provide service in a home?

Do you drive patients to their doctor's appointments?

Do you prepare their meals too?

Thanks.

Actually, the schedule of a HHA is considerably different than a visiting nurse (at least, it was for the company for whom I worked as an HHA, and I'm pretty sure this is true across the board). I worked 8-hour night shifts in one home at a time and provided basic CNA care that varied depending on the needs of the patient - help with turning, moving, bathing, dressing, ROM exercises, etc. It did depend on the family, though - I worked one assignment for a woman who was a quadriplegic and trached, and my only responsibility was to listen for when she made a little smacking sound with her lips, which meant she wanted me to get one of her family members who were sleeping. I think - although I'm not positive - that we weren't allowed to transport patients in our cars due to liability issues, though I did do some shopping for one of them. And there was another couple that I did some meal preparation for, although by the time the woman was wheeling into the kitchen and basically ordering gourmet meals from me, I was about ready to suggest to my company that what she needed was a live-in housekeeper, not an HHA :rolleyes:

Specializes in Neuro, Neuro ICU.

I do in home care for an elderly lady and I clean, cook, etc along with the ROM, Bathing, Dressing, Etc... I also will go with her husband to doctors appointments (he drives) but he cannot lift/transfer her since she is in a wheelchair. I think it depends on if you work through an agency or not though. I work for this lady's husband who pays us from his own checking account. There is someone there 24 hours a day, 7 days a week unless she is in the hospital for some reason.

The posters above are probably working in private duty or extended care home health, which is a little different from my area of experience. The HHA position I described in my first post would be in an intermittent home health setting, working for a "skilled" home health agency (before I get flamed, that's just how it's termed for licensure, I'm not saying there aren't personnel with skills working in PD or EC), when a pt is seen 2-3 times a week for relatively short periods of time, for personal care assistance, and also receiving intermittent nursing or therapy services.

As you can see, there are different ways you can go even within the home health field.

Specializes in NICU.
The posters above are probably working in private duty or extended care home health, which is a little different from my area of experience. The HHA position I described in my first post would be in an intermittent home health setting, working for a "skilled" home health agency (before I get flamed, that's just how it's termed for licensure, I'm not saying there aren't personnel with skills working in PD or EC), when a pt is seen 2-3 times a week for relatively short periods of time, for personal care assistance, and also receiving intermittent nursing or therapy services.

As you can see, there are different ways you can go even within the home health field.

What's the official distinction between private duty, extended care, and intermittent home health? I don't think I was working "private duty" (although that's based on my assumption, possibly flawed, that private duty HHAs are hired directly by the patient/family, not through an agency). "Extended care" is possible, given that I dealt with mainly patients like that quadriplegic and occasionally a hospice case, but the woman who was directing her meal prep only needed help transferring to the bathroom at night while she recovered from a broken hip, which seems more "intermittent" to me.

Specializes in Peds Homecare.

First of all to do Home Health Aide work you need to take the HHA class, in New York State. CNA and HHA, are not interchangeable. Also cases vary from 1-2 hours, to 8. It just depends. Sometimes you do shopping for them, sometimes you do baths, assist with dressing,acompany them to drs appts, tidy up their homes,cook meals for them, excetera. It all depends on the patients needs. There is not a set list of duties. give an agency in your area a call, I'm sure they can give you more information.

In Illinois, you must be a CNA to work as Home Health Aid in Intermittent Skilled Home Health agencies.

The terminology is probably different in different areas of the country, or maybe even from agency to agency within the same area. I think what Coffee Nurse is describing would be referred to as Home Services (a brand new type of licensure in IL as of 2008). These agencies provide workers, or "homemakers", (who are not required to be CNAs but often are) to assist with personal care as well as housekeeping, errands, transportation, meal prep, and so on. They can work either for short periods of time (1-2 hours) for a variety of clients each day, or they can provide "shift" services of 8-12 hrs up to around the clock care. Most clients who require ATC care pay privately for most of their services or may have LTC insurance to help. Some gov't agencies provide payment assistance for those clients who only need help for short periods of time a few days a week. These services do not require orders from a physician or oversight by a nurse.

In intermittent skilled home health, a Home Health Aide must be a CNA. They provide services through a Medicare approved agency in conjunction with nursing or therapy services. They assist with bathing, grooming, and dressing, and can also perform simple dressing changes, ROM exercises, and VS checks, under the supervision of an RN or PT/OT. Physician's orders are required for all services, and they are provided intermittently, usually 2-3 times a week, for periods of time lasting 1/2 hr - 1 1/2 hrs or so.

To further confuse things, IL has a third category of licensed services called "Home Nursing". These agencies are sort of in between Home Health and Home Services. You must be a CNA to work in Home Nursing. Services provided are similar to Home Health, but can be intermittent or shift. Physician's orders are required.

I did it before and won't do it again.

Specializes in NICU.
In Illinois, you must be a CNA to work as Home Health Aid in Intermittent Skilled Home Health agencies.

The terminology is probably different in different areas of the country, or maybe even from agency to agency within the same area. I think what Coffee Nurse is describing would be referred to as Home Services (a brand new type of licensure in IL as of 2008). These agencies provide workers, or "homemakers", (who are not required to be CNAs but often are) to assist with personal care as well as housekeeping, errands, transportation, meal prep, and so on. They can work either for short periods of time (1-2 hours) for a variety of clients each day, or they can provide "shift" services of 8-12 hrs up to around the clock care. Most clients who require ATC care pay privately for most of their services or may have LTC insurance to help. Some gov't agencies provide payment assistance for those clients who only need help for short periods of time a few days a week. These services do not require orders from a physician or oversight by a nurse.

In intermittent skilled home health, a Home Health Aide must be a CNA. They provide services through a Medicare approved agency in conjunction with nursing or therapy services. They assist with bathing, grooming, and dressing, and can also perform simple dressing changes, ROM exercises, and VS checks, under the supervision of an RN or PT/OT. Physician's orders are required for all services, and they are provided intermittently, usually 2-3 times a week, for periods of time lasting 1/2 hr - 1 1/2 hrs or so.

To further confuse things, IL has a third category of licensed services called "Home Nursing". These agencies are sort of in between Home Health and Home Services. You must be a CNA to work in Home Nursing. Services provided are similar to Home Health, but can be intermittent or shift. Physician's orders are required.

Actually, it sounds like HHAs in New Hampshire (which is where I worked, since it seems it makes a difference) align most closely with the "home nursing" area -- CNA certification was required, and we reported to an RN by phone if there were any changes in patient condition.

Thank you all so much for the infos and experiences you shared.

HMarie, thank you for the explanation of the difference between HHA and Homemakers working under agencies.

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