Direct Care Staff / Aides for the Developmentally Disabled

  1. 4

    Direct care staff persons, also known as aides for the intellectually disabled, may disputably be the most important types of workers in the lives of the patient populations whom they serve because they provide all of the personal care for their developmentally disabled clients.

    Direct Care Staff / Aides for the Developmentally Disabled

    Developmental disabilities nursing is an often-overlooked specialty in need of tolerant employees who can provide sensitive care and patiently keep up with the various challenges that are unique to clients with mental retardation. Four degrees of mental retardation exist: mild, moderate, severe and profound. Direct care staff, also known as aides for the intellectually disabled, might be the most significant type of workers in the lives of the clients whom they serve.


    In the developmental disabilities industry, direct care staff members are the employees who attend to the most basic needs of clients who have the varying degrees of mental retardation that were previously listed. Direct care staff persons help maintain the smooth operation of the facilities that shelter intellectually disabled clients through the provision of essential care such as oral care, bathing, showering, incontinent care, toileting, dressing, meal preparation, feeding, hydration, transfers and other activities of daily living.

    Due to working in homelike settings such as group homes and apartments, many direct care staff members also perform light housekeeping tasks on occasion such as doing laundry, making beds, washing dishes, sweeping, mopping floors, vacuuming carpets, and disinfecting countertops. Some direct care staff persons accompany the clients to their day programs and field trips, while others might be required to use company vehicles to drive clients to and from various appointments from time to time. Many companies allow direct care staff members to pass oral and ophthalmic medications to clients after having undergone specified training. Direct care staff persons sometimes play games, eat meals and watch television with their clients.

    Work Environment

    Direct care staff members typically work in climate-controlled settings such as group homes, residential care facilities, state hospitals, and day program centers. Many of these workplace settings require 24-hour staffing, so some direct care staff persons work days, evenings, nights, weekends and holidays. Heavy lifting may be required because immobile clients will be unable to transfer themselves from the bed to a wheelchair. Contact with blood, urine, feces and other bodily substances might occur; however, the risk can be minimized through proper use of personal protective equipment when providing the types of direct care that are likely to result in exposure.

    Educational Requirements

    The duties and responsibilities of direct care staff members can be learned through on-the-job training. Most companies will require candidates to have a minimum of a high school diploma or GED. A handful of organizations prefer that applicants possess a CNA (certified nursing assistant) certificate and previous healthcare experience in a direct care role.

    Personal Attributes

    Ideally, direct care staff members should be patient, calm and able to deal with intellectually disabled clients who might display problematic behavioral issues at times. Direct care staff members should also exhibit a tolerant attitude toward unpleasant sights and smells. In addition, the ability to multi-task and learn quickly will serve direct care staff persons well.


    According to the United States Bureau of Labor Statistics, the May 2010 median pay of direct care staff persons employed at residential mental retardation facilities was $23,360 annually.


    Feeling the Strain: Job Stress and Satisfaction of Direct-Care Staff in the Mental Handicap Service (pdf)
    Direct Care Staff Training: Training Overview
    Psychiatric Technicians and Aides : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics
    Last edit by Joe V on Jun 17, '18
    Do you like this Article? Click Like?

  2. Visit TheCommuter profile page

    About TheCommuter, BSN, RN Moderator

    TheCommuter is a moderator of and has varied experiences upon which to draw for articles. She was an LPN/LVN for more than four years prior to becoming a registered nurse.

    Joined: Feb '05; Posts: 38,032; Likes: 69,313
    CRRN, now a case management RN; from US
    Specialty: 11 year(s) of experience in Case mgmt., rehab, (CRRN), LTC & psych

    Read My Articles


  3. by   ShelbyaStar
    I am a DSP working on my prereqs for nursing school. Once I have my CNA I will do that instead, but for the time being I thought this was a great way to see if I could handle healthcare. I do believe it pays slightly more than CNAs in this area, and I also am getting experience passing meds.

    The house I work in has a variety of patients. One is high care needs, one only needs a little bit of support, one is verbally aggressive and one is physically aggressive. Most houses are a bit more homogenous than that. Usually if you are in high care you get paid a little more, and definitely if you are in a house with a lot of physical behaviors.

    In any case it's worked out well for me. The scheduling has been pretty flexible (since starting school I dropped to being fill in but have no shortage of shifts to pick up) and if something at one house isn't working out I can transfer to another. It's great experience and it's been rewarding. It gave me a lot of insight not only to health care but mental as well.
  4. by   dsplori
    I've been a DSP for over 23 years. We are the most overlooked, underpaid people in the medical field. Most people in the medical field don't even know what we are.
  5. by   TheCommuter
    Quote from dsplori
    I've been a DSP for over 23 years. We are the most overlooked, underpaid people in the medical field. Most people in the medical field don't even know what we are.
    However, developmental disabilities nursing is one of nursing's best-kept secrets. In the area where I live, many RNs work as care managers for companies that run the group homes that house the MHMR clients. It's a nice gig...
  6. by   Farawyn
    If this is about Direct Care Workers, as they were called back in my day, I have many mixed feelings. I worked as a DCW for 3 years until I got my BA in Psych and became an Applied Behavior Spec. Then I went back during nursing school. Total time there> 6 years.
    It was the best and worst job ever.
    Worst? The pay. OMG, the pay was terrible! We showered the guys, were AMAP trained, so we passed narcs, were SCIP trained ( I think it's called something else now, and is totally different...) for "takedowns' The guys were straight out of Willowbrook. When they first got to the home, they used to just poop on the floor. They had no idea. I worked with moderate to profound mental retardation. Half the population could not speak.
    Also, because the pay was bad, the requirements for this job was "HS diploma". Yes, the company tried to hire people with an interest in Psych, SW or Health Care, but really, if you needed to work nights, they did not care.
    The best? Well. The guys themselves. We called them "the guys". I think the proper term was "clients" at that time. No. They were "the guys". We had the best time with them. They were fun and excited and eating machines and really earnest in trying to masturbate (but most were on too many drugs to make that happen) Caring for them, eating with them, taking them out, day trips, road trips, the Special Olympics? Some of the best memories I've had.
    Scary times were the non stop seizures. And the elopements. And the tardive dyskinesia. And the hospitalizations. And the rages. I got my butt handed to me by a 55 year old man who wanted to rip every bit of my hair out because he didn't earn his "star" that hour. I also got bit, and still have the scars.

    Being a Direct Care Worker to these 13 guys (and ladies) was what made me consider nursing over Psych. Most of the guys were not at home, or in group homes, they were institutionalized. It was the day to day hands on care that made me feel as if I made a difference.
  7. by   TheCommuter
    Quote from Farawyn
    Also, because the pay was bad, the requirements for this job was "HS diploma". Yes, the company tried to hire people with an interest in Psych, SW or Health Care, but really, if you needed to work nights, they did not care.
    Yep! I got my first direct care worker gig with no education beyond a high school diploma. This was 15+ years ago when I was 19. The $8/hourly wage left much to be desired, especially considering the fact that I also administered clients' medications.

    However, my experience at the DD group home solidified my decision to become a nurse. It also made me realize that real nursing takes places in settings outside the hospital upon which everyone seems to place on an undeserved pedestal.
  8. by   Farawyn
    Here's a blurb on Willow Brook, with Geraldo Rivera!

    Geraldo Rivera: Willowbrook
  9. by   Farawyn
    Also, I have to say the TAs who work in the school with the guys are pretty great, too. Not direst care worker per se, but it is a hands on job sometimes.
    Last edit by Farawyn on Nov 25, '15