Home Health Aide Worker qualifications in the United States

Entry-level qualifications in the USA require workers to have a High School Education or GED and some agencies require 1 year experience, and must pass a competency test. Competency implies the worker has knowledge of home and patient safety, ability to safely deliver personal care, proper use of assistive equipment (wheelchair, walker, cane, crutches, mechanical lifts, etc.), food preparation, care of the home, sanitary conditions, etc. Workers need to also display the ability to observe and report to the nurse any changes in the patient's overall condition. Many of the duties of home care workers involve good common sense also.
Often workers have had experience in a Nursing Home (institutional care) prior to being hired in a home care agency. Workers can take an examination to become a State tested Certified Nursing Assistant (CNA) and be included in a State Registry. Other requirements in the U.S.A. include a background check (police check with finger-printing), drug testing, general references and applicant interview. There is no specialization of workers for particular types of patients, but employees receive individual instruction (usually by the Registered Nurse) as needed for specialized patient care.

Home Health Care in the United States

While there are differences in terms used in describing aspects of Home Care or Home Health Care in the United States and other areas of the world, for the most part the descriptions are very similar.
Estimates for the U.S. indicate that most home care is of the informal variety with families and friends providing substantial amounts of care, including very high tech kinds of care as well as simpler assistance with bathing or dressing. For formal care, the health care professionals most often involved are nurses followed by physical therapists and home care aides. Other health care providers include respiratory and occupational therapists, medical social workers and mental health workers. Physicians may perform home visits also. To find such a physician, contact the American Academy of Home Care Physicians (AAHCP). In the U.S., home health care is generally paid for by private employer-sponsored health insurance or public payers (Medicare and Medicaid), or by private-pay (paid with the family's or patient's own resources).

• ADLs and IADLs
  Activities of daily living (ADL) refers to six activities (bathing, dressing, transferring, using the toilet room, eating, and walking) that reflect the patient's capacity for self-care. The patient's need for assistance with these activities for the Study mentioned was measured by the receipt of help from agency staff at the time of the survey (for current patients) or the last time service was provided prior to discharge (for discharges). Help that a patient may receive from persons that are not staff of the agency (for example, family members, friends, or individuals employed directly by the patient and not by the agency) was not included in the Study.
  Instrumental activities of daily living (IADL) refers to six daily tasks (light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone, and managing money) that enables the patient to live independently in the community. The patient's need for assistance with these activities was measured in the Study by the receipt of help from agency staff at the time of the survey (for current patients) or the last time service was provided prior to discharge (for discharges). Help that a patient may have received from persons who are not staff of the agency (for example, family members, friends, or individuals employed directly by the patient and not by the agency) was not included in this Study.
  Most agencies do not provide transportation, such as to doctor's offices. Workers can do errands for the patient though.
  
• Licensure and Providers in Florida
  Florida is a Licensure State which requires different levels of licensing depending upon the services provided. Companion assistance is provided by a Home Maker Companion Agency whereas Nursing Services and assistance with ADL's can be provided by a Home Health Agency or Nurse Registry. The State licensing authority is the Agency for Health Care Administration (AHCA)

The Concept of Home Health Care

Home Care and Home Health Care are phrases that are used interchangeably in the United States, by both laypersons and professionals, to mean any type of care given to a person in their own home. Both phrases are used interchangeably regardless of whether the person requires Skilled Care by professionals or not.

Home care aims to enable people to remain at home rather than use residential, long-term, or institutional-based nursing care. Care workers visit service users (patients) in the person's own home to help with daily tasks such as getting up, going to bed, dressing, toileting, personal hygiene, some household tasks, shopping, cooking and supervision of medication.
There may be differences in other countries about types of services delivered. In the United States, a Home Care Patient might receive care from Home Health Aide workers only; or a combination of Skilled Services by a Licensed Professional and Home Health Aide workers.
From the description of services for the United Kingdom, there are apparently large differences in the number of visits to a patient in the home (In the description below, care is given twice daily in the United Kingdom.) In the U.S., workers visit the home on a schedule determined in part by a Licensed Physician and in part by the type of insurance a patient has. Visits range from a few days a week, to every day. Visits are at minimum 2 hours' duration, but can range up to around-the-clock service in the U.S.