All About Unlicensed Caregivers in the Home

There is often confusion about the roles of unlicensed caregivers in the home. There are even different titles used to talk about caregivers, such as home care aides, homemakers, personal care assistants, and personal care aides.

Another title, direct support professional, describes an unlicensed caregiver who helps clients with special disabilities. As you can see, it can be confusing!

Unlicensed caregivers in the home are usually employed by home care agencies, organizations, or clients’ families. Daily assignments may involve working with 1 client or many clients. Work settings include:

• Clients’ private homes
• Hospice facilities
• Residential care facilities
• Adult day care centers
• Senior centers

A Few Facts About Unlicensed Caregivers

The U.S. Department of Labor offers a few facts about caregivers in the home:

• Demand for services is growing faster than for any other home care staff.
• Typical education for employment is high school diploma or equivalent.
• Duties for unlicensed caregivers may vary, from state to state and agency to agency.
• No work experience is usually required.
• Training is usually on-the-job and brief.
• Average wage in 2017 was $23,100.

There are some certification programs available, but they are not typically required. Individual states or employers may require home caregivers to meet some standards, such as:

• Learn basic first aid and emergency response procedures.
• Abide by specific restrictions when preparing meals for clients.
• Provide their own reliable transportation to work.
• Be in good physical condition to handle the physical demands of the job.

Unlicensed Caregiver Role

An unlicensed caregiver’s role in the home is to provide unskilled services that serve the needs of clients who are unable to take care of their own hygiene, nutrition, or living space without help. They also provide companionship. Clients should perform their daily activities as independently as possible, and unlicensed caregivers will follow a service plan in providing assistance.

General Duties

Each home care agency will decide the things that unlicensed caregivers are expected to do for and with clients. They typically include:

• Helping with meals.
• Light cleaning.
• Laundry.
• Changing bed sheets and towels.
• Assisting clients with personal hygiene care.
• Helping clients get dressed, from laying clothing out to helping them put clothing on.
• Getting clients’ mail and newspaper.
• Helping with a transfer or walking beside clients who are unsteady, especially to the bathroom or for a walk outside.
• Assisting with toileting.
• Driving clients to run errands, get to an appointment, or meet with others.
• Shopping for items such as food and toiletries.
• Picking up clients’ medications from the pharmacy.
• Reading medication labels for clients and reminding them to take their medications. It may also include handing a pre-filled medication box to a client and opening the lid for them.
• Providing minor first aid per agency policy and procedure.
• Assisting with changing wound care dressings that do not require medication IF the agency and state law allow it.
• Lifting light loads.
• Being a friendly, engaged companion.

Some states and agencies may allow unlicensed caregivers to do range of motion exercises with clients. Some may have them check clients’ vital signs. If an agency provides certified home health or hospice care, unlicensed caregivers may be asked to do formal training and pass a test.

What Are Unlicensed Caregivers NOT ALLOWED To Do?

Clients or their families may ask caregivers to perform tasks that are outside of their qualifications, responsibilities, and job duties as an unlicensed caregiver.

Guidelines must be firmly established by the home care agency or organization and communicated to the caregiver.

There are a few specific things that are NOT ALLOWED, such as providing any type of medical services. Unlicensed caregivers may not:

• Give medications of any kind.
• Mix medications for clients or fill their daily med minder box.
• Give advice about medications.
• Perform a medical assessment.
• Provide medical care.

If there is ever any question about what an unlicensed caregiver may or may not do with or for a client, the service plan and the supervisor can provide guidance.

A Critical Role

Unlicensed caregivers have a special role to fulfill in home care. The typical duties required may vary from agency to agency and state to state. It is important to be aware of what they are being asked to do, as well as what they are allowed to do as unlicensed caregivers. They are critically important in helping clients live as independently as possible in their own homes!

Without this crucial member of your staff, it would be extremely difficult to provide the best quality of care for clients and keep your home care agency prospering.