Personal Care Assistant
- This article deals with employed personal assistants of disabled (primarily mobility impaired) individuals. For the more general concept of (unpaid) caregiving among relatives or friends of a disabled individual, please see caregiver; for the employed assistants of developmentally disabled individuals, see direct support professional. For personal assistants in business and related fields, see the article personal assistant.
A Personal Care Assistant (PCA) - variously known under alternate names such as caregiver, personal care attendant, patient care assistant, personal support worker and home care aide - is a paid, employed person who helps persons who are disabled or chronically ill with their activities of daily living (ADLs) whether within the home, outside the home, or both. They assist clients with personal, physical mobility and therapeutic care needs, usually as per care plans established by a rehabilitation health practitioner, social worker or other health care professional.
While there is no single definition or professional title for PCAs, in general they may be distinguished as persons who carry out their work as part of the formal health and social services labour market, in contrast to relatives, friends and others who are unpaid for their caregiving activities.
Personal Care Assistants may help with daily activities, such as helping the individual bathe, eat, prepare meals and maintain their home. Personal Care Assistants may provide rehabilitative assistance for individuals who have had surgery or been ill. In-home hospice care may also be provided.
Training and employment
Personal care assistants provide routine health and personal care support and assistance with activities of daily living to patients with physical impairments or disabilities in private homes, nursing care facilities, and other residential settings. According to the International Standard Classification of Occupations, they usually do not require extensive health care knowledge or training to practice their profession, but typically require a high level of manual dexterity and good interpersonal communication skills.
Personal care assistants help clients with mobility restrictions to get out of bed, bathe, dress, and groom. They may provide some basic health-related services, such as checking the patient's pulse rate, temperature, and respiration rate; helping with simple prescribed exercises; and assisting with medications administration. They may advise families and patients on nutrition, cleanliness, and household tasks. Depending on the clients' needs, they may change simple dressings, provide skin care, or assist with braces and artificial limbs. Some accompany clients to doctors' appointments or on other errands, and may also provide light housekeeping and homemaking tasks.
A PCA may be either independently contracted on a freelance basis directly by the person needing the assistance or their family, or employed by a larger staff network of care providers, such as in an assisted living facility, or employed by a private, government-operated or community-based organization that systematically dispatches providers of personal care to persons in need. The PCA may work exclusively with one client, or have a number of different clients. Some PCAs work with clients with long-term care needs, while others may primarily help discharge hospital patients who have relatively short-term needs.
There is no single model for how a PCA may be employed or paid, just like there is no single model for a larger health and social care system. The services of a PCA may be paid directly for some clients under a universal coverage health care system. Or financial assistance programs for the disabled may exist amidst the structure of a country's welfare system, with 'supplement' schemes meant to provide individuals with funds to enable PCA care. Or PCAs may be wholly self-employed and only work for clients who can pay set fees. Because a PCA does not generally provide round-the-clock care or stay overnight at a client's residence, most PCAs work in shifts to meet individual clients' needs.
In some countries, PCAs must receive formal training and pass a competency test in areas such as personal hygiene, safe transfer techniques, reading and recording vital signs, infection control, and basic nutrition in order to qualify to work for certified personal care service agencies that receive reimbursement from social insurance programs, such as Medicare or Medicaid in the United States.
Around the world, demand for PCA services are expected to rise sharply over the next three decades with population ageing and rapid increases in the number of persons reaching the oldest age groups and in need of personal assistance and long-term care.
In some developed countries, a careers rights movement has developed in which, its PCAs claim, there does not exist adequate program funding to give rise to adequate pay for the often very intense and physically demanding work. The fact that most persons who are disabled or chronically ill tend to have very limited individual financial resources to pay, or even to supplement, the PCAs' wages themselves, means that this lack of funding for all parties possibly creates stressful work environments for both the workers and their clients.
- World Health Organization: Classifying health workers. Geneva, WHO, 2010.
- "DEFINITION OF CARING FOR ELDERLY". LiveStrong.com. Retrieved 15 June 2012.
- International Labour Organization: International Standard Classification of Occupations, ISCO-2008: Minor group 532-Personal care workers in health services. Geneva, ILO, 2010.
- US Bureau of Labor Statistics: Occupational Outlook Handbook, 2010-11 Edition: Home Health Aides and Personal and Home Care Aides http://www.bls.gov/oco/ocos326.htm
- OECD: Long-term Care for Older People. Paris, OECD http://www.oecd.org/document/50/0,3343,en_2649_33929_35195570_1_1_1_37407,00.html