What Is a Personal Care Attendant? And What Do They Do?

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

The terminology around professional caregiving and home care can be very confusing. As people age, their health status could require additional responsibilities and caregiving that families are unable to provide. For those who have the funds, professional caregiving can be an option. Each state has different requirements for professional caregivers, which can limit the types of tasks they can help clients with.

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Aging in place as an alternative to assisted living is what most older adults state they want, meaning they desire to stay in their homes for as long as possible. Depending on the type of care needed, there are some caregivers that can make aging in place happen.

A personal care attendant (PCA) is a specific type of caregiver who has much to offer. Understanding the different terms used to describe caregivers will help you create the most comprehensive care system for your loved one.

Definition of a Personal Care Attendant

A PCA is a person who assists older and disabled adults and children with a range of tasks and services. This type of attendant may work alongside other health care caregivers and professionals such as Certified Nursing Attendants (CNAs), home health providers, or nurses. A PCA can be a younger or older person, and people from all walks of life become PCAs because they enjoy helping people become more independent. 

What’s the Difference Between a Personal Care Attendant, CNA, or Caregiver?

The terms caregiver, PCA, and CNA are often used interchangeably, but they differ in their training and licensing. These designations indicate a person who takes care of someone in need, but the differences lie in what they can do. All have a valuable place in the healthcare system.

Personal Care Attendant

A PCA is a person who usually works for an agency that offers caregivers to families in need. Those who wish to become PCAs generally do not need to have any special licensing or certification, and they may not need a high school diploma. It depends on the state where they practice. Regardless of state requirements, PCAs will undergo training for their job from the agency they work for. 

Typically, PCAs may receive training in CPR, blood pressure checks, first aid, feeding, and general caring for clients. Some home care agencies require that their PCAs also have training in working with people who have dementia.

PCAs work in a wide range of settings, including hospitals, home health, medical clinics, hospice, emergency rooms, home care, assisted living, nursing homes, and rehab centers. Additional training and certifications might be required depending on the state, the setting, and what the PCA expects to do. 

Certified Nursing Assistants (CNA)

CNAs can do quite a bit more than a PCA due to their training, but there is overlap between the two in practice. CNAs must have classroom experience, clinical experience, and pass an exam. Many CNAs go on to get their nursing licenses. CNAs work in hospitals, home health, assisted living, emergency rooms, hospice, and outpatient health clinics. They can do the following in most states:

  • Take vital signs like temperature and blood pressure
  • Turning or positioning patients
  • In some states, CNAs can administer medications
  • Draw blood in some states
  • Do glucose checks in some states
  • Do uncomplicated dressing changes
  • Help with all activities of daily living

Caregivers

The word caregiver applies to family members, friends, PCAs, and CNAs. In other words, anyone that takes care of another person. Online consumer to caregiver platforms allows family members to hire a caregiver and negotiate pricing and terms between them. So, a caregiver can be anyone who supports another person’s needs. Sometimes those needs are complex, and other times minimal.

What Duties Does a Personal Care Attendant Perform?

The duties we outline here are those that most PCAs can do regardless of setting or state. The client or patient’s condition and what they need dictates what duties a PCA performs.

Activities of daily living

PCAs help people with bathing, dressing, personal hygiene, and grooming. PCAs may also assist someone with transferring from the bed to a walker or wheelchair and back in bed again. A PCA may reinforce physical therapy exercises and encourage healthy habits like drinking enough water and following dietary guidelines. 

Household duties

Household duties could include housekeeping, mail sorting, organizing and decluttering, pet care,  laundry, and other reasonable household chores. Bill paying or handling of finances is not something a PCA would do.

Shopping and meals

A PCA can shop for groceries, medications, clothing, or anything else the client needs. The PCA can also prepare meals and assist the client with eating, cleaning dishes, and planning the next meals.

Toileting and continence care

Sometimes people have difficulty getting to the toilet and keeping themselves clean. A PCA can help the person to the bathroom safely. If someone has a catheter for example, a PCA cannot change the catheter but if there is a bag they can empty it.

Companionship

Companionship is sometimes an underrated service that PCAs can provide. When people are sick, physically compromised, or have dementia, they get lonely and tend to isolate. Although working with someone who has dementia does require some special training, PCAs, once trained, help keep people with dementia calm and safe. Isolation can lead to loneliness and contribute to depression and anxiety.

Transportation

Transportation is a vital part of anyone’s life, and for someone who can’t get out due to physical or mental conditions, a PCA can drive them. Getting to medical appointments, leisure, and social events are all possible with the help of a PCA.

Communication

Communication with family members and other healthcare providers is an essential part of what a PCA does. PCAs report changes in medical condition, mental health, or memory. 

Who Typically Needs a Personal Care Attendant?

Most of the time, personal care attendants attend to aging adults. However, PCAs also help disabled children and young adults with intellectual disabilities, but with the growing older population, the demand for their services is increasing. Let’s look at some typical situations where a PCA can help.

Someone recovering at home or assisted living

As people come home to recover from an illness or accident, they often need help. In other cases, a person with a chronic medical condition like COPD or heart failure may worsen over time and need help with daily living activities, transportation, and cooking. 

In assisted living settings, you will often find PCAs on the staff to help residents with their care needs. Someone on home health might need assistance with bathing and dressing. 

Someone with dementia

When a person has dementia, they start to lose the ability to make safe decisions—wandering and leaving the stove on. Also, someone with dementia may be vulnerable to scams and exploitation. A PCA can be present to make sure the client is safe. 

Someone with a neurological disorder

Neurological disorders like multiple sclerosis, Parkinson’s, and ALS are usually progressive. Over time someone with one of these conditions can lose balance, have memory problems, and have difficulty eating and drinking. 

How Much Does a Personal Care Attendant Usually Cost? How Do You Pay for It?

The cost of personal care attendants will vary depending on the agency they work for and whether you are hiring through an online platform. The hourly median cost of care in 2020 was $23.50 for a PCA. While most families will pay for a PCA, other possible sources can include long-term care insurance and Medicaid. 

How to Find the Best Personal Care Attendant

Currently, the demand is outstripping the availability of PCAs as the need for caregivers is expected to grow by 33 percent from 2020 to 2030. However, according to the U.S. Bureau of Labor Statistics, the 2020 median pay for a PCA was $13.20 an hour. The work of being a PCA can be physically and emotionally demanding. With that said, it is possible to find the best PCA if you take time and follow our steps.

Find a good home care agency

The first step is to find a good agency that will make every effort to recruit and properly train staff. Look online or ask other healthcare providers for home care agency recommendations. Since staffing is an issue across the country, ask the agency about their staffing and if they can supply the hours you need.

Ask about training

Ask any PCA under consideration about their experience and training and ask for proof of both. If your loved one has a specific condition such as dementia and a PCA doesn’t have experience in this area, you may want to consider someone else.

Conduct a personal interview

A personal interview can tell you about a person’s professionalism and personality style. Have a list of questions prepared. If possible, include your loved one in the interview to give their opinion and feel like they are part of the process. 

Keep a good PCA

Keeping a good PCA once you have found one is just as valuable as finding one in the first place. There are some things to keep in mind when working with a good PCA. One is to show your gratitude for their work. The other is to augment their pay if you can afford it. Most agencies don’t allow the client to pay a PCA any extra outside the regular payroll. They are happy, however, to increase a PCAs hourly rate through payroll with additional funds from you.

Be flexible in your search

Considering the tight job market, you will want to try and be flexible. Choosing a good PCA means that you are unlikely to get everything you want. Once you find someone, there is always the possibility that they will move on to another job, and you will have to start over.

Learning More About Personal Care Attendants

Personal care attendants do the hard work of caring for our loved ones, and they are often underappreciated. As you plan for the needs of your loved one, an understanding of what caregivers can and can’t do will help you make the best choice. 

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