​

​

 

 

 

 

Homecare Aide Assistance in Daily Living (ADLs) and Limitations 

​

Light Housekeeping & Cleaning

The homecare aide may provide assistance with essential household chores, such as dusting, vacuuming, moping and tiding up the client's home. If needed, the homecare aide will help the client organize closets, cabinets and drawers. Cleaning responsibilities include washing dishes; cleaning the kitchen after meals; throwing out the garbage and making sure bathroom is clean. Homecare aides do not provide deep-cleaning services and clients or their responsible parties must provide all cleaning supplies. 

​

Laundry

The homecare aide must use a machine washer for the client's personal laundry, including linens and towels; place them in the dryer; fold; and put them away. Ironing clothing is excluded from this category.

​

Meal Preparation

The homecare aide can prepare meals for the client based on their preferences. Serving the meal, clearing the table, taking care of dishes and kitchen clean-up are included in the homecare aide's responsibilities.

​

Personal Care

Personal care may include skin care only when skin is intact, using only non-medicated or non-prescription products and preventive general care of unbroken skin. Wound care or dressing changes application and application of lotion/solutions requiring a physician prescription are not allowed by the homecare aide. The homecare aide may assist the client with dressing and grooming. Bathing assistance is possible only if the client is able to have sufficient balance and strength to reliably stand, pivot and assist in the process and only if the client does not require skilled skin care or wound dressings that will require attention before, during, or after the shower/bath. Personal tasks more detailed:

•  Ambulation

• The homecare aide can assist with ambulation using adaptive equipment such as a walker, cane, and wheelchair after the client has been trained by a registered nurse/physical therapist/occupational therapist. The worker should not assist with ambulation of a client who is currently in training on how to use their device. 

• Bathing

• The homecare aide will assist the client with bathing only if the client is able to direct and communicate. A bed bath can be given by the worker only if properly trained and evaluated. Bathing services in the event that the client has skilled skin care needs or wound dressings that will require attention before, during, or after bath are excluded. ​

• Dressing

• Assistance with dressing is provided by the homecare aide and can include clothing and support stockings that can be purchased without a physician prescription. Exclusions: No elastic bandages applied; No sequential compression device that requires a physician MD prescription.

• Exercise

• The homecare aide may offer passive assistance that is limited to encouraging normal bodily movement. Passive range of motion and physical therapy are excluded.

• Feeding

• The client may only be assisted with feeding if they can independently swallow and can be positioned upright. Ssyringe feeding, tube feeding, or intravenous nutrition and feeding of a client at high risk of choking is not permitted.

• Hair Care

• The homecare aide can provide maintenance and appearance of hair (non-medicated shampooing, drying, combing, styling hair). Exclusions are shampooing with shampoo requiring a physician prescription.

• Mouth Care

• Assistance in and performing mouth care, denture care, and basic oral hygiene, including suctioning for mouth care is provided by the homecare aide. These tasks cannot be provided to an unconscious patient.

• Nail Care

• Assistance with nail care including soaking of nails, pushing back cuticles without utensils, and filing of nails is permitted by the homecare aide. Exclusions include nail trimming and nail care of clients with conditions that might involve peripheral circulatory problems or loss of sensation (e.g. diabetic).

• Positioning

• Positioning may include simple alignment in a bed, wheelchair, or other furniture.

• Shaving

• The homecare aide assists with shaving, however only with an electric or safety razor.

• Toileting

• Client may be assisted to and from the bathroom, with bed pans, urinals, and commodes; Provide pericare, change clothing and pads of any kind used for care of incontinence, In addition, the homecare aide may empty or change external urine collection devices, such as catheter bags or suprapubic catheter bags; Empty ostomy bags and provide assistance to client directed ostomy care only when there is no need for skin care. Exclusions include: No insertion or removal of catheters or care of external catheters; No removal of the Ostomy Wafer attached to the skin; No digital stimulation, insertion of suppositories; No enemas.

​

Transfers

Assistance with transfers is provided only when the client has sufficient balance and strength to reliably stand, pivot and assist with the transfer to some extent. Adaptive and safety equipment may be used in transfers provided the client is fully trained in the use of the equipment and can direct the transfer step-by-step. Gait belts may be used for safety as long as worker has been trained in their use. The training and competency in use of gait belts by a professional must be confirmed and documented. The homecare aide can assist the client in the use of a mechanical or electrical transfer device only when the following conditions are met:

a) The worker has been trained in the use of the device

b) The client or client’s representative must be able to direct transfer step-by step; and

c) The agency has conducted a competency evaluation of the worker using the type of device that is in the home.

Exclusions: No assistance with transfers is possible when the client is unable to assist with the transfer.

​

Medication Reminding

The homecare aide is limited in assisting the client with medication reminding, however only when medications have been preselected by

the client, a family member, a nurse, or a pharmacist, and are stored in containers (pill box) other than the prescription bottles.

Medication reminding includes inquiring as to whether medications were taken; verbal prompting to take medications; handing the appropriately marked pill box to the client; and opening the appropriately marked medication container for the client if the client is

physically unable to open the container; Immediately report to supervisor any irregularities noted in the pre-selected medications, such

as meds taken too often, not often enough.

​

Observation and Reporting

The homecare aide is required to observe the client functioning, well-being

or any incidents such as falls and report to the supervisor immediately.

The homecare aid may not perform vital signs or provide any medical

assistance.

​

Companionship

The client and homecare aide are encouraged to have light conversations,

take the client on a short walk or play board games and other light activities.

 

Shopping and Appointments

The homecare aide may assist the client with

shopping for essential groceries at the

neighborhood grocery store and escort to

appointments outside the home. The homecare

aide may not drive the client and is only able to

use public transportation or be driven by a third

party.

​

Respiratory Care

Not allowed by the homecare aide.

​