High School

Many home health care programs require only a high school diploma for entry-level positions. Previous or additional course work in home economics, cooking, sewing, and meal planning are very helpful, as are courses that focus on family living and home nursing.

Postsecondary Training

Health care agencies usually focus their training on first aid, hygiene, and the principles of health care. Cooking and nutrition, including meal preparation for patients with specific dietary needs, are often included in the program. Home health care aides may take courses in psychology and child development as well as family living. Because of the need for hands-on work, aides usually learn how to bathe, dress, and feed patients as well as how to help them walk upstairs or get up from bed. The more specific the skill required for certain patients, the more likely an agency is to have comprehensive instruction.

Most agencies will offer free training to prospective employees. Such training may include instruction on how to deal with depressed or reluctant patients, how to prepare easy and nutritious meals, and tips on housekeeping. Specific course work on health and sanitation may also be required.

Other Education or Training

The National Association for Home Care & Hospice offers continuing education opportunities through its Home Care University (HCU) is an affiliate of the National Association for Home Care & Hospice. Topics include non-skilled care, advanced clinical skills, and leadership. Visit http://www.homecareuniversity.com for more information. 

Certification or Licensing

Certification is provided by state and local home care associations and local training programs. Visit https://statelocator.nahc.org for a list of state associations. 

The federal government has enacted guidelines for home health aides whose employers receive reimbursement from Medicare. Federal law requires home health aides to pass a competency test covering 12 areas: communication skills; documentation of patient status and care provided; reading and recording vital signs; basic infection control procedures; basic body functions; maintenance of a healthy environment; emergency procedures; physical, emotional, and developmental characteristics of patients; personal hygiene and grooming; safe transfer techniques; normal range of motion and positioning; and basic nutrition.

Federal law suggests at least 75 hours of classroom and practical training supervised by a registered nurse. Training and testing programs may be offered by the employing agency, but they must meet the standards of the Centers for Medicare and Medicaid Services. Training programs vary depending upon state regulations.

No experience is needed to become a home health care aide. Training is typically provided on the job.

Caring for people in their own homes can be physically demanding work. Lifting a client for baths and exercise, helping a client up and down stairs, performing housework, and aiding with physical therapy all require that an aide be in good physical condition. Aides do not have the equipment and facilities of a hospital to help them with their work, and this requires adaptability and ingenuity. Oftentimes they must make do with the resources available in a typical home. 

An even temperament and a willingness to serve others are important characteristics for home health care aides. People in this occupation should be friendly, patient, sensitive to others' needs, and tactful. At times an aide will have to be stern in dealing with uncooperative patients or calm and understanding with those who are angry, confused, despondent, or in pain. Genuine warmth and respect for others are important attributes. Cheerfulness and a sense of humor can go a long way in establishing a good relationship with a client, and a good relationship can make working with the client much easier.

Home health care aides must be willing to follow instructions and abide by the health plan created for each patient. Aides provide an important outreach service, supporting the care administered by the patient's physician, therapist, or social worker. They are not trained medical personnel, however, and must know the limits of their authority.