Personal Care Assistants are individuals who assist with providing healthcare to those with disabilities, such as individuals with ALS.
Many terms are used for Personal Care Assistants, which vary regionally. Some regions may use multiple terms interchangeably.
| Term | Abbreviation | Regions Used |
|---|---|---|
| Assistant in Nursing Nursing Support Worker |
AIN | Australia |
| Personal Support Worker | PSW | Canada |
| Personal Care Assistant | PCA | Canada, United States |
| Personal Care Attendant | PCA | Canada |
| Health Care Assistant | HCA |
New Zealand United Kingdom |
| Clinical Support Worker | CSW | United Kingdom |
| Unlicensed Assistive Personnel | UAP | United States |
Fundamentally, PCAs are expected to do tasks that the patient would ordinarily be able to do on their own. This ranges from personal care such as dressing or using the bathroom, to ordinary tasks such as opening an envelope or changing the channel on a TV. PCAs are not expected to nor allowed to practice medicine; they cannot administer drugs, nor perform medical treatments of any kind.
PCAs may be scheduled to spend a set period of time with a patient, during which they offer supervision and companionship. They might read books, watch TV, or engage in conversation with the patient during this time.
| Table: tasks included in the scope of work of PCAs | ||
|---|---|---|
| Task | Included in Scope | Notes |
| Bath / Shower | Yes | Some PCAs may not be comfortable cleaning the genitalia, and may require the use of washcloths or something similar. PT will likely be required to do this part on their own if they are capable of it. |
| Bedsheets / Linens | Yes | – |
| Body / Pubic Hair | No, with exceptions | Some PCAs may be willing to do certain hair removal tasks, such as on the ears. |
| Dental / Oral Care | Yes | Includes brushing, flossing, and placement of dentures. |
| Dishes | Yes, with limitations | Dishes for PT only, not entire household. |
| Dressing | Yes | – |
| Facial hair | Yes, with limitations | Typically, only electric trimmers are permitted, no blades. |
| Garbage and Recycling | Yes, with limitations | For PT only. May not be willing to take it to the curb or a dumpster. |
| Housekeeping | No, with exceptions | PCAs are expected to clean up messes created while under their care, such as spills. |
| Laundry | Yes, with limitations | May not be scheduled to stay long enough to transfer from washing machine to dryer. |
| Meal Preparation | Yes, with limitations | Meals with relatively low preparation complexity only. May not be allowed to use certain sharp utensils or barbeques. |
| Medications | No, with exceptions | Medications may be administered if the PCA has been delegated by a licensed practitioner, such as a nurse. |
| Nail care | No, with exceptions | Some PCAs may be trained and permitted to perform nail care; some may volunteer to trim fingernails only. |
| Skin care | Yes, with limitations | Only the basics, such as applying lotion. |
| Toileting / Incontinence Products | Yes | – |
| Transfer assistance | Yes, with limitations | May only be permitted to operate certain types of transfer equipment. In some cases, the PCA may require delegation from a licensed provider. |
There are countless tasks to manage in daily life, and PCAs could assist with many of them. It's perfectly reasonable to request help from a PCA for almost anything that isn't dangerous or illegal.
Certain tasks that typically require a licensed nurse or other medical professional can be carried out by a PCA through a process known as delegation. The PCA will receive specific training for the task, tailored to an individual patient, from their licensed supervisor. Once the training is completed, written authorization will be granted to the PCA, allowing them to perform the task.
Tasks that may require delegation include:
The quality of care carried out by PCAs can vary, especially in home care settings where they are unsupervised. Kind, compassionate PCAs tend to flourish in such an environment, while others may not.
Any mistreatment, abuse, or negligence should be reported to the PCA's supervisor. Such issues include:
Personal care assistants can be hired in one of the following ways:
Hiring through a home care agency is the simplest way. Overhead such as training, liability insurance, and so forth is handled by the agency. Agencies are also generally able to provide substitute caregivers when the primary caregiver is not available. However, as a consequence, the hourly rate is generally higher than hiring directly, sometimes significantly.
Hiring a PCA directly has the advantage of lower cost, as there is no middleman. Expectations on how the care is administered can be managed directly instead of involving the agency's management apparatus. Tasks which are typically not allowed by agencies, such as nail cutting or trips outside the home are possible, as long as the employee consents to it.
Hourly rates for home care agency services, or the wages of a directly hired PCA vary from region to region. Some home care agencies do not reveal their hourly rate until the client has proceeded a significant distance through their client intake process.
A ballpark estimate of what a PCA may be willing to work for can be made by doing the following:
A patient or their family that is hiring a PCA would have to pay a slightly higher rate than a home care agency for the following reasons: