Unlicensed Assistive Personnel are individuals who assist with providing healthcare to those with disabilities, such as individuals with ALS.
Many terms are used for Unlicensed Assistive Personnel, which vary regionally. Some regions may use multiple terms interchangeably.
| Table: terms used for Unlicensed Assistive Personnel | ||
|---|---|---|
| Term | Abbreviation | Regions Used |
| Assistant in Nursing / Nursing Support Worker | AIN | Australia |
| Personal Support Worker | PSW | Canada |
| 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, UAPs 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. UAPs are not expected to nor allowed to practice medicine; they cannot administer drugs, nor perform medical treatments of any kind.
UAPs 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 UAPs | ||
|---|---|---|
| Task | Included in Scope | Notes |
| Bath / Shower | Yes | Some UAPs 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 UAPs 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 | UAPs 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 UAP has been delegated by a licensed practitioner, such as a nurse. |
| Nail care | No, with exceptions | Some UAPs 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 UAP may require delegation from a licensed provider. |
There are countless tasks to manage in daily life, and UAPs could assist with many of them. It's perfectly reasonable to request help from a UAP 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 UAP through a process known as delegation. The UAP 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 UAP, allowing them to perform the task.
Tasks that may require delegation include:
The quality of care carried out by UAPs can vary, especially in home care settings where they are unsupervised. Kind, compassionate UAPs tend to flourish in such an environment, while others may not.
Any mistreatment, abuse, or negligence should be reported to the UAP's supervisor. Such issues include: