Home Health Care Jobs


This section is excerpted from chapter ten of Health Care Job Explosion and features home health care job opportunities. An interview with a registered home care nurse and an overview of home health care is excerpted along with a sampling of resources from the all new 4th edition of Health Care Job Explosion!. The remaining occupations are featured in the same format as presented for licensed practical nurses in the text version of Health Care Job Explosion! Occupational groups are divided into primary and related occupations so that individuals can investigate other fields for additional job opportunities.

Health Care Job Explosion features over 1,400 career exploration and job vacancy resources. Resources are grouped with each occupation and a sample of related resources are included with the first occupation.

Interview With A Registered Home Health Care Nurse

Lily Chan, RN PhotoLily Chan, a registered nurse with Children’s Home Care in Los Angeles, was born in Hong Kong May 23, 1953. She completed a three year nursing program and worked four years as a staff nurse there prior to moving to England. She took additional courses in pediatric and cardiothoracic nursing before coming to the United States.

When asked why she chose nursing, Lily said "I felt the need to take care of someone as a basic personality trait." In addition, she enjoyed studying biology and anatomy, and felt nursing could provide her with a good income. She also thought that "the education and experience in nursing would help me take care of my own health." Lily feels that the most satisfying aspect of a nursing career is "providing a quality environment for the patient. Even the more menial tasks become satisfying if you look at it that way."

A recruiting agency arranged for Lily to come to the United States in 1983 and take the NCLEX licensing exam for RNs. They also found employment for her at Methodist Hospital in Lubbock, Texas, as an interim permittee while waiting for her RN license. In April of 1984, she began working at Childrens Hospital Los Angeles. In 1995, Children’s Home Care was formed as an affiliate of CHLA.

Lily pointed out the advantages to working in home health care. "In home health, you have time to deal with just one patient and family at a time. In the hospital you can get pulled in five directions at once when it gets busy." You also have a more flexible time schedule.

Lily was asked why she specifically likes pediatric home health care. "With pediatrics, you are interacting with the whole family." Once she was taking care of a child and complimented the mother on how good the chicken she was cooking smelled. When she finished with the patient, the table was set with dinner for her.


Lily advised that anyone considering home health as a career must evaluate their capabilities. "For home care you have to have a very broad knowledge base and be creative and flexible. You have to improvise a lot." She also warned, "the fear of many who transfer to home health care is that in a hospital, if there is any problem, you can just yell and get assistance, while with home care that security is lost. On the other hand, home care patients may not be as ill as those in the hospital and there is emergency help available, such as calling 911."


When asked for advice in finding employment, Lily responded, "It is hard for a new graduate to get into, as they need a few years in acute care in a hospital to develop the assessment skills." NurseWeek and the local newspaper are good sources for job ads. Check with hospitals, too. Some have their own home health care department.


I asked how to evaluate a home health care agency as a potential employer. "Look for leadership quality. The whole mission and philosophy of the agency has to support staff providing quality care. This affects how good you feel about yourself. The agency has to balance the quality with cost."


If you really enjoy working with people and have confidence in your skills, you will probably derive great satisfaction from caring for your patients in their homes.


Home Health Care Occupations.


Four occupations in home health care are presented in Chapter Ten:

Also presented are resources for the many professionals involved in caring for patients in the home. These include, but are not limited to:

  • Physicians
  • Dieticians
  • Nurses
  • Pharmacists
  • Physical Therapists
  • Social Workers
  • Occupational Therapists
  • Speech-language Pathologists


Home Health Care Overview


The development of in-home medical technologies, substantial cost savings, and patients’ preference for care in the home have helped make home health into one of the fastest growing segments of the health care industry. The National Center for Health Statistics reported 1,355,290 home health care patients in the United States in the year 2000.

Expected to increase at a 5.4-percent annual rate to 1.3 million jobs by 2014, this industry’s growth reflects an aging population, many of whom will have functional disabilities and will desire to maintain an independent, home-based life style. One limit on home care growth is that Medicaid prefers to pay for nursing home care, which is often more expensive. Vermont is the first state to experiment with home care for Medicaid patients.

A rapidly evolving facet of modern health care is telemedicine, the use of high-tech video equipment to facilitate communication among physicians, patients, families, nurses and other allied-health professionals. In home health, terms used are remote care technology, telehealth, and telehomecare. Having telemedicine equipment in the patient’s home, or in a van that can be driven to the home, means that fewer health care professionals are needed to monitor patients. Remote care is a supplement to home visits, not a substitute. Home health care workers can check in with patients as often as needed, even viewing the progress in wound healing by video camera.

Personal and home care aides, and home health aides,
 will be in great demand.

Not all patients needing home care are elderly. Disabled people of any age may need some degree of home care. Patients recuperating from acute illness or injury may need temporary home care. Children and adults with chronic illnesses may need medical treatment that can be provided at home by a home health professional, or may need training in specific medical therapies.

Home Health Care Defined

Home health care means providing health services and equipment to patients in their home. Depending upon the needs of the individual patient, services may be delivered 24 hours per day. Sometimes the purpose of home care is restoration of health and/or function, while other times it is to maintain comfort, as in hospice care. Home health care may provide for both the medical and the personal needs of patients and their family members. Professionals involved include physicians, nurses, physical therapists, occupational therapists, dieticians, pharmacists, social workers, speech-language pathologists, homemakers and home care aides.

Many, but not all, patients are referred to home health care agencies after a period of hospitalization. Patients should have a thorough evaluation, including not just medical needs, but also assessment of the mental state of the patient. In addition to evaluating the patient’s ability to comply with treatment such as dietary recommendations and/or drug schedules, the family and social environment needs to be considered. Various health care professionals may be involved in this evaluation process.

Numerous factors may influence the decision to provide care for the patient in the home rather than in a hospital, nursing home or other facility. Among these are studies that have shown patients tend to recuperate sooner from an accident or illness in familiar surroundings with caring family members. Another consideration is the availability of competent assistance from family or friends. The physical layout of the home must also be evaluated for adaptability to the patient's needs. For example, a patient in a wheelchair will need appropriate access to shower and toilet facilities.


Once the decision has been made that home health care is appropriate for a patient, service is usually provided by a home health agency, hospice or homemaker/home care aide agency. Staffing and private-duty agencies can provide nurses, homemakers, home health aides or companions, but are not always required to be licensed. Pharmaceutical and infusion therapy companies employ pharmacists and nurses to assist patients requiring intravenous infusions. Medical equipment suppliers and manufacturers may provide installation of medical equipment and instruct patients on use. Some provide respiratory therapy services. Registries connect home health nurses and aides with individual patients, who employ them directly. Many home health care professionals are independent of agencies and are employed directly by the patient or self-employed, often having several clients at once.

How Home Health Agencies Work


The National Council on the Aging defines a home health agency as "a company that provides many professional health care services, in the home, under the direction of a physician. These comprehensive services include skilled nursing, personal care assistance, physical, occupational and speech therapy, and medical social work. Medical equipment, supplies and infusion therapies may also be available. Home care agencies have an administrator or a director who is responsible for the business and managerial operations. This person is often a doctor, nurse, or social worker who has education or experience in administration.

Certified agencies must meet licensing requirements. In addition, some are accredited by the Joint Commission on Accreditation of Health-care Organizations, (http://www.jcaho.org) or Accreditation Commission for Health Care, Inc. (http://www.achc.org), Community Health Accreditation Program (http://www.chapinc.org), and the National Committee for Quality Assurance (http://www.ncqa.org). Those participating in Medicare must also meet federal requirements.

Do You Have What it Takes?

A recent article by Lazelle Benefield, PhD, RN, in the American Journal of Nursing explored the personal qualifications required for nurses to be happy in their choice of home health nursing. The considerations cited apply to many other professions. One advantage to home care nursing is the ability to follow your patient’s progress consistently.


One issue in caring for patients in their home is the freedom of making independent decisions versus the responsibility of making clinical decisions on one’s own. Some people relish the independence, while others may feel comfortable with more structure and more interaction with peers and supervisors. Dr. Benefield emphasizes being proactive. Ask for advice from others in the field, subscribe to home health journals and focus your continuing education units on home health. If you are nervous about making independent decisions (you will of course be consulting daily with professionals in other disciplines), seek out the counsel of other nurses.

Another problem in home health is sorting out the variety of restrictions placed on patient services by all the different HMOs, PPOs and insurance companies. The home health nurse is responsible for documenting patient progress and justifying continuing care based on patient capabilities or safety. If confidence is a problem, obtaining extra training with experienced home care providers may help.

In an accompanying article, Janet Dyer is very specific about the personality traits needed for success in the home health care field.6 She writes, "Nurses who flourish in home health tend to be self-starters, independent and creative thinkers...they also need to be well-versed in the latest technology...home health tends to reward flexibility and well-rounded skills..."


Resources (Partial List)

Educational Opportunities - Online healthcare degree & certificate programs

Over 125 total resources are presented in the paperback version of Health Care Job Explosion! 4th edition by Dennis V. Damp for this occupational group. Resources include Job Ads, Job Hotlines, Job Fairs, Placement services, Associations, Books, Directories and Internet (Web) Sites. Your local library may have this book in their reference section or you can purchase a copy for $19.95 plus shipping with all major credit cards from our toll free service at 1-800-782-7424 (Orders Only).

American Association for HomeCare - 625 Slaters Ave., Suite 200, Alexandria, Virginia 22314; 703/836-6263. (http://aahomecare.org/, info@aahomecare.org) This is a national trade association that represents all the elements of the home care industry. The web site has directories of home health care providers, consultants and state associations in the US and Canada.

CaregiversGuide - http://www.caregiversguide.com Search by state for long term care facilities, home care agencies, adult day care and alternative facilities.

Google.com (www.google.com) has directories of hospices, extended care facilities and home health agencies. Click on the word "more" then on "Directory" and then on "Health" to access resources. Over 360 home health and hospice providers are listed.

National Association for Home Care and Hospice (NAHC) - 228 Seventh Street SE, Washington, DC 20003, 202/547-7424. (http://www.nahc.org/) Members are agencies providing home care and hospice services. The Community area of the web site provides an Agency Locator with information on more than 22,000 providers and a Job Exchange searchable by region. Contact information is available for home care and hospice state associations.


Nursing Home INFO (http://www.nursinghomeinfo.com/) Use the Facility Search feature to find nursing homes by facility name, state, city, county or type of service.

State departments of health or insurance may be helpful in obtaining a Medicare Survey Report to locate home health care providers in your area. Use any search engine with the keywords "health department" and the name of your state or use the state government listings in your telephone book to contact them.


Other Occupations


The following occupations are featured in the all new 4th edition of Health Care Job Explosion!. Each of the following occupations are featured exactly like the Home Care Occupations occupational description and includes resources for each listing. Your local library may have this book in their reference section or you can purchase a copy for $19.95 plus $5.75 shipping with all major credit cards from our toll free service at 1-800-782-7424 (Orders Only). Also available at bookstores nationwide.