Differences between Elderly Caregiver Roles

When we think of elderly caregivers, we often picture nurses working in hospitals or assisted living facilities. But the truth is that you don’t need a nursing degree to become an elderly caregiver. In fact, in some cases, all you need is a high school diploma and some training.

Caring for the elderly is a rewarding, but challenging experience. It’s not a career choice one should decide upon a whim. Before you decide to go down the path of elderly caregiving, first ask yourself these questions.

  1. Do you like working with people?
  2. Are you willing to work with potentially difficult, combative, stubborn, and even abusive patients?
  3. Are you physically able to lift and carry a full-grown adult to and from various locations such as vehicles, wheelchairs, or beds?
  4. Can you handle long, physically and mentally exhausting days and possibly nights?
  5. Will you be comfortable helping patients with personal hygiene, bathing, and using the toilet? What if the patient was of the opposite sex?
  6. Can you maintain a professional yet friendly disposition regardless of physical, mental, and emotional fatigue?
  7. Will you be comfortable speaking with the patients’ families regarding difficult situations?
  8. Will you be able to keep a cool head in the event of a medical emergency?
  9. Will you be able to emotionally handle a patient’s death?
  10. Are you willing to do all these things for very little pay?

If this list of questions didn’t scare you off and you’re still interested, then congratulations! You’re on your way to a fulfilling career in elderly caregiving. However, before you start applying to hospitals and nursing homes, you first need to understand that there are actually several types of positions available. The differences lie in how much education or training is required, whether or not you need certification, and the type of medical-related duties involved.


Personal Care Assistant (PCA)

Personal care assistants require the least amount of education, training, and medical expertise.

Job Description: As the job title suggests, personal care assistants focus on the personal care of their patients, with very minimal medical-related responsibilities. Their duties include running errands, bathing, providing transportation, preparing meals, general hygiene care, and companionship.  Some personal care assistants work with current family caregivers to help with more difficult tasks such as moving the patient from a wheelchair to a bed.

Minimum Required Level of Education: High school.

Training: Not required unless you receive federal payment through Medicare or Medicaid.

Certification: Only if you receive federal payment through Medicare or Medicaid, in which then you need a minimum of 75 hours of training to receive certification.

Medical-Related Duties: Simple tasks such as taking temperature, reminding patients to take their medicine, or collecting lab specimens such as stool samples.

Salary: About $25,000 a year (as of November 2018).


Home Health Aide (HHA)

Home health aides are a step up from personal care assistants in terms of training, certification, and medical-related duties. Whereas training as a personal care assistant isn’t really necessary, becoming a home health aide requires training and certification. In fact, some HHAs are certified nursing assistants or even nurses.

Job Description: Home health aides provide many of the same duties as personal care assistants related to a patient’s personal care. However, they also have the ability to perform more medical-related duties.

Minimum Required Level of Education: High school.

Training: Training for home health aides are usually on-the-job, provided by health professionals. However, similar to personal care assistants, home health aide training is required if you work for a federally funded program. You need a minimum of 75 hours of training, but most states require additional hours.

Certification: Not required unless you work for a federally funded program.

Medical-Related Duties: Monitoring a patient’s vital signs, writing observations in their patient’s journal, changing dressings and bandages, assisting in physical therapy or certain exercises, and possibly even administering medication.

Salary: About $24,558 as of October 2018.


Certified Nursing Assistant (CNA)

Certified nursing assistants work under the supervision of registered nurses, and thus act as go-between patients and their supervisors. Although a patient is cared for by a nurse, it’s the CNA’s job to help that nurse juggle their many patients.

Job Description: A certified nursing assistant does everything that a PCA and HHA does, but has more medically-related responsibilities. They’re closer to nurses than personal care assistants.

Minimum Required Level of Education: High school.

Training: Unlike PCAs and HHAs, training for certified nursing assistants is mandatory. In fact, in some cases, some CNAs go on to become RNs.

Certification: After training, budding CNAs must complete assigned hours of supervised training at a clinical facility, followed by a certification exam.

Medical-Related Duties: These include checking patients’ vital signs, maintaining medical equipment and machines, observing patients’ bodies for bleeding or bruising, and restocking medical supplies.

Salary: A certified nursing assistant’s salary as of October 2018 is roughly $32,108.


Registered Nurse (RN)

Becoming a registered nurse requires the most schooling, training, and certification. They are also entrusted with the greatest amount of medical-related responsibilities.

Job Description: Unlike the other three roles, registered nurses do not normally tend to a patient’s personal care and general errands. Rather, their primary tasks are medical-related. Therefore, registered nurses often work with say, a home health aide or personal care assistant. The nurse would attend to medical-related duties for a few hours, but the remainder of care comes from the personal care assistant or home health aide.

Minimum Required Level of Education: Associate Degree in Nursing (ADN). Many registered nurses continue on to obtain a Bachelor of Science in Nursing (BSN).

Training: Achieved while obtaining an ADN and/or BSN.

Certification: Required.

Medical-Related Duties: In addition to basic tasks that can be performed by CNAs, PCAs, and HHAs, registered nurses can insert and maintain catheters, admit and discharge patients, take care of wounds, perform life-saving techniques, and administer injections.

Salary: Out of the four elderly caregiver roles featured in this article, registered nurses receive the highest average pay, with $73,550 a year (as of May 2018).


As the baby boomers continue to age, elderly caregivers become increasingly important in society. Not everyone is capable of caring for their parents full-time. Many need to hire professional caregivers to attend to their parents’ medical and daily needs.

Becoming an elderly caregiver is no small feat. Although it requires completing a certain level of education and training and the ability to meet the standards mentioned on the list, the most important things about elderly caregivers are that they must have an immense amount of compassion, patience, and respect for their patients.

If you want to start a career in elderly caregiving, or if you need to hire professional care for a loved one, please visit us at Community Home Health Care fill out the query on the home page and someone will get back to you as soon as possible.