Caregivers are immensely important members of society. They help to improve the lives of the most vulnerable people within a community: the elderly and disabled. Becoming a caregiver is one of the most rewarding (and downright tough) things an American can do. There are no higher education requirements for caregivers – who can begin their training after receiving a high school diploma.

Despite the low educational bar and often high levels of reward in caregiving, there is a huge shortage of qualified professionals in the field. Recent studies have indicated that there will be a shortage of around 150,000 professional care workers by 2030. The fact that the population is aging makes these shortages all the more worrying.

As demand for professional caregivers grows, it is hoped that pay and conditions will improve in the sector. Strong unions are being formed, and organizational associations are gaining traction in the wake of the coronavirus pandemic – in which caregivers were placed under particular strain. Now might be a good time to train up as a care worker. The role of care workers in society has now come into the light more than ever: in part due to the work of these professionals during the pandemic.

There are three main kinds of qualified caregivers in the United States: PCA, HHA, and CAN. Here is a quick guide to the roles taken on by each professional cadre and the training that each of their members is required to receive.


Personal Care Assistants – often referred to as PCAs – are the least medically trained of the professional caregivers. People wanting to enter the field often start their careers as PCAs before moving on to other kinds of care work.


Personal Care Assistants work to ensure that their clients can live the best lives they can. To this end, they assist with the distribution of medication, mobility, and household chores. They essentially operate as a helper – somebody that can take over the responsibility for tasks that would otherwise be extremely hard for the client. PCAs need to be competent in safeguarding, be able to follow medical instructions, and have a compassionate way of interacting with clients. They must be patient and able to handle the often stressful caregiving environment. Personal Care Assistants often act as the primary care staff members in elder care environments. They often develop friendly and supportive relationships with their clients but must be able to keep some degree of professional distance.


Although Personal Care Assistants have fewer medical responsibilities than their peers, PCA training is still very thorough. Several core courses are provided in most PCA educational programs. Infection control, abuse prevention, emergency procedures, and fall prevention are all core modules. Infection control training is seen as more important than ever in the wake of the covid-19 pandemic. The vulnerable people who required care during the pandemic were some of the most at risk individuals. Personal Care Individuals are trained to maintain a clean environment free of infection risks. Once they are in a role, they may also receive training for any technology they may be using for the job, such as the offering on the ShiftCare website, so that they are able to work as efficiently as possible.


HHA stands for Home Health Aid. Home Health Aids look after clients in their own homes. Much like PCAs, these caregivers only receive very minimal medical training. HHAs are extremely important for some clients. Many people understandably want to stay in their own home as they grow older instead of transferring to a more observed and impersonal environment. Home Health Aids allow people to remain in their home while being supported by a professional. Although the positive and negative impacts of staying home in old age have been debated to no end, there will always be people keen to stay in the place they love.


Home Health Aids have many of the same responsibilities as PCAs – with the main difference being that the HHA will always work in a client’s place of residence. This means that there are some more stringent safeguarding responsibilities on the shoulders of the HHA. They may be one of the only people that a client sees on a regular basis, which makes them a very important port of call. HHAs are also often responsible for providing a sense of companionship to clients that may be lonely. Loneliness is a huge problem among elderly and disabled people. HHAs must be compassionate and empathic people capable and willing to form real and meaningful bonds with their clients.


HHAs receive much of the same training as PCAs. They may receive additional training on elder mental health issues and safeguarding.


A CNA is a Certified Nursing Assistant. These are the caregivers that work with people who have complex health and mobility issues. All good care homes and care provision companies will have a cadre of nurses and nursing assistants able to help look after clients.


Certified Nursing Assistants are caregivers able to help with some of the more demanding aspects of caring for a person with a disability or who is reaching the end of their life. Because of their medical training, they are able to help with medication, with bandage changes, and with mobility. Certified Nursing Assistants may sometimes take on a senior role in a care home – advising less trained caregivers and stepping in to complete more complex tasks. They also usually provide all of the other care that less qualified personnel are expected to.


Certified Nursing Assistants are not nurses and do not need a nursing degree in the same way that an RN does. Instead, they take part in an eight week course designed to equip them with the medical knowledge that they need to competently perform basic nursing tasks. This includes modules on homeostasis, medication measurement, and a whole host of other subjects. They learn how to safely and professionally administer medication through injection. Once a CNA is qualified, they may choose to work as a caregiver or to assist nurses in a hospital setting. Ultimately, a CAN is trained in everything that an HHA or PCA is trained in, but with additional education on practical medical matters.

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