This type of care is provided in the home by individuals who do not have medical training or licenses. They attendants may be certified nursing assistants, CNAs, but if they are they are still limited to the type of services that they can provide. Each State has its own system and structure and some States have more regulations than others. Some places this is called Private Duty. The attendants are not nurses. They are often homemakers and companions that family hire to do light housekeeping, laundry and cooking. They may also assist with ADLs. They may not provide any skilled nursing services such as medication administration and management, dressing changes, wound care, intravenous or line care or feeding tube nutrition. They are simply an extension of the family when the family caregiver is in need of assistance. Each State has its own regulations regarding the type and scope of services these agencies can provide. On occasion, these attendants may be employed to augment the needs of the senior in an assisted living or nursing home. many independent living facilities will not allow these attendants because that means that the senior is not longer independent and requires the next level of care.
The non medical attendants are classified as come and go or live in. The come and go attendant works a limited shift of four (4) to twelve (12) hours and then leaves. The live in is at the home around the clock for supervision.
Staff attendants may come from an agency where the attendant is an employee. In that case, the attendant is accountable to agency management policies and procedures. If an attendant is not a fit with the senior it is the agency’s responsibility to find a replacement. Some of these agencies are locally owned and operated and others are franchises. The other option for non medical care is hiring an individual independently.
When the family does this, they are responsible for the attendant as their employee with responsibility for compliance with all of the employment, tax and worker’s compensation laws.
The positive of in home attendants is that the senior stays in their own home. The negative of non medical home care is that the lack of socialization that the senior has access to. Social engagement is usually limited to the attendant and family who come to visit.