Hiring a Direct Care Worker: Job Description, Salary, & More

Direct care workers—ranging from nursing assistants to home health aides—offer a critical service to those who need it. Hiring a direct care worker requires a candidate who understands the unique nature of the job and possesses the right combination of hard and soft skills to help clients maintain a good quality of life. This article will break down the role of a direct care worker to understand 1) why they are essential and 2) how to hire the best candidate for your direct care needs.

What is a Direct Care Worker?

Direct care workers provide personal care services to the elderly or those living with disabilities or chronic health conditions. The U.S. Department of Labor divides direct care workers into three predominant categories:

• Certified nursing assistants
• Home health aides
• Personal care aides

The exact setting, responsibilities, and credentials of a direct care worker differ based on the level of care they need to provide:

Category	Setting	Specialty
Certified Nursing Assistants/Aides (CNAs)	Often found in healthcare settings such as hospitals, nursing homes, assisted living facilities, or other community-based care.	Assisting patients/residents with activities of daily life and providing clinical care such as administering medication.
Home Health Aides	Commonly work out of patients’ homes or community-based health settings.	Similar care and services to a CNA, but they may also assist with light home duties. Clinical care is provided under the supervision of a licensed professional.
Personal Care Aides (Also referred to as home care workers or caregivers)	Typically provide services in private homes or group homes.	Capable of assisting with activities of daily life, but not providing clinical care. They commonly support housekeeping tasks such as meal preparation and medication management.

Direct Care Worker Roles and Responsibilities

Direct care workers provide crucial assistance in completing daily tasks and fulfilling the basic needs of their patients. Although care varies based on a client’s unique health circumstances, common responsibilities listed in a direct care worker’s job description include:

• Assisting clients with activities of daily living (ADL) tasks such as walking, ambulating, feeding, dressing, personal hygiene, and toileting
• Providing compassionate care and companionship
• Monitoring a patient’s daily life conditions/quality of life and reporting changes to designated health professionals
• Medication management, like setting reminders, filling prescriptions, and helping patients with treatments that would ordinarily be self-administered
• Maintaining a safe and clean environment
• Offering mobility support to individuals suffering from limited mobility

Specialized responsibilities per role may include:

• CNAs are licensed to provide certain clinical care to patients, such as administering medication, offering basic rehabilitation care, addressing mental health needs, and social services.
• Under the supervision of licensed professionals, home health aides may provide extensions of clinical care like wound care, restorative care, infection prevention, and basic nursing services like blood pressure readings.
• Personal care aides or home health aides may offer extended household support such as daily chores, light cleaning, changing bedding, running errands, preparing meals, and similar daily life tasks.

Credentials and Qualifications of a Direct Care Worker

The services needed will determine the credentials required by a direct care worker. For example, there is no required federal training or competency requirements to become a personal care aide. However, many states have training requirements for agency-employed personal care aides. Medicare-certified home health aides are required under federal legislation 42 CFR 484.36 to complete:

• At least 75 hours of training
• Including 16 hours of supervised practical training
• Plus 12 hours of continuing education every year

In addition, states require additional credentials, such as onsite clinical training. Medicare- and Medicaid-certified CNAs are required under the Omnibus Budget Reconciliation Act of 1987 and federal legislation 42 CFR 483.152 to be trained and evaluated through state-approved training programs. Similar to home health aides, they are required to complete:

• A minimum of 75 hours of training
• Including at least 16 hours of supervised training
• Plus additional training determined by the state

Direct care workers may also choose to obtain additional certifications such as CPR, certified dementia practitioner, or mental health technician certification. They may also take specialized training courses such as:

• First aid training
• Hospice care training
• Cultural sensitivity training

Regardless of the required credentials, direct care workers are encouraged to understand the principles and ethics of caregiving and demonstrate proof of competency.

Top Skills of a Direct Care Worker

Providing daily care for people with chronic illnesses, advanced age, or disabilities requires a special individual. Hiring managers should seek out compassionate candidates who possess essential caregiving qualities, such as:

• Patience and understanding towards an individual’s circumstances or limitations
• Empathy for others, especially those who depend on others for daily care
• Calm under pressure
• Reliable and consistent to maintain repetitive, routine schedules
• A good sense of humor, especially in the face of unexpected situations
• Adaptability and flexibility
• Strong communication skills, both verbal and nonverbal
• Proficient scheduling skills
• Physical ability to support an individual’s daily tasks and needs
• Technically proficient to operate any daily technologies such as phones or medical devices

Job Outlook and Pay for a Direct Care Worker

According to data from PHI National, there were 4.7 million direct care workers in the United States in 2021, with nearly 1.2 million new jobs projected by 2030. The anticipated growth stems from a few reasons, namely:

• The number of Americans aged 65 and over is projected to double from 49.2M in 2016 to 94.7M in 2060.
• The ratio of prime working-age adults is shrinking. Currently, there are 31:1 working-aged adults to adults aged 85 and above. By 2060, that ratio will be 12:1.

There is a huge and growing need for competent and well-trained direct care workers. Direct care jobs tend to be entry-level positions in the healthcare industry. Average pay depends on multiple factors, like employment type and geographic location. According to Salary.com, the median CNA annual salary is $35,265, with a typical range of $32,311 to $38,833. Keep in mind that 2021 data from the Bureau of Labor Statistics indicates that CNAs who provide home healthcare services earn the least among different CNA jobs. According to Salary.com, the median home care aide annual salary is $28,172, with a typical range of $26,196 to $31,246. According to Salary.com, the median personal care aide annual salary is $25,531, with a typical range of $23,196 to $28,217.

Common Interview Questions for a Direct Care Worker

Interview questions can help hiring managers avoid common mistakes and determine if a direct care worker is the right fit. These common interview questions are designed to find a candidate who possesses the right hard competencies and soft interpersonal skills:

• Why did you choose to become a direct care worker? What appeals to you most about providing direct care?
• Share the level of care and tasks you have provided to patients previously.
• Have you provided direct care to individuals with any specialized conditions?
• What steps do you take to ensure your clients/patients take their medication as prescribed?
• How do you plan and execute meal plans for your clients/patients? How do you ensure the meal plan is suitable for the client/patient’s tastes and dietary requirements?
• Share a time when you noticed a change in your client/patient’s deteriorating health. How did you notify the patient’s family and medical physician? Did you have to adjust the type of care you were providing?
• How do you handle emergency situations? What coping strategies do you rely on to remain calm under pressure?
• Have you ever disagreed with a care decision made by a patient’s family or medical team? How did you handle the situation?
• What has been your most rewarding direct care patient or experience?

Get Started with Hiring Direct Care Workers

Direct care workers are part of a growing field that offers critical assistance to the elderly, disabled, and chronically ill. Competition to hire these essential workers can be fierce, but a healthcare staffing agency can help. Whether you are looking for a certified nursing assistant, a home health aide, or another type of healthcare worker, Insight Global has the candidate pool to match you with your next right fit.