Within the sphere of a home health agency dealing with elder care, there is a vast array of health-related careers and caregiver positions, each with their own levels of education and licensing requirements. Below are several elder-care related careers, as well as their education and licensing criteria.
By definition, a non-certified caregiver does not need state licensing to work. Either employed privately or through non-medical care agencies, non-certified caregivers acquire on-the-job training, and may assist elderly clients with basic non-medical tasks.
Home Health Aide (HHA)
A Home Health Aide works with disabled, elderly or convalescent patients in their home, performing basic medical services, such as checking vital signs, handing out medication and assisting with medical equipment.
To become a Home Health Aide, candidates must possess a high school diploma. Further training depends upon the state of residency and the employer, either of which may require specific certifications. If an employer accepts Medicaid or Medicare compensation, HHAs must complete 75 hours of formal training—the federally-mandated minimum. Entrance into a program may require a physical exam, state-mandated blood tests, CPR certification and a background check. Training generally takes place in both a classroom and a clinical setting and can include administering medication, cooking, cleaning and assisting with personal hygiene.
Certification for an HHA occurs after successful completion of the training program—receiving passing grades and properly demonstrating the ability to complete specified skills.
HHA Education and Licensure in Massachusetts
- Completion of a minimum of 75 training hours, of which 16 must be clinical experience.
- Completion of 12 hours of continuing education per calendar year.
Certified Nursing Assistant (CNA)
CNAs work with patients under the supervision of an LPN or RN. Their duties can include taking and recording vital signs, assisting with mobility, feeding and helping with personal hygiene.
CNAs must complete a post-secondary, non-degree certificate or diploma, as well as pass a state certification exam. Certification programs vary from state-to-state, requiring students to complete anywhere from 75 to 180 training hours. These hours include both classroom and clinical work. Most programs must be state-approved in order to sit the state certification exam. Most states offer a list of approved programs. Also, entrance into a training program often requires certain documentation, which can include immunization records, valid identification, TB test results, CPR and First Aid certification and a physical exam.
State certification exams generally have two components—a written exam and a demonstration of skills proctored by a registered nurse. Topics generally covered in the written exam can include the aging process, infection control, medical terminology and nutrition, while skills demonstrated could be feeding tube care, catheter care and ostomy changes.
Example: CNA Education and Licensure in Florida
- Written verification of training program completion
- Background check
- Passage of the Prometric Nurse Aide Exam
Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN)
Working under the supervision of RNs and doctors, LPNs perform basic nursing duties, such as taking vitals, collecting samples and administering medication. LVNs are essentially the same as LPNs, just different terminology.
Prospective LPNs must have a high school diploma or equivalent, and participate in a state-approved training program. Some states may require passing an entrance exam prior to program enrollment. In addition to state-approved training, LPNs can seek professional certifications within specific disciplines, such as gerontology, pharmacology, IV therapy and hospice care.
LPN’s considering career advancement can enroll in an LPN-to-RN or LPN-to-BSN program
Upon completion, students must pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN). This is a national test, but each state is responsible for authorizing test takers. Candidates must undergo an application process through their state of residency, and that can include a criminal background check and paying a fee.
Example: LPN Education and Licensure in Texas
- Completion of an accredited practical nursing program, including 1 year of academic coursework, laboratory and clinical training.
- Criminal background check
- Passage of the Texas Nursing Jurisprudence Exam (NJE) with a score of 75% or better.
- Passage of the NCLEX-PN exam
- License renewal every two years with 20 hours of continuing education
Registered Nurse (RN)
Registered nurses perform all aspects of nursing care and at a minimum should hold an Associate’s degree in nursing (ADN) from an accredited program. Depending on the program, students may need to complete certain prerequisites prior to admission, such as achieving a minimum score on the SAT or ACT or maintaining a minimum GPA. Although not required, many states and employers are moving to require a Bachelors of Science in Nursing (BSN). RNs can also achieve the title Advanced Practice Registered Nurse (APRN) by going on to complete a master’s degree in a chosen specialty. Types of APRNs are nurse practitioner, nurse midwife and clinical nurse specialist.
After completion of an accredited degree program, students must complete the application process of the National Council Licensure Examination for Registered Nurses(NCLEX-RN), including submitting application and licensure fees. Some states allow the submission of this application prior to degree program completion in order to expedite the process.
Example: RN Education and Licensure in California
- Completion of an associate’s or bachelor’s degree program.
- Criminal background check
- Passing the NCLEX-RN exam.
Physical Therapist Assistant (PTA)
PTAs must complete an associate’s degree in physical therapy. Training includes therapeutic exercise, massage, and operation of support devices, such as braces. Licensure varies from state-to-state, but most require passing a state exam and completing a specified amount of clinical experience.
Physical Therapist (PT)
PT candidates must enroll in a post-graduate physical therapy program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE). This is commonly a doctoral program—Doctor of Physical Therapy (DPT)—lasting around three years. In addition to a bachelor’s degree, there also may be further prerequisites prior to enrollment, such as completing specific science courses or gaining some volunteer and observational experience. Doctoral candidates in physical therapy often undergo both academic coursework—such as biomechanics, human anatomy and the musculoskeletal system—and training in a clinical setting.
Physical therapy licensure varies by state, but all candidates must pass the National Physical Therapy Examination by the Federation of State Boards of Physical Therapy. Depending on state requirements, continuing education may be required when renewing license. Licensed PTs can also obtain certification in a chosen specialty through the American Board of Physical Therapy Specialists. These certifications require passage of relevant exam and 2000 hours of clinical practice in a chosen specialty, such as geriatrics or cardiovascular and pulmonary.
Example: PT Education and Licensure in Colorado
- Completion of a CAPTE-accredited physical therapy program
- Submission of application and related fees
- Passage of the NPTE
Occupational Therapist (OT)
Occupational therapists treat patients through the therapeutic application of every day activities.
Occupational therapists must complete a master’s degree in an accredited OT program. They must also complete a certain number of clinical fieldwork hours—depending upon state regulations. Common OT courses revolve around kinesiology, functional anatomy, therapeutic communication skills and foundations of occupational therapy just to name a few.
OT Licensure: NBCOT Certification
All states require OTs to obtain a state-issued license. Although similar, requirements of licensure are not the same for each state, varying by fees and other requirements. OTs must pass the National Board for Certification in Occupational Therapy (NBCOT) Certification Examination. Those that achieve NBCOT certification can then use the title Occupational Therapist Registered.
Example: OT Education and Licensure in Arizona
- Completion of degree a NBCOT-approved occupational therapy program.
- Completion of 928 hours of field experience or internship under the supervision of a licensed occupational therapist—paid or unpaid.
- Passage of the NBCOT licensure exam—$500 fee for online exam, $540 fee for a paper exam.
- Completion and submission of state application for licensure, including submission of licensure fees and all required documentation. These include two signed recommendations, fingerprint card, statement of citizenship and NBCOT notice of verification
Speech Therapist (ST)
Speech therapists, also referred to as speech pathologists, must complete a speech therapist degree or a bachelor’s degree in a related field, such as communication sciences and disorders. This degree must be accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology.
Some states require a master’s degree and the Certificate in Clinical Competence-Speech Language Pathology (CCC-SLP), offered by the American Speech and Hearing Association. Certification requires post-graduate clinical fellowship, generally 36 weeks and 400 hours of clinical work under supervision. CCC-SLP certification also requires passing the Praxis Examination in Speech-Language Pathology.
Example: ST Education and Licensure in New York
- Completion of a graduate degree, including 75 semester hours in specific courses and a minimum of 400 supervised clinical training.
- Passage of the Praxis II Examination.
Social Worker Careers
Given the vast scope of social work, there are many different types of social workers with different education requirements, exams and licensure criteria.
Types of social workers include:
- Licensed Bachelor of Social Worker (LBSW)
- Licensed Master of Social Worker (LMSW)
- Licensed Master Social Worker-Advanced Generalist (LMSW-AG)
- Licensed Clinical Social Worker (LCSW)
Social Worker Licensure
In addition to academic course work, hands-on training and post-graduate work experience may be required. LBSWs are not required to perform post-graduate work experience, but LMSWs, LMSW-AGs and LCSWs must complete a specified number of years of post-graduate work experience, usually under supervision. After completion of a degree program, students must then pass the equivalent exam for degree type.
Example: Licensed Clinical Social Worker Education and Licensure
- Complete a master’s degree in social work.
- Undergo 2 to 3 years of postgraduate work experience.
- Pass the Clinical ASWB Examination.
- Fulfill any additional criteria required by the state of residency.
Medical Social Worker (MSW)
In general, medical social workers work within the spheres of public health, palliative, geriatric and in-patient medical or mental health care. Individual MSWs commonly specialize in one area of care.
Medical social workers must complete a master’s degree with a specific clinical focus. This program must be accredited by the Council on Social Work Education (CWSE). All accredited programs have a clinical component in addition to academic coursework. The clinical component includes at least 900 hours of training in a hospital setting under the supervision of a qualified medical social worker. Students can also earn additional certificates by taking a sequence of courses within a particular branch of health.
After completion of a degree program, students must pass a licensing exam through the Association of Social Work Boards. Other certifications and requirements vary by state.
Caregiver Ongoing Training Requirements
As licensure and education differ for each profession, so do ongoing training requirements. This is perhaps the most important part for home care agencies. Continually training their caregiver staff on the agencies internal policies as well as general practices in caregiving is critical. In fact, required in many states. Stay tuned an in depth follow up article that will described each and every requirements as it relates to home care agencies and their staff. In the meantime, website like teaching guide offer a great overview on online Udemy courses. Also, here are some resources that will help you lear about these requirements.
- In the Know – An excellent source for training material
- Caregiverlist Caregiver Training Center: Certified Caregiver
- Caregiving.com Certified Caregiving Consultant
- American Caregiver Association: National Caregiver Certification Course (NCCC)
- American Caregiver Association: Advanced National Caregiver Certification Course (ANCCC)
- American Caregiver Association: Certificate of Caregiver Leadership: Level l
- Family Learning Center: Caregiver Training
- aQuire Family Care Training
- Caregiver Training Institute: Caregiver Training Course
- aQuire Caregiver Training
- American Caregiver Association: Certificate of Personal Development: Level I
- Medifecta: Online Training
- The Caregiving Training Company: Online Senior Care Training
- Universal Class: Caring for Seniors
- American Caregiver Association: Certificate of Caregiver Ethics: Level I
- Family Caregiver Education Program
- Institute for Professional Care Education: Caregiver Core Certification
- Caregiver Cloud: Online Healthcare Training Courses
- Sunrise Services: 75 Hours Basic Home Care Aide Training
- Sunrise Services: Nursing Assistant Certified (NAC) Bridge
- Sunrise Services: Online Caregiver Training Program
- Family Caregiver Online Training
- Caregiverlist Basic Training
- Zen Hospice Project: Mindful Caregiving Education
- Care Academy
- Alison: Diploma in Caregiving
- Institute for Professional Care: Webinars
- Alison: Health and Safety for Caregiving
- Alison: Introduction to Caregiving
- Institute for Professional Care Education: Dementia Care Certification
- Institute for Professional Care Education: Diabetes Care Certification
- Institute for Professional Care Education: End of Life Care Certification
- Institute for Professional Care Education: Personal Care Aide Certification
- Institute for Professional Care Education: Post Hospital Care Certification
- Cannabis Care Certification Patient Education Program
- Family Caregiver Alliance: Caregiving Webinars
- Veterans Health Administration: Family Caregiver Programs
- Alzheimer’s Association: Online Workshops
- NCBAC Alzheimer Caregiver Course
- CAC™ – Certified Alzheimer Caregiver™
- CRTS™ Certification
- Alison: Caregiving Skills – Dementia Care
- Alison: Elderly Care and Caring for the Disabled
- Alzheimer’s Association Classes
- Certified Eden at Home Associate Training
- American Caregiver Association: National Assisted Living Manager Certification (NALMCC)
- The American Association for Caregiver Education: Basic Training for the Professional Family Caregiver Facilitator
- The American Association for Caregiver Education: Family Caregiving Master Planning for the Professional
- EasyCEU: NAB-Approved Continuing Education Units (CEUs)
- American Nurses Credentialing Center (ANCC) Certification Program
- Medifecta: Home Health Aide Training Program