Learning More: Homecare Services and Personal Care Assistants

Posted by Reeve Staff in Life After Paralysis on November 30, 2021 # Community Education

woman and man sitting togetherIn honor of Homecare and Hospice Month, we want to share with you some tools that the Reeve Foundation’s National Paralysis Resource Center (NPRC) offers to families. Our goal is to ensure you and your family are equipped with the information and tools necessary to make the right decisions when looking for home care services.

For those just beginning their journey of homecare and the search for services, a Personal Care Attendant (PCA) is usually the first and most daunting task that lays ahead of them. The first step in acquiring a new PCA is to have a thorough list of your daily activities outlined. This will give you and the person applying an idea of the daily help you or your loved one will need. Be sure to list all things you may need assistance with and activities like bathroom and grooming routines, meal prep, travel, and other household activities and chores. You can find out more about getting a PCA through our blog, “Selecting and Hiring a PCA,” which lays out every step, from identifying your needs, developing a job description, all the way up to finding and training your new PCA.

Though finding the right PCA is only half the battle in ensuring you or your loved one has quality homecare being provided. Even after hiring what appears to be a great candidate, sometimes PCA’s will exhibit unprofessional behaviors. You want to make sure that you set boundaries and be clear that those boundaries must be respected, and your guidelines must be followed. This will help to define the working relationship. One solution is to draw up contracts or agreements to make sure all parties understand these guidelines and boundaries. When you have in-home caregivers, these boundaries and other lines can begin to blur. It is important to remember that you are the employer, and the PCA is the employee. This does not mean you cannot be friendly or develop a connection, but you do not want your PCA crossing any personal lines that may cloud the relationship. You can learn more about PCA dynamics and how to navigate them in our blog, “Managing a Personal Care Attendant.”

So, you found a PCA, great! Though even after a long and successful tenure, there will be a time that comes when you part ways. The first question to think about is why you are parting ways. If duties are not being carried out, it is best to be upfront and honest about what is troubling you. If this malpractice or poor work ethic is becoming a pattern, it is time to look for someone new to fill this role.

However, you want to be sure to have a parting plan for your PCA. If you believe there is an issue of misconduct like theft, mental or physical abuse, or neglect, you need to have a plan that protects you. You want to reduce any risk or liability when firing or letting your PCA go, and signed agreements and third-party witnesses are the best way to ensure these separations are carried out peacefully and amicably. You can find out more about separating with your PCA in our blog, “Parting with your Personal Care Attendant.” There you can read more about termination procedures, confirmation of misconduct, and corrective actions you can take as an employer.

You can find more information on our website. If you want to share more resources with your PCA, you can find patient education booklets on issues like Preparing to Transition Home and our Paralysis Resource Guide. These resources include all the conditions that cause paralysis, secondary conditions caused by paralysis, as well as everything else that transitions in your life after paralysis. You can also reach out to our Peer & Family Support Mentors to get more personalized and practical insight into some of the questions you may have on local homecare services and any recommendations from other community members. Our Peer & Family Mentor Program utilizes volunteers from across the country to ensure we can provide this service to any caller from anywhere in the country. You can reach out to our Peer and Family Mentor program through our website, or by calling at this number 1-800-539-7309. You can also reach out to our Information Specialists team that can help educate you and your PCA on homecare practices. You can reach by calling at this number 1-800-539-7309 or through this link for our Information Specialists.

Written by Kyle Marrs, Community Outreach Associate. To learn more about the free programs and services that the National Paralysis Resource Center offers please contact Kyle at [email protected] for a presentation.

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.