How to Become a Home Health Aide


By Kelli Hansen, RN
HHA helping a client keep track of her medications

Home health aides are a valuable part of any health care team. If you have a desire to make a positive impact on the lives of the sick, disabled, and elderly, this could be a great position for you to consider. Home health aides (HHAs) assist patients with completing important personal tasks such as dressing, bathing and a variety of hygiene needs. Additional aspects of this position include assisting clients to remain safe in their own homes by providing a higher level of assistance with minor cleaning and instrumental activities of daily living (IADLs) such as cooking, light housekeeping, and laundry.

Tasks may include written documentation of patient care performed, patient’s condition, or problems to be reported to a supervising health care professional. In some instances, HHAs also assist with arrangements for transportation and planned leisure activities for clients. Some states allow home health aides to administer medications or check vital signs under the supervision of a health care practitioner such as a registered nurse (RN). Although the administration of medications by HHAs continues to be somewhat controversial, states have been increasing consideration to allow this job function within regulations. States such as Missouri, Arkansas, Colorado, and New Jersey now permit HHAs to perform a wider range of services.

If a person wants to enter the health care field, the job function as a home health aide offers considerable reward, enabling the individual to focus on providing patients hands-on care with a personal touch. The length of time to obtain education for such a position is much shorter than one might think.

Salary and Job Outlook

Interactive Map of Salary and Job Outlook Projections

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The Bureau of Labor Statistics reports that the overall mean wage for home health aides is $22,400, up from $21,020; that’s an increase of over $1300.00 in just one year. The median salary is $21,380, or $10.28 per hour. Wages vary based on geography and working environment; certified HHAs account for much of the higher reported wages, as a consequence of varying geographic and workplace requirements. The lowest 10% of HHAs earn $17,040 annually, while the highest 10% earn $29,560.

According to the US News & World Report on the Best Health Care Jobs of 2015, home health aide rank #23 as one of the fastest growing positions on their list. As the population ages, so does the need for the level of assistance that can be provided by HHAs. Many seniors prefer to remain in their own homes as long as possible; having the assistance of home health aides supports this option. The Bureau of Labor Statistics predicts that there will be a rapid growth of 48% within this industry between the years 2012 and 2022, which means demand for approximately 424,000 new home health aides. Certified HHAs have more options for employment consideration than those not taking the certification training.



There are no formal education requirements for home health aides, but most aides do possess a high school diploma. Aides choosing to work in a certified home health or hospice agency are required to obtain formal training and pass a standardized test, often including a hands-on demonstration of competency on associated topics in the presence of a registered nurse. Some preparatory classes are offered at various community colleges or through vocational/technical schools that ensure students meet the educational requirements before they are permitted to work with a client independently. Most classes require students to be at least 18 years of age.


If formal training is required in the state in which you live, it is often performed by a licensed RN. Some states require the formal training by an RN, as well as the standardized testing and hands-on competency assessment, before an HHA is permitted to work with a client. If your state does not have these requirements, the training can often be instructed by other experienced HHAs or health care professionals with various levels of education, as well as family members. Much instruction in those settings is completed with on-the-job training and return demonstration.

Educational programs and on-the-job training are beneficial to learn overarching necessary skills; however, each client will have unique needs that may require additional training that lasts from a few hours to a few days, depending on the complexity of the patient’s health care needs. Examples of patient-specific needs may include special dietary needs for those patients requiring dietary/cooking assistance, or specific transfer techniques to ensure patient safety.

In some states, certified home health agencies may provide the required training classes, the standardized written testing, and hands-on competency assessments in order for candidates to be considered for patient assignments once hired. Standard skill sets include learning basic safety techniques when working with patients, not only to keep the patient safe, but to prevent injury to the HHA when completing tasks such as transfers, bathing and dressing. Training will also include emergency response skills, such as basic first aid training and cardiopulmonary resuscitation (CPR). The associated expenses with completing these training programs can vary from a couple hundred dollars to nothing at all if the agency is providing the training to new employees.


Home health aides do not hold professional licensures; however, many employers require their HHAs to be certified, either due to preference or due to state regulation requirements. The certification process includes the successful completion of a minimum of 75 hours of training and hands-on skills. Several states actually require up to 120+ hours. Refer to State-by-State Training Requirements for exact requirements in your state; details can be reviewed either by the map or in an easier-to-understand table format.

The aide must then pass the standardized written testing, as well as complete a hands-on demonstration of each associated skill appropriately.

Necessary Skills and Qualities

Performing the duties of a home health aide can be physically demanding at times. In order to perform this job, a person must be able to lift at least 50 lbs. and must primarily be in good health. Because aides focus on direct patient care, patience is a necessity, as are dependability, effective interpersonal skills, good communication, and effective time management. According to the US Department of Labor (DOL), HHAs sustain on-the-job injuries and illnesses at a higher-than-average rate compared with people in other occupations. Most employers require an applicant to pass a criminal background check that includes checking for elder or child abuse and neglect. The applicant must also complete testing for tuberculosis (TB) and test negative before working with patients. In addition, many employers require drug testing prior to completion of the hire process.

If you would like to gain the necessary education to become a home health aide, we highly recommend that you check out our free School Finder Tool located HERE.

Work Environment

As you consider the career path of a home health aide, you must reflect on what type of environment you would find comfortable when providing patient care. Working as a home health aide does not always require a person to work in a private home of a patient. Your clients may reside in independent living apartments, retirement communities, assisted living facilities, or even group homes and transitional housing. Most HHAs focus on providing direct personal care with one patient at a time, but may visit several patients on the same day. HHAs are typically supervised by a patient’s health care provider such as a registered nurse providing care and oversight to that specific client. The patient’s family members may often be providing the supervision in cases when the HHA is caring directly for a patient privately without the interaction of a certified home health agency.

9 questions to consider:

  1. Would you be comfortable going into patient homes alone?
  2. Do you plan to work in a geographical area of high crime?
  3. Are you able to be self-directed and do you like to be independent? (Are you capable of performing required tasks without the direct supervision of another health care professional?)
  4. Are you comfortable speaking to a client’s family members if needed?
  5. How would you react if you were asked to provide client care in a cluttered, unsanitary home?
  6. Do you like a slower pace of patient care, or do you prefer a fast-paced, exciting environment?
  7. Are you able to lift a patient without injuring yourself?
  8. Do you have any pet allergies? Often, if your client has pets, there could be the presence of pet hair on furniture, unsanitary litter boxes or carpeting, and overall pet odors.
  9. Would you feel comfortable providing personal care to a male patient if you are female (or, if you are male, providing care to a female)?

Opportunities for Advancement

Once home health aides have performed the required job duties for many years, their wide variety of skills allows some employers to consider advancing those with the most experience into supervisory roles, overseeing and educating other HHAs and acting as mentors, onboarding orientation trainers and supervisors. HHAs who possess a high school diploma can choose to further their education and training in order to become medical assistants, nurses or other associated health care professionals. Having the prior experience as a home health aide often makes it less overwhelming to seek additional career training. It is not uncommon for a nursing student to work as a home health aide or certified nursing aide while attending school. The HHA experience helps a nursing student increase his or her comfort level when working with patients, and may bolster prospects of academic success.

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