Looking for Work

If you're thinking of joining the profession, or if you're a direct-care worker who's thinking of switching to a new setting, there are many factors to consider:

Is this the right kind of work for you?
Despite the challenges of direct-care work, many people find it rewarding because it allows them to help others care for themselves or enhance the quality of their lives. If you have ever cared for someone other than an infant who needed help with things like eating, dressing, bathing, or toileting and you liked it, direct-care work may be right for you.

You may enjoy direct-care work if you're mature, responsible, and motivated by the desire to make a difference in people's lives and to form long-term, caring, and mutually respectful relationships. You're also likely to be good at this work if you're a good listener and problem-solver, you like juggling many tasks at once, you're open-minded about people who are different than yourself, and you prefer interacting with people to working on your own or at a desk job.

Who do you prefer to work with?
All kinds of people need direct-care assistance, from elders with Alzheimer's disease or chronic illness living in nursing homes and assisted living facilities to children with physical or developmental disabilities living in group or private homes. Thinking about what sort of people you’d prefer to work with will help you decide what kind of job you want to prepare or apply for.

What type of setting do you want to work in?
If you like the stimulation and sense of community that comes from interacting with a lot of people daily, including other direct-care workers and a variety of consumers, you might consider a nursing home, an assisted living facility, an adult day center, or some other busy setting where you’d work with many people during a shift.

If you like the idea of working in an intimate atmosphere and having a lot of one-to-one interaction with the people you assist, you might prefer being a personal assistant or home care worker. That could mean reporting to a consumer who hires you directly, working in a small group home, or working for an organization such as a home health agency or a public authority that matches you up with people in community-based settings who need direct care.

Different settings also provide very different amounts of structure and supervision. If you prefer to work without much daily oversight, home- and community-based care might suit you best. There is also less supervision and activity during the night shift at nursing homes and other residential facilities than there is during the day.

Who do you want to work for?
To find potential employers in your area, don’t just check the Help Wanted ads, especially if you want to work for a facility or agency. The place that would be best for you might not be hiring when you happen to be looking, but if you went there and talked to the person in charge of hiring, they might let you know when a job opened up. Besides, the facilities and agencies that advertise the most are usually the ones with the highest turnover, indicating that they’re not the best places to work.

If you’re interested in working directly for a consumer, Help Wanted ads are a good place to start. If there’s an independent living center in your region, see if someone there can help you find people in need of assistance. You might also want to contact the public authority if you live in one of the states – currently California, Washington, Oregon, and Michigan – that has one.

Once you’ve figured out who the candidates are, you need to find out whether you’d want to work for them. If you or someone you know knows anyone who works for the organization or individual or who recently left the job, ask if you can talk to them about what it’s like to work there. Compare the wages and benefits to what other local employers are paying for the same kind of work. Is there a union? If so, are the CNAs generally happy with it? Unions often win improvements in wages, benefits, job security, and/or working conditions for CNAs, but members must pay monthly dues.

Find out what kind of initial training the employer offers, if any, and what opportunities there might be for continuing education. Look for peer mentoring or career ladder programs, which demonstrate an employer’s commitment to employee development and advancement. If you are considering working at a nursing home or other facility, find out how many residents each nursing assistant generally assists. If you are considering home care, find out how many hours of work people usually get per week and whether it would be difficult for you to work as many hours as you’d like to. Also ask if workers are paid for the time they spend traveling between jobs. And if the employer you’re talking to seems to be constantly hiring new direct-care workers, try to find out what’s behind the high turnover rate. There may be a good explanation, but it may also be a sign of trouble and an indication that the staff on duty is “working short” and low in morale.

How do you get the training you need?
What kind of training you'll be required to have – if any – will depend on the kind of work you choose to do. For instance, the federal government doesn't require any training or personal assistance workers or direct support professionals, but many states do, and employers may have their own training requirements. The federal government does have training requirements for all nursing assistants and home health aides who work for organizations that get funding from Medicare or Medicaid, as nearly all nursing homes and most home health agencies do. The federal government requires at least 75 hours of classes and hands-on practice covering specific topics. In addition, some states require additional hours of training or cover additional content.

For more information about training requirements, click on the link for the kind of work you’re interested in on the Job Duties and Training Requirements page.

Even if training isn’t legally required, you may want to seek out a program that can help you develop the skills you will need on the job. The Paraprofessional Healthcare Institute has written a pair of issue briefs that outline what’s available. Click here to read about standard training practices and ways of finding good programs. Click here to read more detail about federal and state training requirements.

Workers on their work

If you think you might be interested in doing this kind of work, listening to someone who's already doing it is probably the best way to learn what it's like. Here are some ways to do that online:

• Visit Voices from the Frontline to read writings by and interviews with direct-care workers.
• Click on Connect With Your Peers for a list of message boards, websites, and listservs where direct-care workers share their thoughts and ideas
• Click here for a list of videos that show direct-care workers talking about their work.

Online Resources

Most direct-care jobs are not listed online, but a growing number of websites offer advice on how to find work, information about job openings, or both.

For a national job bank hosted by the U.S. Department of Labor and backed by the American Health Care Association and the American Association of Homes and Services for the Aging, click here.

For general job-hunting advice or for contacts for all types of direct-care jobs in Cuyahoga County, Ohio, click here.

For information about openings for direct support professional in Wyoming, click