Do I Need a Home Health Aide or a Home Care Nurse

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An increasing number of people, mainly elderly individuals and people with chronic conditions, are increasingly opting to receive the care or treatment they need from specialists who provide in-home visits, whenever it is possible. These specialists are widely available, both in the private sector and through government-funded organizations.

While there are a variety of different specialists that may be required to provide these home care services, depending on the needs of the client, this article will focus specifically on the services provided by a home care nurse (HCN) and a home health aide (HHA).

This article will provide insights into, and answer the question of which of these healthcare professionals might be more appropriate for certain situations.

Differences between Home Health Aide and Home Care Nurse

Home care nurses provide care that often requires more (specialized) skills and training than the services provided by a home health aide. They are trained to work with patients with a range of health challenges, including but not limited to administering medication, health education and counseling, performing various health-related tasks like taking vital signs, coordinating patient care with other health care providers, providing patients and families with emotional support, and more.

It is noteworthy to mention that home nursing care can sometimes be provided by either a Certified Nursing Assistant (CNA) a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). They usually work under the supervision of a clinical staff of professionals, including more senior and experienced nurses. These disciplines will often work together in a skilled nursing facility and are known collectively as SNFists

Home health aides, on the other hand, are individuals who usually work independently or under the supervision of a home healthcare agency. They may or may not be certified, depending on the requirements of the specific state, and their main responsibilities revolve around providing various personal care services as well as some limited health-related ones like administering prescribed medication.

That said, some of the core differences between a HCN and a HHA will be observed in the following areas:

  • Roles and Responsibilities

The duties of a home care nurse will vary with the needs of the patient, and/or they will be in line with the care instructions of a supervising physician or nurse. Their responsibilities will usually be broader in scope and will often include some health-related tasks like drawing blood samples, taking vital signs and more, and, but they can also include some personal care duties. 

The role of a Home health aide will, more often than not, be limited to tasks that are of a personal nature, like helping with activities of daily living like dressing, bathing, cooking and others.

  • Education and Training

Home nursing education in the United States is regulated by law and students receive intensive theoretical and clinical education as undergraduate and graduate students. 

Home nurses and home health aides (HHAs) are both important healthcare providers offering extensive medical and personal care services, but their educational qualifications, training, and the types of services they provide greatly differ.

Home nurses, therefore, need to meet higher educational and training requirements and offer relatively complex care than HHAs based on the job descriptions, HHAs often have to go through a short training and certification program, or they receive on-the-job training.

  • Scope of Medical Care

A home care nurse can perform skilled nursing services including complex and intravenous medications in the patient’s home, under the direction of the patient’s doctor, assess a patient’s physical and psychosocial needs and evaluate their dynamic health status. They may also act as a source of coordination between various other healthcare providers that the client has like a dietician or a behavioral health practitioner.

The scope of medical care that a HHA may provide is rather limited. Examples might include things like taking a patient’s temperature, pulse and respiration, and performing a physical examination without the use of instruments. They may also change simple wound dressings, apply support bandages, clean a drainage tube site that does not extend more than one inch into the body, take body fluids for approved testing, assist with physical therapy exercises, and assist with health teaching, e.g., how to use a glucometer, etc.

Since the home health aide does not carry out physician-prescribed treatments, the home health aide is not implementing the plan of care.

Choosing the Right Home Caregiver

There are various things to consider when the decision between going with a HCN and a HHA is to be made. There are certain instances when the patient may have no choice, so to speak, as to the type of caregiver they get or need. If there are certain health challenges the patient suffers from, then they may, without question, need an HCN to care for them at home, moreover if this is at the direction of a physician. 

If the main task that the client needs mostly has to do with activities of daily living (ADL), or even companionship, they will likely need to hire an HHA.

If the need is for a caregiver that can do both, I.e. provide ADL and some medical services, then it would be pertinent to ask what type or scope of medical services are required. If they are tasks that a home health aide can perform, then this caregiver will almost certainly be more cost-effective to hire. But if the services are more advanced and beyond the scope of an HHA, then, again, there might be no choice but to hire an HCN.


While receiving care from home can be more affordable, convenient, and beneficial, the differences in occupation can make it confusing when deciding between the right type of home care service professional to choose from.

Therefore, the best and simplest answer to the question of who you need between a home care nurse and a home health aide, is that it depends on your specific needs and circumstances.