Home Health Aide Duties List: What They Can and Can't Do

You hired a home health aide for your father. She's been coming three days a week for a month. Yesterday you asked her to change his wound dressing, and she said she wasn't allowed to. Today you asked her to pick up his prescriptions, and she seemed confused about whether that was part of her job. The root problem isn't the aide — it's that nobody defined the scope of her duties in writing before she started.

Home health aides operate within clear boundaries that separate personal care from skilled medical care. Understanding these boundaries prevents unsafe requests, reduces conflict with agencies, and ensures your parent gets the right level of support.

Standard Personal Care Duties

These are the tasks most home health aides are trained and authorized to perform:

Activities of Daily Living (ADLs):

• Bathing and grooming assistance (showering, hair washing, oral care)
• Dressing and undressing
• Toileting assistance and incontinence care
• Transferring (helping the parent move from bed to chair, chair to standing)
• Feeding assistance (serving meals, cutting food, monitoring intake)
• Mobility support (walking, positioning, fall prevention)

Instrumental Activities of Daily Living (IADLs):

• Light meal preparation
• Light housekeeping (tidying the parent's living areas, washing dishes, laundry)
• Medication reminders (reminding the parent to take pre-sorted medications — not administering or sorting)
• Grocery shopping and errands
• Companionship and conversation
• Escorting to medical appointments

What Home Health Aides Cannot Do

Aides are prohibited from performing skilled clinical tasks. These require a licensed nurse, therapist, or physician:

• Administering injections (insulin, blood thinners, vaccines)
• Managing sterile wound dressings or wound care
• Inserting or managing catheters
• Suctioning tracheostomies
• Adjusting oxygen equipment settings
• Conducting clinical assessments or diagnosing conditions
• Changing medication dosages or sorting medications into pill organizers

If your parent needs any of these skilled services, they require a home health nurse — a fundamentally different role, typically covered by Medicare when ordered by a physician.

The Difference Between Home Health Aides and Home Health Nurses

This distinction trips up many families:

Home health aides provide non-skilled personal care. They help with daily living tasks and keep the parent comfortable and safe. They're employed by private agencies or hired independently, and they're paid hourly — typically $25-$40/hour depending on location.

Home health nurses deliver medically necessary, physician-ordered skilled care: physical therapy, wound care, speech therapy, clinical monitoring. Under Medicare, home health nursing is covered if the parent is documented as "homebound" and requires part-time or intermittent skilled services. Medicare pays 100% for covered skilled services. A home health aide is covered by Medicare only on a part-time basis while the parent is receiving active skilled clinical therapies.

Writing a Clear Task List for Your Aide

The most effective way to prevent scope confusion is a written daily task list that the aide reviews and signs at the start of each shift. Include:

Morning routine: What time to arrive. Which ADLs to assist with (bathing, dressing, medications). Breakfast preparation details (dietary restrictions, consistency requirements for dysphagia).

Midday tasks: Meal preparation. Light housekeeping. Scheduled activities or exercises. Medication reminders.

Evening routine: Dinner preparation. Evening personal care. Bed transfer and positioning.

Shift handoff notes: A brief log of the parent's mood, appetite, mobility, bowel movements, and any unusual observations. This log is critical when multiple aides rotate shifts — without it, each aide starts from scratch.

What's explicitly excluded: List the tasks the aide should never attempt and who to contact instead (the supervising nurse, the agency, or emergency services).

Managing Rotating Aides

When your parent has two or three aides covering different shifts, consistent documentation becomes the coordination mechanism. Each aide should:

• Read the previous shift's handoff notes before starting
• Record their observations in the same log
• Flag any changes (new confusion, appetite loss, mobility decline) to the primary family coordinator

Without this system, subtle changes go unnoticed because no single aide sees the full picture.

A structured daily task checklist and shift handoff log keeps rotating aides aligned and gives you a running record of your parent's day-to-day condition. The Building a Care Team toolkit includes printable daily task checklists and communication logs designed for exactly this coordination challenge.