What is a personal care aide (PCA)?

Personal care is hands-on help with the routines of the body: bathing, dressing, grooming, toileting, eating and moving safely. It's what most people mean when they say their mother "needs help getting ready" each morning. At Endurance, personal care includes everything in companion care, plus that hands-on help.

State law uses different words for it, and that matters when you compare agencies. The definitions below come from each state's own statutes.

New York's Public Health Law defines personal care services as help with personal hygiene, dressing, feeding and household tasks essential to the patient's health, prescribed by a physician under a plan of home care supervised by a registered nurse. An agency that provides personal care services needs a license from the Department of Health.

The Department of Health says a personal care aide (Level II) holds a certificate from an approved NYSDOH or NYSED training program that must offer a minimum of 40 hours, and performs fewer health-related tasks than a home health aide. Programs can upgrade a personal care aide to a home health aide with 35 more hours.

Endurance doesn't hold a New York home care license, so in New York it provides companion care only, and hands-on personal care is not part of it. Companion care there means company, meals, light housekeeping, errands, rides to appointments and reminders.

New Jersey's statute defines personal care services as services performed by licensed or certified personnel to assist with activities of daily living that may involve physical contact: bathing, toileting, transferring, dressing, grooming, and help with walking or exercise. Companion services, by contrast, are basic supervision and socialization that do not include help with activities of daily living.

In practice that means you should ask what certification the caregiver holds, and who employs them. A firm that employs, places or refers people to provide companion, health care or personal care services in the home of a person with a disability or age 60 or older must register with the Division of Consumer Affairs. Endurance is registered in New Jersey as a Health Care Service Firm, HP0435100.

Connecticut doesn't use the title "personal care aide" in its homemaker-companion law. The statute defines homemaker services as supportive services, including cooking, household cleaning, laundry, personal hygiene and other household chores. The Department of Consumer Protection lists personal hygiene among the services a registered agency may provide, and rides to appointments too.

We found no state training-hour requirement for personal care aides in Connecticut. The law does require a full background check before hire, a written contract or service plan within seven days of starting service, and training for staff as mandated reporters. Medical services are excluded: DCP says registered agencies may not administer medications or shots, or provide nursing services such as assessing blood pressure or wound care.

Endurance is registered in Connecticut as a Homemaker-Companion Agency, HCA.0002450. Skilled nursing, home health aides and physical therapy come from Endurance Home Health, a separate company.

When the daily routine has become hard to do alone: getting out of bed, washing, dressing, using the bathroom, eating. If it's company, meals and errands that have slipped, companion care may be enough. If a nurse is managing a condition and delegating tasks, you may need a home health aide.

Medicare doesn't pay for custodial or personal care when it's the only care you need, so most families pay privately for it. A long-term care insurance policy may reimburse it, depending on the policy.