How to Become a Caregiver in the USA

Are you interested in becoming a caregiver in the United States? If so, then you really need to read this article. It talks about a lot of the basic things you need to be aware of before becoming one.

The information shared in this video is from an OFW YouTuber who works for a caregiver agency. You will definitely learn a lot from her as you prepare for your own caregiving journey.


Disclaimer: The information posted here is based on the personal experiences shared by the OFW in the video below. Please let this post serve as a guide only. If you have specific questions, you may ask the OFW by commenting on their video on their accounts.

Caregiving in America: What You Need to Know

OFW YouTuber Ann Daniel shares the following information about the profession in the USA. Check out the full video right here:

There are two types of caregivers in America, these are:

  • CNA – Certified Nurse Assistant
  • CHHA – Certified Home Health Aide

Based on the names, a CHHA is more on the house, while CNAs are mostly working in facilities, rehabs, and in the hospital sometimes. They are basically assistants of nurses.

How to be a Caregiver

You need to study, be certified, and be licensed. To be a CNA, you have to undergo 90 hours of training, including clinical hours. For the CHHA, it’s going to be 76 training hours, clinical hours also included.

For CNA, your clinical hours are done in an actual facility, while for the CHHA, these hours are just done in the school where you trained. Therefore, your CNA school is most likely tied up with a health facility, but you don’t necessarily have to work with real patients; you can just practice your new skills among your classmates.

Moreover, for CNAs, the actual exam is standardized within the state, but for the CHHA, the exam is created by the program coordinator, e.g. the main instructor during the training.

In fact, for CNA training, you have an instructor, but you also have examiners in charge of handing out the exams. During the exams, representatives from the state will also visit the test takers.

More about CNA vs CHHA

In addition, CNAs and CHHAs belong to two different higher umbrella bodies or government departments. It’s not like in the Philippines where almost all health practitioners fall under the Department of Health.

In fact, in the United States, CNAs are under the Department of Health, while CHHAs are under the Board of Nursing.

For both CNA and CHHA, you are required to have completed required vaccinations, have a Doctor’s certificate after a medical exam, and basically you need to be physically fit in order to work.

A CNA cannot work as a CHHA. There are separate licenses for both. If you think about it, both professions are similar in the sense that they offer personal care and safety to the patients, it’s just that the setting and location are different for both.

That’s why, even if you already have 90 hours of training for CNA, you still have to undergo training if you want to be a CHHA. What’s unusual though is if you are already a CHHA with 76 hours of training, those actually count for partial CNA training, which means you only have a few hours remaining to be qualified as a CNA as well.

If you find yourself in this situation, check out the community college near you, as they are likely going to offer this training for CHHAs wanting to be CNA certified.

CHHAs that work at Facilities

CHHAs can also work at facilities for assisted living, but only as companions and not as CNA. In this case, they can’t do the major tasks that only CNAs can do, like changing their patient’s clothes, cleaning them, transferring them to the bed or another. They can do simple tasks, though, like handing the TV remote, phone, calling someone, etc.

CHHAs are restricted from doing these major tasks that only CNAs can do at a facility because they are not employed by the facility anyway. If you go beyond the restrictions of your duty, and, God forbid, something terrible happens to the patient, then that can only be bad news for all parties involved.

CHHAs can be hired by the patients as companions, even if they already have a CNA assigned to them at a facility. Patients do this because there are some instances when they are already in critical condition; they need a round the clock assistant.

Some patients just like having a companion because they want to receive constant full attention.

Salary of Caregivers in the USA

Both CHHAs and CNAs have just about the same salary range of 12 dollars to 16 dollars per hour, but this depends on the state. In fact, our YouTuber says that in New York, you can reach as high as 20 dollars.

CHHAs or Home health aides can live in with their patients. That means they are really staying in the patient’s home, sleeping there for a couple of days. Perhaps 3 to 5 times a week is the average. There are other CHHAs that live in their patient’s house 24 hours a day 7 days a week; it really depends on the patient and their needs.

If you are a CHHA though that is tied with an agency, then they really try to avoid you working for very long hours. That’s because those extra hours count as overtime hours. You can only work for a certain number of hours per week, specifically 40 hours, and if you go beyond that, that’s already considered overtime, and you’re getting overtime pay.

Converting your earnings in a day as a live in CHHA, you can earn around 6,000 to 10,000 Philippine pesos per day. That’s really a lot of money, but of course you are in the US, and that means the cost of living is high, and there are a lot of bills to pay.

Working as a live in CHHA though has its perks when it comes to expenses. Yes, you will still pay taxes, but by living in, you don’t have to spend money on accommodation, food, electricity, and more. You will probably only spend on phone bills, food if you don’t want to eat what your patient is eating.

The usual agreement between caregiver and patient is that whatever your patient is eating, that’s what you’re eating as well. However, it’s best not to expect that you will be given food generously.

Whatever the case is, you need to respect your patient. There needs to be mutual respect between the two of you. Otherwise, your patient can sue you for negligence if you don’t do your job well. They can even sue you for abuse. That’s why you need to protect your license.

Advantages of Being a CNA

So far, we’ve mostly talked about being a CHHA, but what are the benefits of being a CNA. First, you will receive benefits from the facility you work in. These include:

  • Medical insurance
  • Vision
  • Dental

Moreover, there are some facilities that provide free tuition fee reimbursements if you want to study. For example, you may want to study to become a nurse. As long as you’ve worked for the facility for at least one year already, then they will pay for your tuition fee for pursuing higher education.

For home health aides, though, the disadvantage is that in many cases, their agencies won’t provide benefits. Another disadvantage is that getting a job is not really assured, since once your patient dies, you will have to wait for when they find another patient for you.

Sometimes it takes a while before they can find another patient for you. When you work in a facility, however, there will always be patients. The catch though, is that there will be lots of patients, and it will be tiring to take care of several patients in a day.

Our YouTuber suggests that if you are 50 years old or above, you can probably still work as a caregiver, provided that the workload is light. For example, you can still work as a CHHA, but as a companion for a patient in a facility.

Hoyer Lift Operation and Drug Administration

Another difference between CNA and CHHA is the operation of the Hoyer lift. That’s a machine that lifts or transfers patients when they are too heavy for CNAs to carry. CHHAs are not allowed to use the device, unless there is a family member who will ask them for assistance.

Again, they can only assist and not be the main operators of the device.

Moreover, CHHAs and CNAs cannot administer medicines. They can only remind the patients, or give the medicine to them. Caregivers are not allowed to take the medicine and put them in the patient’s mouth. Aside from that, caregivers are not allowed to refill the medicines in the pillbox.

The main goal for both CHHA and CNA are the following:

  • Safety
  • Personal care
  • Ensure that the patients are not neglected
  • Keep the patients clean and free from infection

Once the state or the family finds out the caregiver is not meeting these goals, they can complain anytime, have a prosecution, and the license can be revoked.

Caregiver Sponsoring

There are a few sponsorships from facilities, but not that many. If you think about it, this is one of the hardest jobs to staff in the US. There is a real shortage of caregivers and nurses in the country.

There are many reasons for this shortage. For one, nurses or caregivers can readily call out or move from their current facility onto another one. They can just easily transfer from one rehabilitation center or facility to another.

Some just quit because of burn out. Nurses, for example, often have 12 hour shifts that can really take a mental and physical toll.

There are facilities that sponsor, according to the YouTuber. You would be lucky if they sponsor you a work visa, or even a green card already.

Studying to Become a Caregiver in the Philippines

There are a lot of Filipinos who are interested in studying to become a caregiver so they can use it abroad, particularly in the United States. After all, the pay is really high, at least compared to how much you can earn in the Philippines.

Our YouTuber, on the other hand, has a unique take in this. That is, you probably won’t need or use the skills you learned in caregiver school in the United States. Once you arrive in the States, you will definitely have to study again. It’s like you just wasted your time, money and effort studying to become a caregiver in the Philippines.

Having said that, it’s totally up to you if you want to study before going to the USA. After all, a little extra knowledge won’t hurt, and you might even end up using just a little bit of what you learned in the Philippines in your USA career.

At the very least, studying caregiver school in the Philippines gives you a mental edge when you’re studying again in the US.

Also, if your previous occupations or academic background don’t really align with caregiving, learning will introduce you to this field of work. Again, though, when you arrive in the United States, they will teach you everything you need to know, from the most basic stuff to the most advanced knowledge and skills you need to be a successful caregiver.

Personal Experience

Our YouTuber, Ann Daniel, shares a little bit about her personal experiences as a worker for a caregiver agency in the USA. For the last three years, she has been working for the agency, and she also has experiences doing the caregiving herself.

So far, she says that she’s really enjoying her job. She met a lot of people, she learned a lot of new things, especially since she didn’t really have that health field background. The learning process and the actual job is worth it for her though, for all of the reasons mentioned above.

Aside from learning about matters related to health, she also learned more about professionalism and how to deal with different types of people.

There you have it. If you are interested in becoming a caregiver in the USA, then visit her YouTube channel for more related content.

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