What Are Home Health Aides Not Allowed to Do in California?

Home health aides play an important role in supporting individuals who need assistance with daily living activities. However, their responsibilities come with specific limitations set by state regulations and professional standards.

This comprehensive guide will explain the tasks that home health aides in California aren’t permitted to perform, providing key insights from a seasoned nursing home abuse and neglect attorney.

Whether you're a client, family member, or caregiver, understanding these limitations is important for ensuring proper care and avoiding potential legal issues.

Understanding the Role of Home Health Aides

Before delving into what home health aides can and can’t do, it's important to understand their primary responsibilities.

Home health aides are trained professionals who provide essential support to individuals who require assistance with daily activities due to age, illness, or disability. Their duties typically include:

• Assisting with personal care tasks, such as bathing, dressing, and grooming
• Helping with mobility and transfers
• Assisting with meal preparation and feeding
• Performing light housekeeping duties
• Monitoring vital signs and reporting changes to healthcare professionals
• Providing medication reminders (but not administering medications)
• Offering companionship and emotional support

While home health aides are invaluable in supporting their clients' well-being, some specific tasks and responsibilities fall outside their scope of practice.

Medical Procedures Home Health Aides Can't Perform

One of the most critical areas where home health aides face restrictions is in performing medical procedures. Home health aides aren’t licensed medical professionals and therefore aren’t legally permitted to carry out tasks that require specialized medical training.

Here are examples of some of the medical procedures home health aides can’t perform:

Medication Administration

Can a home health aide give medication? The short answer is no. According to Cal. Code Regs. Tit. 22, § 74710, home health aides aren’t allowed to directly administer medications to their clients. This includes:

• Giving oral medications
• Administering injections
• Applying topical medications
• Inserting suppositories
• Administering eye or ear drops

Only licensed healthcare professionals, such as registered nurses or doctors, are authorized to administer medications. Home health aides can, however, provide medication reminders to clients to make sure they take their prescribed medications on schedule.

Wound Care and Dressing Changes

Complex wound care and dressing changes are outside the scope of a home health aide's responsibilities. These professionals should not:

• Clean or debride wounds
• Change sterile dressings
• Apply advanced wound care products
• Remove sutures or staples

These tasks require special training and are typically performed by licensed nurses or other qualified healthcare professionals.

Catheterization and Ostomy Care

Procedures involving catheters or ostomies are considered invasive and require extensive medical training. As such, home health aides aren’t allowed to:

• Insert or remove urinary catheters
• Perform catheter care beyond basic cleaning
• Change ostomy appliances
• Irrigate ostomies

Duties like these must be left to nurses or other primary care providers.

Intravenous (IV) Therapy

Any tasks related to intravenous therapy are strictly prohibited for home health aides. This includes:

• Inserting or removing IV lines
• Administering IV medications
• Adjusting IV flow rates
• Flushing IV lines

Interfering with a patient’s IV treatment in any way could expose a home health aide to legal liability.

Tracheostomy Care

Tracheostomy care requires specialized knowledge and sk7ills that are beyond a home health aide's training. They cannot:

• Suction a tracheostomy
• Change tracheostomy dressings
• Clean or replace tracheostomy tubes

Furthermore, the presence of a tracheostomy tube could affect a home health aide’s ability to provide nourishment or hydration to the client, making careful instruction and oversight crucial.

Medical Decisions and Assessments Home Health Aides Can't Make

While home health aides are responsible for monitoring their clients' well-being, they aren’t qualified to make medical decisions or perform complex assessments. Here are some of the restrictions they face in this area:

Diagnosing Medical Conditions

Home health aides aren’t permitted to diagnose medical conditions or illnesses. They should report any observed symptoms or changes in their client's condition to the appropriate healthcare professionals.

Interpreting Medical Test Results

Interpreting lab results, X-rays, or other diagnostic tests is outside a home health aide's scope of practice. Such tasks should be left to licensed medical professionals.

Developing or Modifying Care Plans

While home health aides may provide input based on their observations, they cannot independently develop or make changes to a client's care plan. This responsibility falls to licensed care providers, such as registered nurses or physicians.

Performing Complex Medical Assessments

Home health aides can monitor basic vital signs, but they aren’t allowed to perform complex medical assessments, such as neurological assessments, advanced cardiac assessments, or respiratory assessments beyond basic observation.

Legal and Ethical Boundaries

Home health aides must also adhere to certain legal and ethical boundaries to protect their clients and themselves. Here are some important limitations:

Accepting Gifts or Money

To maintain professional standards and avoid potential conflicts of interest, home health aides generally aren’t permitted to accept gifts or money from clients or their families beyond their agreed-upon compensation.

Engaging in Financial Transactions

Home aides also shouldn’t engage in financial transactions on behalf of their clients, such as managing bank accounts, writing checks, or making investment decisions. These activities could potentially lead to accusations of financial abuse or exploitation.

Signing Legal Documents

Additionally, these professionals lack authorization to sign legal documents on behalf of their clients, including wills, power of attorney forms, or healthcare directives.

Providing Legal or Financial Advice

Offering legal or financial advice is strictly outside the scope of a home health aide's role and could potentially harm the client if the advice is incorrect or inappropriate.

Emotional and Personal Boundaries

Along with the legal and ethical considerations, it’s also imperative for home health aides to maintain appropriate emotional and personal boundaries. This applies to situations like:

Developing Romantic Relationships

Home health aides are expressly forbidden from engaging in romantic or sexual relationships with their clients. This is considered a serious breach of professional ethics and can lead to termination, along with potential legal consequences.

Sharing Personal Information

While building rapport with clients is important, home health aides should set and adhere to professional boundaries by limiting the personal information they share about themselves or their families.

Imposing Personal Beliefs

Home health aides must respect their clients' beliefs and values and shouldn’t impose their own religious, political, or personal beliefs on their clients.

Professional Scope and Training Limitations

Home health aides are expected to work within the boundaries of their training and certification. Here are some limitations related to their role:

Performing Tasks Without Proper Training

Home health aides shouldn’t perform any tasks for which they haven’t received proper training, even if requested by the client or their family members.

Working Beyond Scheduled Hours

Home health aides should adhere to their scheduled work hours and not provide care outside of these hours without proper authorization from their employer.

Bringing Unauthorized Individuals to Work

Home health aides aren’t allowed to bring friends, relatives, or other persons to their clients’ homes during work hours.

Consequences of Exceeding Scope of Practice

When home health aides perform tasks outside their scope of practice or violate professional boundaries, the consequences can be serious. They may include:

• Risk to patient safety: Performing medical procedures without proper training can lead to injury, infection, or other health complications for the client.
• Legal liability: Home health aides who act beyond their normal responsibilities may face legal action from clients or their families if harm occurs.
• Professional consequences: Violating scope-of-practice rules can result in disciplinary action, including loss of certification or termination of employment.
• Criminal charges: In cases of financial exploitation or abuse, home health aides may face criminal charges.
• Reputational damage: Exceeding limitations can harm the reputation of both the individual aide and their employing agency.

For all of these reasons, it’s essential for home health aides to thoroughly understand the nature of their professional duties and adhere to their scope of practice at all times.

When to Seek Legal Assistance

If you suspect that a home health aide has exceeded their limitations and harmed you or a loved one, it's important to seek legal guidance. Signs that may indicate a need for legal intervention include:

• Unexplained injuries or health complications.
• Sudden changes in financial status or unusual financial transactions.
• Signs of neglect, such as poor hygiene or malnutrition.
• Emotional or psychological distress related to the aide's behavior.

An experienced attorney can assess your case and help you take appropriate legal action.

Get Help Protecting Your Loved Ones

Susan Kang Gordon, A Professional Law Corporation, focuses on abuse and neglect cases in the San Francisco Bay Area. Founder and lead attorney Susan Kang Gordon can help you understand your rights and seek justice for a loved one who’s been subjected to mistreatment.

Don’t hesitate to seek professional legal advice. Contact us today for a free, confidential consultation, and let us help you protect the dignity and well-being of those you care about most.