Industry Expert Led Affordable Training for Polishing Skills and Landing Jobs

Miriam Phipps

Job Growth Is Strong for Caregivers, Whose ‘Hearts’ Are in Demand

For a former top real estate agent and landlord in southeastern Massachusetts, the downturned economy in 2006 did not merely mean that less business was coming in, it also meant that commissions on her sales were being slashed and her tenants were not coming up with the money to pay their rents. Unable to survive the triple-whammy, she lost not only her two rental properties but her own home as well.

For this career changer, who asked that her name be withheld, starting over meant retraining – in something that would guarantee a consistent income. With an aging American population, she wagered that she could find job security in caring for the elderly. This was not a bad bet. Caregiving positions are at the top of the US Bureau of Labor Statistics list for anticipated career growth between 2014 and 2024 – with Home Health Aide (HHA) jobs growing at 38 percent, Personal Care Assistants (PCA) at 26 percent and Certified Nursing Assistants (CNA) at 17 percent.

Meanwhile, for this writer, the decision to become a caregiver came after a 2003 layoff from a biotech research position in Andover. I had already been craving more interaction with the public and was considering a career as a health care professional. Caregiving offered a safe way to test the waters, before making any deeper commitments. As a CNA or PCA, I would be working alongside nurses and therapists, and have ample exposure to the types of tasks they perform and issues they troubleshoot on a daily basis.

As a PCA, I might even occasionally assume some of the responsibilities of the nurses, when working in assisted living facilities that operate under a social rather than medical model and where nurses are not on duty round the clock. There, PCAs may make emergency decisions, such as when to send a resident to the ER, or may perform emergency procedures, such as CPR. And, in assisted living facilities, it is the PCA who assists residents with their medications.

In skilled living facilities, CNAs may be required to obtain vital signs or assist with nursing procedures, such as catheterization or wound care. About 50 percent of a CNA’s day in nursing homes, however, involves toileting, which means everything from draining catheters to rolling residents onto bedpans to changing diapers in bed.

Regardless of which environment you work in, caregiving is about being there for those in need. That means being the eyes for those who can’t see, the ears for those who can’t hear and the arms and feet for those who can’t move. It may even mean being the memory for those who have forgotten how to sit, stand or eat.

In home care settings, where there are no activity directors on duty, a key component of the job may also be providing emotional support and socialization. So, Home Health Aides may spend time escorting their clients out on walks, taking them out to lunch or just playing cards with them at home.

Job interviews for caregivers tend to focus on personal qualities, since having a CNA license indicates that the job candidate already has the required skills. Interviews are typically conducted by the director or assistant director of nursing. Because the candidates will be working under a supervising nurse’s license, a key factor in hiring decisions is for the nurses to feel confident they can be trusted to exercise good judgment in their daily tasks, follow through on their directions and keep their residents happy.

When asked what she looks for in her CNAs, Registered Nurse Jennine Sarfo of Sunny Acres Nursing and Rehab in Chelmsford, Mass., says she needs to know that they are “reliable and honest,” explaining that it is important she feel confident in her aides to always convey what’s going on.

Asked if she agrees that hiring decisions are based more on personality traits than on technical skills, Marilyn Mauro, program manager of Homestead Rest Home in Charlton, Mass., exclaims, “Well, I don’t want a robot.” After all, this job is working with a population that is slow and forgetful, so it requires compassion and patience.

David Robinson, owner of Always Best Care home health agency in Belmont, Mass., agrees with both of them, saying what he values is good communication skills, and adding: “They have to have a heart.”

The median salary for certified nursing assistants is $29,000, according to the Massachusetts Executive Office of Labor and Workforce Development statistics, $24,590 for entry-level positions. Training and testing for CNA licensing is arranged through the American Red Cross. The cost of the month-long class, which covers both theory and practice, is $1,250. The practical training takes students through the steps of assisting with the activities of daily living (bathing, toileting, dressing, grooming and oral care), as well as obtaining vital signs, performing input/output calculations and documenting.

Home Health Aide certification is obtained before the completion of the class. And at completion, the Certified Nurse Aide licensing examination – both written and clinical – is scheduled, for another $93, at one of several testing sites throughout the state.

There is a lot of work in this field, however the work is hard and the wages are low. Those who survive these conditions best are those who pace themselves so that they are able to work plenty of overtime.


Miriam Phipps, a certified nursing assistant since 2005 in Massachusetts and in Florida, where she is also a certified medication technician (CMT), is developing a career as a writer. She can be reached at




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