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Home care worker service

Home Care Worker Service

What most older adults at home need most is not injections or dressings, but day-to-day personal care: bathing, toileting, feeding, lifting and escort to appointments, together with rehabilitation, cognitive and swallowing practice under a therapist's guidance. We arrange trained care workers to come to the home, so that older adults can age at home and carers can be relieved of some of the load. A care worker is not a nurse. The nurse assesses and makes the plan, the care worker carries it out day to day, and the two roles complement each other.

  • Trained care workers
  • Home visits across Hong Kong
  • From $243 per hour, no minimum spend
  • Guided by nurses and therapists
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Areas of care worker support

Choose care worker support by need

What a care worker does: personal care, carrying out the care plan and respite

A care worker (personal care worker) is part of the Social Welfare Department's elderly service system and completes a certificate course of about 50 to 100 hours, with training that focuses on personal care and lifting techniques. The core duty is full "daily living care", which includes help with bathing, oral hygiene, toileting, changing continence pads, feeding, helping with medication as directed by healthcare staff, lifting and safe transfers, regular turning and positioning, checking the skin, escort to appointments and everyday companionship. For older adults with limited mobility or who are bedbound long term, this careful care, repeated every day, is the basis of personal dignity and quality of life.

Besides daily personal care, a care worker also follows the programme set by a nurse or therapist, helps the older adult with rehabilitation exercise, cognitive stimulation, daily function and swallowing practice, and reports progress to the professionals concerned. A visiting care worker also gives respite, so that family members who have carried the pressure of caring alone for a long time can take a break. This matters in preventing physical and mental burnout in carers.

Care worker and nurse: who does what

To choose a suitable service, it helps to be clear first about how the two roles divide the work. The care worker is responsible for daily personal care. The registered nurse is responsible for clinical nursing that carries medical risk and needs professional clinical judgement. The two roles complement each other and do not replace each other. In the ideal care model, the nurse assesses the older adult's condition and makes the nursing plan, and the care worker then carries out the plan day to day.

Care worker (personal care)A care worker is a personal care worker within the Social Welfare Department's elderly service system. The usual work includes helping the older adult to shower, use the toilet, change continence pads, eat, transfer to a chair, turn regularly, and attend appointments with company. Under the guidance of a nurse or therapist, the care worker also practises rehabilitation exercise, cognitive training, daily self-care and swallowing with the older adult. The focus is on looking after daily living and carrying out the care plan.
Registered nurse (clinical nursing)A registered nurse holds a practising certificate issued by the Nursing Council of Hong Kong and handles nursing procedures that carry medical risk, including wound cleaning and stitch removal, nasogastric tube, stoma and urinary catheter care, injections (for example insulin), blood taking, checking vital signs and making the nursing plan. These procedures must be done by a registered nurse in person (see the home nursing service for details).
How the work is sharedThe two work together. The nurse assesses and makes the nursing plan first, and the care worker then carries it out day to day. If the older adult needs wound dressings, catheter care, injections or a nursing assessment, a nurse should be booked. If the older adult needs help with daily personal care or someone to practise rehabilitation with, or if the family wants someone to take over so that they can rest, a care worker can be hired.

Five areas of care worker support

In each of the areas below, the programme is assessed and drawn up by the relevant nurse or therapist, and the care worker helps to carry it out and practise it day to day:

Nursing support
Helping with personal hygiene, feeding, reminders to take medicines as directed by healthcare staff, recording basic vital signs, safe lifting and transfers, regular turning and positioning to prevent pressure sores, and escort to appointments and everyday companionship.
Rehabilitation exercise support
Following the home exercise programme set by the physiotherapist, staying alongside the older adult during daily rehabilitation exercise, watching for safety, recording progress and reporting to the therapist regularly.
Cognitive training support
Under the guidance of a therapist or nurse, doing different kinds of cognitive stimulation activities with the older adult, such as talking about the past (reminiscence), reality orientation, table games, and cognitive practice built into daily life.
Functional training support
Under the guidance of an occupational therapist, practising daily self-care movements (ADL and IADL) and hand fine-motor training with the older adult, and reminding the older adult to use assistive devices correctly and to keep the home safe.
Speech training support
Following the programme set by the speech therapist, putting swallowing safety measures into daily care (including adjusting the sitting position for meals, preparing food of a suitable texture and watching over the older adult during meals) and keeping the older adult company in communication practice.

Trained care workers compared with untrained care

Hiring a properly trained care worker makes a real difference to care compared with family members managing alone or leaving the work to an untrained domestic helper. Systematic research shows that home carers who are trained and professionally supervised, working in a care model built around the older adult's needs, help to improve health-related quality of life. The respite support that care workers give also eases the pressure on family members. The figures below are all taken from local or international studies that have been checked. It should also be noted that research evidence that care workers directly improve clinical outcomes is still limited, so the benefit is best understood as helpful, not guaranteed:

15.5%
Proportion of carers in Hong Kong with burnout
The figure comes from a local study covering nearly ten thousand carers of people with dementia. It found that carers who looked after a spouse, helped with daily personal care (ADL) and spent more than 21 hours a week caring were at high risk of exhaustion (Chan/Cheung 2021, HK).
Improved
Effect of carer training and supervision on older adults' quality of life
In one systematic review, the only higher-quality randomised controlled study found that setting meaningful goals for the older adult, together with carer training and supervision, helped to improve health-related quality of life. The overall research evidence is still limited (Cooper 2017).
8% vs 13%
Turning frequency and incidence of pressure sores
This study compared the incidence of pressure sores when turning every 2 to 3 hours with turning every 4 to 6 hours. It is a common example of a plan made by a nurse and carried out day to day by a care worker. The certainty of the evidence in that study is low (Avsar 2020).

Older adults who may benefit from a care worker

Who it suits

  • Older adults with limited mobility or who are bedbound long term, who need help with daily living and pressure sore prevention
  • Older adults who have just come home from hospital and need someone to take over daily care, following the nurse's care plan
  • Older adults receiving physiotherapy, occupational therapy or speech therapy who need someone at home to practise with them to keep up progress
  • Older adults who live alone or have little support from relatives and friends, and need someone to accompany them to appointments and keep them company
  • Families in which one person has been caring alone for a long time and feels exhausted, and who need someone to take over for a while so they can rest

Situations that must be handled by a registered nurse (not a care worker's duty)

  • Wound cleaning, stitch removal and stoma care
  • Daily care and regular changes of nasogastric tubes or urinary catheters
  • Injections of all kinds (for example insulin) and blood taking
  • Professional assessment of vital signs, and making an individual nursing plan
  • If the older adult has any of these medical nursing needs, please book the home nursing service

In short, therapists and nurses are responsible for professional assessment and making the programme, and the care worker is responsible for looking after daily living, practising with the older adult according to the plan, and taking over so that family members can rest. Rehabilitation, cognitive and swallowing programmes that have a therapeutic effect must be led by a therapist. The care worker's role is to help the older adult build this training into every day and keep practising, while sharing the carer's load.

Frequently asked questions

What is the difference between a care worker and a registered nurse? Which should we choose?
A care worker is a personal care worker within the elderly service system of the Social Welfare Department. The work is mainly daily personal care, including bathing, toileting, changing continence pads, feeding, transfers and escort to appointments. Under the guidance of a nurse or therapist, a care worker also helps the older adult with rehabilitation, cognitive and swallowing practice. A registered nurse carries out clinical nursing work that carries medical risk, such as wound care, nasogastric tube or urinary catheter care, injections, blood taking and overall nursing assessment. In short, if the older adult needs daily personal care and someone to practise rehabilitation with, a care worker is suitable. If the need involves dressings, catheters, injections or a professional nursing assessment, a nurse must do it. The ideal arrangement is for a nurse to assess first and make the plan, and for the care worker to carry it out day to day. The two roles complement each other.
Is there a real difference between hiring a trained care worker and hiring an untrained helper yourself?
Yes. Systematic research shows that home carers who are trained and professionally supervised, working in a care model built around the older adult's needs (rather than just finishing tasks), help to improve the older adult's health-related quality of life. One of the higher-quality randomised controlled studies found that setting meaningful goals for the older adult, together with carer training and supervision, improved quality of life. Note that the total amount of research here is still limited, but the findings point in the same direction: training and supervision are the key to service quality. All Nova Health care workers go through careful selection and professional training.
What can a care worker help with? Do they do wound care or injections?
A care worker is responsible for personal care and for carrying out the care plan. The work covers personal hygiene, feeding, helping with medication as directed by healthcare staff, transfers, regular turning to prevent pressure sores, escort to appointments and everyday companionship. Under the guidance of a physiotherapist, occupational therapist or speech therapist, the care worker also helps the older adult with rehabilitation exercise, daily function and swallowing practice. Tasks that carry medical risk, such as wound care, removing stitches, nasogastric tube or urinary catheter care, injections and blood taking, belong to the professional scope of a registered nurse and are not handled by a care worker alone. If the older adult has these medical needs, the home nursing service can be used.
Family members are already exhausted from caring. Can hiring a care worker give the carer a rest?
Yes. This is exactly the purpose of respite service. A Hong Kong study covering nearly ten thousand carers of people with dementia found that as many as 15.5% of carers already showed burnout. The highest-risk group were carers who looked after a spouse, gave personal care and spent more than 21 hours a week caring. The research also points out that day care or respite services help to ease carers' burden. Arranging a care worker to visit regularly and take over daily personal care gives the carer room to rest and helps avoid physical and mental exhaustion.
For an older adult who is bedbound long term, what is the most important thing a care worker does each day?
Preventing pressure sores (also called bedsores) is one of the main priorities in caring for someone who is bedbound. Research data show that turning the older adult more often (every 2 to 3 hours versus every 4 to 6 hours) lowers the incidence of pressure sores (8% vs 13%). Regular turning, adjusting position, checking and cleaning the skin and daily feeding are usually carried out each day by the care worker following the care plan drawn up by the nurse, and the nurse then reviews the skin and wound condition regularly. This shows how the nurse (who assesses and plans) and the care worker (who carries out the plan day to day) complement each other.
Is a care worker's help with rehabilitation exercise and cognitive training the same as therapy?
They are different. Rehabilitation exercise, cognitive stimulation and swallowing programmes that have a therapeutic effect must be assessed and drawn up in person by a physiotherapist, occupational therapist or speech therapist. The care worker's role is to help the older adult keep practising every day under the therapist's guidance, to stay alongside and keep the older adult safe, and to report progress to the therapist regularly. In other words, the therapist plans the programme and the care worker helps the older adult carry it out consistently. Results depend on the two working closely together.

Would you like to arrange a trained care worker for an older adult, or find out about rates and home visit arrangements? Message us on WhatsApp for a free enquiry and an instant quote.

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Disclaimer: This article is general health information and is not professional medical advice. If you have any health concerns, please consult a qualified healthcare professional.

References

  1. Cooper, C., Cenko, B., Dow, B., & Rapaport, P. (2017). A systematic review evaluating the impact of paid home carer training, supervision, and other interventions on the health and well-being of older home care clients. International Psychogeriatrics, 29(4), 595–604. PubMed
  2. Chan, C. Y., Cheung, G., Martinez-Ruiz, A., et al. (2021). Caregiving burnout of community-dwelling people with dementia in Hong Kong and New Zealand: a cross-sectional study. BMC Geriatrics, 21, 261. PubMed
  3. Vandepitte, S., Van Den Noortgate, N., Putman, K., et al. (2016). Effectiveness of respite care in supporting informal caregivers of persons with dementia: a systematic review. International Journal of Geriatric Psychiatry, 31(12), 1277–1288. PubMed
  4. Avsar, P., Moore, Z., Patton, D., O'Connor, T., Budri, A. M., & Nugent, L. (2020). Repositioning for preventing pressure ulcers: a systematic review and meta-analysis. Journal of Wound Care, 29(9), 496–508. PubMed
  5. Social Welfare Department, Pilot Scheme on Community Care Service Voucher for the Elderly (care worker services can be used with the Community Care Service Voucher; refer to the latest Social Welfare Department announcement for the official voucher value). swd.gov.hk
  6. Legislative Council Question 13: Support for elderly persons living alone (28 June 2023) (gives the number of elderly persons living alone; the 2021 Population Census recorded about 188,569 households of elderly persons living alone). info.gov.hk