What does an in-home caregiver do?

A typical day for a Resource One caregiver

Most caregiving doesn't happen in one long shift. A common pattern in West Tennessee is a morning visit, a midday check-in, and an evening visit — totaling 4 to 8 hours a day. Some clients have 24-hour coverage; many have a few hours twice a week. The shape of the schedule depends entirely on the care plan.

The morning visit is usually the longest. The caregiver arrives, helps the client get out of bed safely, into the bathroom, through a shower or sponge bath, dressed for the day, and to the breakfast table. They prepare a meal, set out medications as a reminder, check that prescriptions are filled, and write a quick log of how the morning went. If there's a doctor's appointment, the caregiver may drive the client there or coordinate transportation.

Midday visits are shorter — a meal, a hydration check, a load of laundry, a walk around the block, sometimes just thirty minutes of conversation. Evening visits mirror the morning: dinner, evening medications, getting the client safely into bed, securing the home for the night.

What in-home caregivers do

Caregivers handle the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) — the everyday tasks that make independent living possible. The list below is what a typical Resource One assignment covers under private pay, long-term care insurance, TennCare CHOICES, or VA Community Care.

• Personal care — bathing, showering, sponge baths, hair care, oral care, shaving, skin care, dressing, and toileting.
• Mobility assistance — safe transfers from bed to chair to walker to bathroom, fall prevention, helping with stairs, and using equipment like Hoyer lifts when needed.
• Medication reminders — caregivers do not administer medications, but they remind, observe, and report concerns to family.
• Meal preparation and feeding — preparing food the client likes and can safely eat, and assisting with feeding when needed.
• Light housekeeping — laundry, dishes, bed-making, vacuuming, and keeping the immediate living area clean.
• Transportation and escort — driving the client to medical appointments, the pharmacy, the grocery store, church, family visits, or simply out for a change of scenery.
• Companion care — conversation, reading, music, photo albums, light exercise, pet care, hand-holding.
• Supervision — being present so a client at risk for falls or wandering isn't alone.
• Communication — keeping family updated by phone or care log, flagging changes that warrant a doctor's visit, and coordinating with home-health nurses when applicable.

What in-home caregivers don't do

This is where families sometimes get confused. A non-medical home care caregiver under a PSSA license is not a nurse. They are not credentialed to perform clinical tasks, even simple ones. The list below is what falls outside the caregiver's scope.

• Administer medications. Caregivers prompt and remind. They do not push pills, draw insulin, or hand-feed prescription doses. Medication administration requires a licensed nurse.
• Wound care, injections, IV management, catheter changes, or tracheostomy care — all skilled nursing tasks.
• Diagnose, prescribe, or change a care plan. The plan is set by the family, the physician, and the home care agency.
• Make medical or financial decisions. Caregivers can drive a client to the bank but cannot sign documents on their behalf, manage their accounts, or make legal decisions.
• Provide therapy. Physical therapy, occupational therapy, and speech therapy are delivered by licensed home-health professionals under Medicare or insurance, not by caregivers.

Caregiver, CNA, DSP, HHA, LPN — what's the difference?

The titles are confusing because they overlap. Here's the short version most families need:

• Caregiver — the umbrella term for anyone providing non-medical home care. May or may not be certified.
• CNA (Certified Nursing Assistant) — completed a state-approved training program and passed a competency exam. Can work in nursing homes, hospitals, or home care. Most Resource One private-duty caregivers are CNAs.
• HHA (Home Health Aide) — similar training to CNA, more home-care-focused. Often used interchangeably with CNA in home care settings.
• DSP (Direct Support Professional) — specializes in support for adults with intellectual and developmental disabilities. Resource One DSPs work primarily under DIDD contracts.
• LPN (Licensed Practical Nurse) — completed nursing school and licensed by the state. Performs skilled nursing tasks under physician supervision. Resource One LPNs work in our DIDD line and in the B2B agency-staffing line.
• RN (Registered Nurse) — higher level of nursing licensure. Can supervise LPNs and develop nursing care plans. RNs in home settings typically work for home health agencies under CON licensure.

How to know if your family needs an in-home caregiver

Most families don't decide they need a caregiver. They notice — a series of small things over weeks or months that quietly compound until they realize someone has to be there.

Common patterns we see in West Tennessee intake calls: the daughter who realizes mom hasn't eaten dinner unless someone reminded her; the spouse caregiver who hasn't slept through the night in months; the discharge nurse who tells the family the patient can't go home alone; the long-distance child who notices unopened bills, expired food, and the same outfit twice in three visits.

If the question "can mom be alone for the day?" makes you nervous, the answer to "do we need help?" is usually yes — at least for a few hours a week, to start.

Starting in-home care in West Tennessee

Most Resource One assignments begin with a free in-home assessment. A nurse-supervised intake visits the home, talks with the client and family, and writes a care plan that says exactly what the caregiver will do and on what schedule. There's no obligation to proceed after the assessment.

Care typically begins within days under private pay or long-term care insurance. TennCare CHOICES, VA Community Care, and DIDD pathways take longer because they involve eligibility and authorization steps — but you can start private pay during the wait and transition without changing agencies.