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  1. Anthony, Maureen PhD, RN

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During the week of June 12th to 19th, we celebrate National Nurse Assistant Week. Nowhere in healthcare are nurse assistants more valued than in home healthcare. More commonly known as home health aides (HHA), these men and women truly deserve the title of angel of mercy. They are the home care workers who spend the most time with patients and families and, although patients may be sorry to say good-bye to nurses and therapists, they often feel they are losing a family member when HHA services are terminated.

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The most memorable HHA in my memory as a home care nurse was Mrs. M., barely 5-ft tall ("no bigger than a minute" as one patient said) with a can-do spirit and a no-nonsense attitude. She could talk the most difficult patient into the tub, rein in the most unrealistic nurse, and cajole a stubborn patient into reconciling with an estranged offspring. We called her Mary Poppins, because magical things seemed to happen when she appeared. The patients were initially wary of her, then loved her, then tried to hang onto her with all their might. She had more offers for fulltime employment than anyone I ever knew.


Another memorable HHA was Rick, a laid-back college student who worked his way through 4 years of college as a HHA. He was 50 to 70 years younger than most of the patients, had long hair, a beat-up car, and played in a garage band in his free time. Nothing about him suggested he would connect so well with his older adult patients, but he was a hit at every one of his assignments. I tried to get him to transfer to nursing, but his heart was in political science (a topic that led to many animated discussions with his patients). After graduation, much to the dismay of his patients, he headed off in the same old car to work on a political campaign in another state. I trust his many conversations with octogenarians made him much more politically astute.


I know every agency receives letters that sing the praise of their HHAs. The following are two examples the Visiting Nurse Service of New York Partners in Care Home Health Aide Division received about two of their HHAs:


There are many wonderful and caring people in this world, however, Beverly, in my opinion, outshines most. Beverly began working for my family about seven years ago. My dad passed away suddenly in December in the caring hands of Beverly. I was so happy she was there for him. It was always comforting to know Beverly was taking care of my Dad. Beverly deserves the highest of praise for her hard work and dedication to her job. I don't think she ever considered what she did a job. Beverly approached every challenge with enthusiasm and persistence. She always had a smile on her face even during the most difficult times. She always had a positive attitude and encouraged my Dad. I truly believe that the excellent care provided by Beverly allowed my Dad to live way beyond his years. I truly believe Beverly's loving, caring and compassionate care was the reason my Dad lived to the age of 92. My dad had become bedbound for almost two years. He never suffered with bedsores; this was truly an accomplishment and a tribute to the excellent care provided by Beverly. I feel truly blessed to have had the privilege of knowing Beverly for so many years. She is family to me and will always be close to my heart. When I lost my Dad, I felt like I lost the rest of my family too - I am talking about Beverly. Beverly is truly an asset to Partners in Care. I hope whomever she cares for in the future recognizes how lucky they are to have someone like Beverly care for their loved ones.


This letter is being written to express my appreciation for the help that I received from Partners in Care and one of its home health aides, Leslyn. Last month I lost the use of my telephone, due to a problem with an outdoor cable, for about four or five days. This presented a problem for me as I am homebound and had little food left to eat. I usually order food from the supermarket by telephone. Fortunately, when Leslyn came to visit me, she waited downstairs until someone let her into the building. Then she went to buy food for me. Leslyn let me use her cell phone in order to call the phone company to get service restored. That was on a Monday. I was told service would be restored on the upcoming Saturday. Leslyn got on the phone and got the phone company to restore service Wednesday morning. I consider Partners in Care and Leslyn to be life-savers. I do not know what I would have done with them.


In April we published a study by Dr. Kathrin Boerner and colleagues about HHAs' experiences when patients they are caring for die. Previous research suggested HHAs experience significant grief at the death of patients, yet are often not notified of deaths, and some agencies have policies that prevent them from contacting family members after a patient passes away. The authors referred to this as "disenfranchised grief" and thought this might be one of the factors that contribute to job dissatisfaction and high turnover among HHAs. Their research suggested that HHAs who work for agencies with these restrictive policies were significantly more likely to be looking for another job and more likely to report lower job satisfaction.


This month and every month, celebrate HHAs for their important contribution to home healthcare. Let them know how appreciated they are with cakes and flowers and other reminders of their value to patients, staff, and the agency as a whole. More importantly, examine your agency's policy regarding staff contact with patients' families after patients die, and consider a change that not only allows, but encourages, HHAs to attend visitations or memorial services.


Best wishes,




Boerner K., Gleason H., Barooah A. (2016). Home health aides' experiences with client death: The role of employer policy. Home Healthcare Now, 34(4), 189-195.