How to Become a Personal Care Attendant for a Person With a Disability

If you’re here, you may be thinking of becoming a personal care attendant (or assistant, as I prefer to say) for a person with a disability. That’s awesome! It’s an important and rewarding job for the right person. Are you wondering if you’re that person? Looking for tips on how to be the best PCA you can be? After over 30 years of having a personal care attendant in some capacity, I’ve worked with many different people, and I’ve learned a lot about what works and what doesn’t. So whether you’re looking to work for me or someone else with a disability, I hope this list of tips can help you get started.

1. Consider whether you’re right for the job before applying.

There are a wide variety of people of all ages who need personal care attendants. Be sure to read the job description carefully, and get to know your potential employer’s needs and preferences before committing to a job offer.

2. Have a clean background check.

Most agencies and Medicaid-funded programs will do a background check. This is a job where trust and responsibility are paramount and most employers care about safety, not second chances. Some minor crimes may not disqualify you, such as a DUI or drug possession, but it depends on the agency, payment processor, and/or client. I suggest you be honest about any charges with a potential employer when you apply; I have hired people who disclosed minor charges, and not hired or let people go for trying to hide them. If you have violent or felony convictions, this is the wrong job for you.

3. Make sure you can be responsible and reliable.

Being a personal care attendant is not like working at Starbucks. If you don’t show up for work at Starbucks, someone might not get their coffee. If you don’t show up for a personal care attendant job, someone will be trapped in bed, or end up in the hospital, or worse. A person’s health and safety depend on you. It’s a lot of responsibility. Being a PCA means you have to come to work even if you’re sick, and must arrange for time off well in advance so your employer can find someone else to work. Don’t become a PCA if your life is unstable. You should have a place to live, reliable childcare (if applicable), a cell phone, and a car unless you live someplace where most people get around using public transportation. In other words, your life and any problems you have should not interfere with your ability to be a reliable employee.

4. Be healthy and strong.

Personal care attendants assist people who have disabilities and/or other chronic health conditions. Many of us need significant physical help including lifting for transfers out of bed, into the shower or bath, etc. Some people may use a lift or other devices, while others may not. Make sure you understand the physical requirements of the job and that you don’t have any old injuries or chronic pain that may interfere.

5. Be open-minded.

People with disabilities are very diverse; we have varied interests, values, beliefs, ethnic backgrounds, sexual orientations, and gender identities. Because you’re going to be assisting us at some of the most vulnerable times in our lives, it’s important that you accept us as we are. If you’re not comfortable with some aspect of someone’s life, don’t take the job, and especially don’t take the job if you think you can change them. I’ve had a personal care attendant try to convert me to her religion while helping me shower, and that is completely inappropriate. I personally try to find someone who holds similar views to mine on important topics, and who can have intelligent discussions about politics and religion without becoming judgmental. Some people with disabilities might want to avoid discussing these topics entirely. It’s up to the individual, and you should respect them.

6. Be flexible and have a good sense of humor.

You should be comfortable dealing with potentially “gross” stuff such as bathroom waste, diapers, catheters, surgical incisions, etc. in a way that is matter-of-fact and not shaming towards your employer. As a personal care attendant, every day will be different and plans can change unexpectedly. When things go wrong in life, being able to laugh about a difficult or embarrassing situation can make it seem not so bad.

7. Accept that anything and everything is in your job description.

You are there to be a person’s arms and legs. If I hire a personal care attendant, it’s to help me with all the things I can’t do for myself, not just those of a medical nature. For example, my assistants are responsible for housecleaning. This is something I would do myself if I physically could. They also help me with cooking, pet care, organizing projects such as cleaning out closets, having a yard sale, making a scrapbook, etc. They go on errands with me, and also to concerts, the theater, and more. I take individual skills and preferences into account, but if it’s legal and safe for you to do, it’s within the job description.

8. Understand that if the pay is crappy, it’s probably not your employer’s fault.

Many personal care attendants are paid by Medicaid, and state pay rates range from low to abysmal. Many people with disabilities are low-income, so they may not be able to pay out-of-pocket. Many of us do try to supplement the pay, even when that causes us or our families hardship, because we understand it’s inadequate. But some people just can’t, and they still deserve good care.

9. Your employer has the right to make their own choices.

If you work for an adult with a disability who does not have a cognitive impairment, please understand that they have the right to make decisions about their lives without judgment from you. Unless you think someone is in imminent danger, it’s their body and their choice. They can choose to eat junk food, drink alcohol, make questionable dating choices, etc. Once a relationship of trust and understanding develops, you can bring up concerns as you would with a friend, but ultimately it is their decision. If they ask for your advice on a topic, be honest but polite. If they ask for help to make better decisions (like being reminded to take medication or to pick healthier food) it’s OK to be more involved, because they’ve invited you to do so.

10. This job can be fun!

Most people with disabilities want to be out and about as much as their health permits. I am not a 90-year-old lady who sleeps all day. I am an active person who likes to go places, have intelligent conversations, and do interesting things. I seek a unique combination of traits in a personal care attendant — someone who can not only do the job well, but be a companion and hopefully in the long run, a friend. Other people with disabilities may seek different qualities, but ultimately we all need someone we can trust to help us make our lives safe and happy.