We are seeking an experienced Home Health Aide (HHA) with extensive experience providing hands-on care to individuals with complex medical needs, hospice-level care, significant dietary restrictions, severe mobility impairments, and behavioral challenges.

The ideal candidate must be comfortable providing continuous 1:1 supervision and bedside care for an individual who is nonverbal at baseline, has severe functional impairment, dysphagia, recurrent TMJ dislocations, significant mobility limitations, and requires extensive assistance with activities of daily living.

This position requires a patient, attentive, safety-focused caregiver who is experienced in recognizing nonverbal signs of pain, distress, choking, agitation, and other changes in condition and communicating concerns promptly to the family and hospice care team.

Primary Responsibilities

Personal Care & Activities of Daily Living

Provide full assistance with bathing and personal hygiene.
Assist with dressing and clothing changes.
Provide grooming, including oral care, face washing, hair care, and skin care.
Provide complete toileting and incontinence care, including brief changes, linen changes, and perineal care.
Assist with bed mobility, repositioning, transfers, and wheelchair/bedside mobility.
Maintain safe positioning and monitor for fall and injury risks.

Feeding & Dietary Support

Provide direct supervision and hands-on feeding assistance as needed.
Prepare and serve a mechanical soft/soft-food diet as required due to dysphagia and recurrent jaw dislocation.
Provide meal setup, cueing, and feeding assistance.
Encourage hydration and monitor food and fluid intake.
Assist with nutritional supplements as ordered/tolerated, including products such as Ensure or Magic Cup.
Monitor closely for coughing, choking, difficulty swallowing, refusal of food, or other changes during meals.
Complete meal cleanup and maintain a clean food preparation area.

Medication Support

Provide medication reminders and cueing.
Re-attempt medication presentation when initially refused, as appropriate.
Provide medication administration assistance only as permitted by agency policy and applicable scope of practice.
When medication administration is outside the aide's permitted scope, provide appropriate setup/presentation and notify the guardian or hospice nurse as directed.
Follow the established care plan regarding medication acceptance strategies, including mixing medications into pudding, applesauce, or food only when specifically authorized by the applicable care team and medication instructions.

Behavioral & Safety Monitoring

Provide continuous 1:1 supervision during scheduled aide hours.
Closely monitor for intermittent behaviors including scratching, punching, grabbing, throwing objects, biting attempts, and other unsafe behaviors.
Maintain a calm and safe environment while responding appropriately to behavioral escalation.
Recognize and report changes from the individual's normal behavior or baseline.
Monitor for nonverbal signs of pain, discomfort, distress, constipation, agitation, or difficulty swallowing.
Promptly communicate significant changes or safety concerns to the appropriate family member, guardian, supervisor, or hospice professional.

TMJ & Specialized Care Monitoring

Monitor for signs of recurrent TMJ dislocation or open-lock, particularly during agitation, chewing, yawning, or biting attempts.
Apply or replace a jaw bra, ACE wrap, or Barton head wrap only when directed by the established care plan and trained/authorized to do so.
Promptly report suspected jaw dislocation, increased pain, changes in jaw movement, or other concerning symptoms.

Hospice & Condition Monitoring

The aide must be able to recognize and promptly report changes requiring attention from the hospice or healthcare team, including:

Choking or coughing during meals.
Difficulty swallowing.
Significant refusal of food, fluids, or medications.
Changes in level of alertness or behavior.
Nonverbal indicators of pain or distress.
Constipation or significant changes in elimination.
Suspected TMJ dislocation.
Increased agitation or unsafe behavior.
Any significant change from the individual's established baseline.

Light Housekeeping

Maintain a clean, sanitary, and safe patient care environment.
Clean the individual's care area.
Complete laundry related to the individual's care.
Change soiled bedding and linens.
Dispose of waste appropriately.
Assist with meal preparation and cleanup.

Required Qualifications

Extensive experience as a Home Health Aide, Personal Care Aide, Direct Support Professional, or similar caregiving role.
Demonstrated experience working with hospice or end-of-life care.
Experience caring for individuals with significant physical disabilities and severe mobility limitations.
Experience providing care to quadriplegic or similarly dependent individuals strongly preferred.
Experience with dysphagia, modified/mechanical-soft diets, and feeding assistance required.
Experience working with individuals who have dietary restrictions and complex nutritional needs.
Experience providing complete personal care and incontinence care.
Experience with wheelchair, bed mobility, repositioning, and dependent transfers.
Experience working with nonverbal individuals and identifying nonverbal signs of pain or distress.
Experience managing or safely responding to behavioral dysregulation and intermittent aggression.
Ability to remain calm, patient, and professional during challenging behaviors.
Strong observation and communication skills.
Ability to follow a detailed individualized care plan and communicate changes promptly.
Current HHA/PCA certification or other required credentials, as applicable.
Ability to pass all required background checks and agency screening requirements.

Preferred Experience

Candidates with experience in the following areas are strongly encouraged to apply:

Hospice or palliative care
Home healthcare
Quadriplegic or highly dependent individuals
Dysphagia and aspiration precautions
Mechanical-soft diets
Nonverbal individuals
Behavioral support
Complex personal care
Wheelchair and dependent transfers
Incontinence care
Nutritional monitoring
Medication cueing/support
Care coordination with hospice nurses, guardians, and family members

Ideal Candidate

The successful candidate will be experienced, dependable, observant, patient, and comfortable providing highly hands-on care. This is not a basic companion-care position. The individual receiving care requires a caregiver who can confidently manage extensive personal care needs, dietary restrictions, mobility limitations, behavioral challenges, and hospice-level support while maintaining dignity, safety, and respect.

Qualified candidates with extensive homecare, hospice, quadriplegic, and complex-care experience are encouraged to apply.

Two shifts available:
Monday -Friday (6 hours daily )(10am-4pm)
Saturday-Sunday (5 hours daily )(10-3pm)

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