Preventative general skin care. When skin is unbroken, and when any chronic skin problems are not active and may include the application of non-medicated lotions and solutions. Or of lotions and solutions not requiring a physician’s prescription.

Assist clients with ambulation.

Assist clients with bathing. Home services workers may assist individuals who are unable to be bathed in a tub or shower only when the following requirements are met:

1. 1. The home services worker shall have been trained in the particular methods required to perform a bed bath;
   2. The client or client’s representative shall be able to participate in or direct the bathing process and provide ongoing feedback to the home services worker; and
   3. The agency shall have conducted a competency evaluation of the home services worker’s ability to employ the methods required to perform a bed bath.

Assist a client with dressing. This may include assistance with ordinary clothing and application of support stockings of the type that can be purchased without a physician’s prescription.

Assist a client with exercise. Passive assistance with exercise is limited to encouraging normal bodily movement, as tolerated, on the part of the client, and to encouragement with a prescribed exercise program.

Assistance with feeding. When the client can independently swallow and be positioned upright.

Assist with the maintenance and appearance of their hair. Hair care within these limitations may include shampooing with non-medicated shampoo or shampoo that does not require a physician’s prescription, drying, combing and styling hair.

Assist in and perform mouth care. This may include denture care and basic oral hygiene, including oral suctioning for mouth care.

Assist with nail care. May include soaking of nails, pushing back cuticles without utensils, and filing nails. No nail trimming.

Assist a client with positioning when the client is able to identify to the personal care staff, either verbally, non-verbally or through others, when the position needs to be changed, only when skilled skin care, as previously described, is not required in conjunction with the positioning. Positioning may include simple alignment in a bed, wheelchair, or other furniture.

Assist a client with shaving only with an electric or a safety razor.

Assist a client to/from the bathroom; provide assistance with bed pans, urinals, and commodes; provide pericare; or change clothing and pads of any kind used for the care of incontinence.

1. A home services worker may empty or change external urine collection devices, such as catheter bags or suprapubic catheter
2. A home services worker may empty ostomy bags and provide assistance with other client­ directed ostomy care only when there is no need for skilled skin care or for observation or reporting to a nurse.

Assist with transfers only when the client has sufficient balance and strength to reliably stand and pivot and assist with the transfer to some extent. Adaptive and safety equipment may be used in transfers, provided that the client is fully trained in the use of the equipment and can direct the transfer step by step. Adaptive equipment may include, but is not limited to,

1. wheelchairs, tub seats, and grab Gait belts may be used as a safety device for the home services worker as long as the worker has been properly trained in their use. A home services worker shall not assist with transfers when the client is unable to assist with the transfer. Home services workers may assist clients in the use of a mechanical or electrical transfer device only when the following conditions are met:
2. The home services worker must have been trained in the use of the mechanical or electrical transfer device by the licensed agency;
3. The client or client representative must be able to direct the transfer step by step; and
4. The agency must have conducted a competency evaluation of the worker using the type of device that is available in the home.

Assist a client with medication reminding only when medications have been pre-selected by the client, a family member, a nurse, or a pharmacist and are stored in containers other than the prescription bottles, such as medication minders. Medication minder containers shall be clearly marked as to day and time of dosage.

Medication reminding includes: inquiries as to whether medications were taken; verbal prompting to take medications; handing the appropriately marked medication minder container to the client; and opening the appropriately marked medication minder container for the client if the client is physically unable to open the container. These limitations apply to all prescription and all over-the-counter medications. The home services worker shall immediately report to the supervisor any irregularities noted in the pre-selected medications, such as medications taken too often or not often enough, or not at the correct time as identified in the written instructions.