Caregiver Training Topics

Know your assignment

Before every visit, review the authorized service plan, scheduled tasks, client preferences, safety needs, emergency contacts and any instructions from the office. Only perform work that is authorized, safe, within your job role and within your demonstrated competency. A request from a client or family does not change the service plan — check unfamiliar tasks with a supervisor first.

Homemaking vs. personal care

Homemaking may include light cleaning, meal preparation, laundry, errands and companionship. Personal care may add help with bathing, grooming, dressing, toileting, eating and mobility when permitted and assigned. Some IHSS or program-specific arrangements have different rules — never assume a general exception applies to your assignment.

Skilled vs. non-skilled tasks — quick reference

This describes ordinary Class B personal care. The current service plan and agency policy always control — do not perform a task just because it appears in the "may assist" column.

Scope-of-practice limits are requirements of Colorado law (6 CCR 1011-1, Chapter 26), not agency preferences. Performing a prohibited task is grounds for termination and may expose you to legal liability. Health Maintenance Activities (HMAs) require the task to be on the care plan and a documented skills validation by the agency's licensed health professional before service.

Introduce yourself, explain what you plan to do, and ask permission before touching the person or their belongings. Protect privacy during bathing, toileting and dressing. Offer choices, honor familiar routines, and help the client do as much as they safely can. The federal HCBS rule is to optimize, not regiment independence — adapt to the client's routine rather than forcing everyone into one schedule. If a client prefers a different (safe) order for their care, follow it.

Consumers of Colorado home care have the right to:

• Information about their care, who will provide it, and advance-directive policies;
• Care without discrimination, and to authorize a representative to act for them;
• To know the name, role and employer of everyone providing or supervising care;
• To participate in planning care and to refuse treatment within the law;
• To be treated with respect and be free from neglect, financial exploitation, and verbal, physical and psychological abuse (including humiliation, intimidation or punishment);
• To be free from involuntary confinement and physical or chemical restraints;
• Confidentiality of all records and personal information;
• To voice complaints — verbally or in writing — without fear of retaliation.

If a client refuses care, never force it or falsely document that it was completed. Record what happened and notify the office if safety or service delivery may be affected.

You are a mandatory reporter. You must report suspected mistreatment of an at-risk person to a law enforcement agency within 24 hours. You do not need to be certain abuse occurred — report a reasonable suspicion. Do not conduct your own investigation, and never assume someone else (like a visiting nurse) has already reported it. In Colorado, willfully failing to report is a class 2 misdemeanor.

"Mistreatment" includes abuse, caretaker neglect and exploitation. Possible signs of financial exploitation include sudden changes to a will, deed or bank account; unpaid bills despite adequate income; and missing money, jewelry or property. If a client says another caregiver stole from them, report to your supervisor immediately and to law enforcement within 24 hours — do not confront the other worker or investigate.

Protected health information (PHI) includes the care plan, schedules with client names/addresses, photos of a client's belongings, and even the fact that someone is a client of the agency. Follow the HIPAA "minimum necessary" rule — know and discuss only what you need for your own assignment.

• Never post or text client photos, discuss clients with friends, or share information with unauthorized people — HIPAA protection continues even after a client dies.
• Refer anyone requesting confidential information to the office, and follow approved consent/disclosure procedures.
• If you lose a phone with client names or addresses, report it to the office the same day — a passcode is not enough.

Hand hygiene — the most important protection

Wash with soap and running water for at least 20 seconds — before and after client contact, before food prep, after toileting, after removing gloves, after contact with soiled items, and between dirty and clean tasks. Use alcohol-based sanitizer when hands aren't visibly dirty; use soap and water when hands are visibly soiled, after the restroom, or when caring for a client with C. difficile.

Standard precautions & PPE

Treat all blood and body fluids as potentially infectious, regardless of diagnosis. Wear correctly sized disposable gloves for body fluids, soiled bedding, incontinence care and open skin. Change gloves between clients and between contaminated and clean tasks — never reuse disposable gloves and never substitute gloves for handwashing. Use masks/eye protection when indicated. Do not handle needles or sharps unless trained and authorized; report exposures promptly.

Cleaning, disinfectants & illness

Clean high-touch and bathroom surfaces per product labels and correct contact times. Never mix cleaning products, especially bleach and ammonia. Bleach, Lysol and EPA-registered wipes are disinfectants; plain hand soap is not. If you develop fever and vomiting, call out and return only after at least 24 hours of improving symptoms with no fever (without fever-reducing medicine). If you cut yourself during a task, stop, cleanse and cover the cut, put on gloves, and report it.

Gather supplies, secure a safe environment, and preserve warmth, modesty and the client's choices. Check bath water comfort — safe bathing water is about 100–105°F — and never leave a person where there's a foreseeable fall or drowning risk. Observe for new skin breakdown or changes, but do not treat wounds or apply prescription products.

• Lotion: you may apply non-medicated lotion to intact skin (not medicated lotion).
• Nails: clean and file only — never cut a client's nails.
• Dressing: assist with regular clothing; prescription anti-embolic/pressure stockings and orthopedic devices require verified training/competency.

Nutrition & feeding

Review allergies, special diets, texture-modification and swallowing precautions and follow them. Make sure food isn't too hot, the client is upright, and allow time to chew and swallow; use adaptive utensils or a straw when helpful and safe. For a client with dentures or dental problems, soft foods like cottage cheese or scrambled eggs are best. Never attempt tube feeding; seek emergency help for choking.

Clear pathways, check lighting and footwear, and lift with your legs, not your back. Only assist with transfers you've been trained and evaluated to perform, and stop if the client's strength, balance or equipment differs from the care plan. Never attempt an untrained mechanical lift. Safe transfer practice includes locking wheelchair/bed brakes, using a gait belt when the plan directs, and pivoting with your feet rather than twisting your spine (don't let the client wrap their arms around your neck).

Homemaking should create a safe, sanitary and comfortable home. When dusting, start from the top and work downward. Before mopping, make sure the floor is swept or vacuumed. In the bathroom, let cleanser sit on the shower, sink and toilet before scrubbing (the pipes under the sink don't need routine cleaning). After shopping for a client, present them with the receipt, all change, and any unused coupons.

For unresponsiveness, severe breathing trouble, suspected stroke, uncontrolled bleeding or serious injury, call 911 first, follow the dispatcher, then notify the office. Remember ABC — Airway, Breathing, Circulation: for an unconscious client, after confirming the scene is safe and trying to rouse them, open the airway and check for breathing (watch the chest/abdomen rise), then call 911. Know the home address, exits and emergency numbers, and follow evacuation plans for fire and severe weather.

• For a sudden change in condition or unusual behavior, call the office and speak with your supervisor immediately — don't diagnose or give unapproved treatment.
• If a scene feels unsafe (shouting, an unfamiliar person at the door), do not enter — return to your vehicle, lock the doors, and call the office.
• Around oxygen in use, avoid smoking, open flame, aerosol sprays and petroleum-based products.

Use calm, respectful language. The two most effective ways to communicate with a hearing-impaired client are visual demonstration and writing the task down. For a client with dementia who repeats a question, answer calmly again and gently redirect to another activity. De-escalate an agitated client by staying calm, lowering your voice, giving space with a clear path to the exit, and validating the feeling.

Professional boundaries: don't borrow money from a client, accept large gifts, or agree to serve as a client's power of attorney. Politely decline gifts and tell your supervisor they were offered.

Clock in/out at the client's location, at the actual moment you begin and end work, using the agency-approved Electronic Visit Verification (EVV) method — which captures the service, the people, the date, location and times. Document actual times, authorized services and observed changes. Never record a shift that didn't happen, borrow a login, sign for another caregiver, backdate records, or round up your hours — even if a client asks (report that request the same day). Falsifying a timesheet or EVV record is a federal false claim. To fix a written error, draw a single line through it, write the correction, and initial and date it.

Each year you'll confirm you understand the core safety topics: hand hygiene and infection-control precautions, health guidelines for employees with infectious diseases, the appropriate scope of work for personal care workers, correct methods for reporting incidents and occurrences, and personal safety within the client's home and the community. Raise any question about safe practice with your supervisor — providing safe, responsible care is always the priority.