Nurse, caregiver or aide: the three tiers people confuse
Matching the tier to the task is the single largest saving available in home care, and the single most common mistake. Tier one is the registered nurse: medication administration, injections, wound dressing, catheter and stoma care, post-operative monitoring, tube feeding. Tier two is the assistant nurse or licensed caregiver: bathing, dressing, toileting, transfers, feeding assistance, basic vital signs, companionship with clinical awareness. Tier three is a non-clinical aide or companion, appropriate only where there is no medical task at all.
Under-buying is the mirror-image error, and it is more dangerous than expensive. Wound dressing, injections and any medication given by the carer rather than taken by the patient legally require a licensed nurse. If a cheap quote quietly assigns clinical tasks to a caregiver, the saving is an infection or a medication error waiting to happen.