Volume 1:
PCA Modules I-XII
Core Curriculum


Volume 2:
HHA Units A-H
Health Related Tasks


Complete Set
Volume 1 and
Volume 2*
*Books may be purchased separately or as a complete set. Included is our bank of 800 DOH-approved test questions and answers.
Slide 1

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH-approved textbooks will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 2

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH-approved textbooks will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 3

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH-approved textbooks will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 4

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH-approved textbooks will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Agencies are using our books because they’re…


Almost half the price of other textbooks


Compatible with our bank of 800 DOH-approved test questions and answers individually formatted by modules and units

Easy to Carry

Conveniently sized to fit in a purse


Available in two volumes for those who do only PCA training


Continuously updated in a timely manner


Follows the logical sequence of the HHATP curriculum

Easy to Read

Written at a simple reading level for easy comprehension


Colorfully illustrated and detailed

Book Previews



Module VI

Unit A: Understanding Developmental Disabilities
Defining Developmental Disabilities

Did you have trouble with math in school? Do you find it hard to understand engines of machines?

Most of us can identify areas where we have problems learning. Mastering these areas may take a lot of time and effort on our part. And sometimes, even with our best efforts, we can only progress to a certain point and no farther. For example, a person may learn to budget a paycheck with ease, yet not grasp algebra.

When it comes to learning, we all have different strengths and weaknesses. We all have a range of disabilities.

This same basic concept can be applied to mental retardation. The word "retardation" itself means "slowing down". Mental retardation slows down the ability to learn and limits the capacity to understand what are called abstract concepts. For example, a moderately retarded adult may not be able to tell time by looking at a clock that has the traditional hands and face. However, that same person may be able to tell time by looking at a digital clock. The important thing to remember is that mental retardation affects all areas of learning, not just one or two.

Mental retardation is sometimes called a "developmental disability". Developmental disabilities are a group of physical conditions that occur before, during, or shortly after birth. Other conditions such as cerebral palsy, cystic fibrosis, and muscular dystrophy are also developmental disabilities. However, mental retardation is the most common one.

Developmental disability affects a person's normal development in at least three of the following areas:
•    self-care
•    communication skills
•    movement
•    self-direction (control over life)
•    potential for independent living
•    potential for financial independence

Look closely at this list. Notice that one basic human ability – the ability to feel emotions – is missing. Developmentally disabled people experience the same emotions that we all have. They feel love, anger, sadness, joy. And they can feel these emotions as deeply as anyone else. Because their disability may affect their ability to communicate, however, they may have trouble expressing their emotions.

Causes of Developmental Disabilities

Many factors can interfere with normal brain development before, during, or after birth. These factors can cause developmental disabilities.

They include:
•    certain infections during pregnancy, such as German Measles
•    poor nutrition during pregnancy
•    premature birth (birth weight is the important factor)
•    brain damage during delivery
•    alcohol or drug abuse during pregnancy
•    lead poisoning (baby eats lead paint chips from walls or furniture)
•    inherited or other defects in the baby's genes (genes are the part of a cell that determines eye color, skin tone, height, etc.). One example is Down Syndrome (once called         Mongoloidism), which is marked by widely spaced eyes and a somewhat flat nose.

These known causes can explain less than half of all cases of developmental disability, however. In most cases, the cause is not known. Developmental disability can occur in families of any race, nationality, or economic level.

Degrees of Developmental Disabilities

As mentioned, the average person has a range of abilities for functioning in life. The same is true of the developmentally disabled person. These are known as different degrees of disability – mild, moderate, severe, and profound. Children who are mildly developmentally disabled are often not diagnosed until school age. They do not appear outwardly different from other children. The problem usually becomes apparent when they function below the level of other children in school.

Nearly 90 percent of all developmentally disabled people fall into the "mild" category. With proper education and training, they can become adults who live and work independently in the community. They can lead full and useful lives.

Children with moderate to profound developmental disabilities are often diagnosed long before they begin school. These children develop at a slower rate physically as well as developmentally. Whereas a normal child at age five has a large vocabulary and good motor coordination, a severely developmentally disabled five-year old may function at the12 to 18 month old level. He or she may have just started walking and may have a vocabulary of just a few words. It is not uncommon for these children to have physical handicaps as well, which can slow their development even further.

Information Sheet 1 briefly outlines the usual stages of development for children with mild to profound developmental disabilities. This sheet is only a general guide, however. As is the case with any other child, the individual development of a developmentally disabled child depends a great deal on how much stimulation and attention he or she receives.

Differences Between Developmental Disabilities and Mental Illness

Developmental disability and mental illness are often confused. Simply defined, developmental disability is a decline in intellectual ability that is severe enough to interfere with a person's daily functioning. Developmental disability is not a kind of mental illness; it is a different problem entirely.

Developmental disability differs from mental illness in several ways:
•    Developmental disability is a permanent condition. Mental illness can be a temporary problem.
•    Developmental disability occurs at or near birth. Mental illness may occur any time during life.
•    Developmental disability always lessens mental ability. Mental illness may or may not affect mental ability.
•    There is no cure for developmental disability, although developmentally disabled persons can be helped. Many mental illnesses can be cured with prompt and proper treatment.

Although developmental disability and mental illness are different problems, they do have one important thing in common – both developmentally disabled and mentally ill persons need support, understanding, and proper treatment and care.

In Unit A, you have learned some basic facts about developmental disability.
•    Developmentally disabled people can learn, but learning takes more time and is limited. Physical and social development is slower. Therefore, mental retardation is called a developmental disability.
•    Like all human beings, the developmentally disabled experience emotions. They have the basic human needs described in Module II.
•    There are different degrees of developmental disability, from mild (where the person can lead a full and useful life after receiving proper education and training) to profound (where a person cannot function independently).
•    Developmental disability differs from mental illness. Developmental disability is permanent, whereas mental illness can be temporary. Developmental disability occurs at or close to birth; mental illness may occur at any time. Developmental disability always lessens mental ability. Mental illness, by contrast, does not always affect mental ability. No cure exists for developmental disability. If promptly treated, some mental illnesses can be cured.

Autism (ASD-Autism Spectrum Disorder)

Autism is a complex, pervasive developmental disorder that involves the functioning of the brain. It is a neurological disorder and not simply a psychiatric disorder. Typically it appears during the first three years of life. In some cases, it can be detected by the age of one or younger. It is four times more prevalent in males than females and is most prevalent in Caucasian males. As of 2004, autism is treatable, but not curable.

Problems that May Accompany ASD

Many ASD children are highly attuned or even painfully sensitive to certain sounds, textures, tastes and smells. Some children find the feel of clothes touching their skin almost unbearable. Some sounds – a vacuum cleaner, a ringing telephone, a sudden storm, even the waves lapping the shoreline – will cause these children to cover their ears and scream.

In ASD, the brain seems unable to balance the senses appropriately. Some ASD children are oblivious to extreme cold or pain. An ASD child may fall and break an arm, yet never cry. Another may bash his head against a wall and not wince, but a light touch may make the child scream with alarm.

Mental Retardation (Developmental Disability)

Many children with ASD have some degree of mental impairment. When tested, some areas of ability may be normal, while others may be especially weak. For example, a child with ASD may do well on the parts of the test that measure visual skills but earn a low score on the language subtests.


One in four children with ASD develops seizures, often starting in early childhood or adolescence. Seizures, caused by abnormal electrical activity in the brain, can produce a temporary loss of consciousness, a body convulsion, unusual movement, or staring spells. Sometimes, a contributing factor is a lack of sleep or a high fever.

Parents are usually the first to notice unusual behaviors in their child. In some cases, the baby seemed "different" from birth, unresponsive to people or focusing intently on one item for a long period of time. The first signs of ASD can appear in children who seem to be developing normally. When an engaging, babbling toddler suddenly becomes silent, withdrawn, self-abusive, or
indifferent to social overtures, something is wrong.

Possible Causes of Autism

•    Vaccinations
•    Environmental toxins
•    Viral infections
•    Foods containing genetically modified organisms
•    A hiatal hernia that disrupts protein digestion

Imagine having a toddler who can't tell you where it hurts. Imagine having an 8 year old who can't say "I love you." Imagine having a teenager with a growing body but stagnant mental age. Imagine your child is an adult with autism who will need care long after you are gone. You are not alone. Meet other parents. Share resources . . . join ASA.

Module VIII

Unit A: The Basics of Nutrition

In this Unit, you will learn about the five major categories of nutrients and their importance in promoting and maintaining good health.

Why is food the foundation of health? If you think about your daily activities, you will have the answer. Food provides the energy you need for work and play. It also provides the energy needed for growth and repair of tissues.

The food you shop for and the meals you prepare as a Home Care Worker can help:
• children grow, develop, and reach their mental and physical potential
• expectant and nursing mothers maintain their health
• adults and the elderly stay active and prevent them from developing certain health problems
• the ill recover more quickly and stay healthy
• the disabled maintain or improve their strength and overall health

When people feel better physically, their general outlook on life often improves. In this sense, nutrition can contribute to mental, as well as physical, well-being.

Take a few moments to think about the different foods you ate yesterday.  Note approximate serving sizes. Be sure to include any snacks or beverages you consumed in addition to your regular meals, as well as the number of glasses of water you drank.

During Jessie's training, she learned the meaning of some words she has been hearing all her life. Of course, she knew that foods were substances that you eat. But she learned that nutrition means how your body uses the food you eat. She also learned that foods contain nutrients, substances that nourish the body.

The Major Nutrients

Nutrients are the individual substances that combine to make foods and to supply our bodies with everything we need to live, move, and grow. Each nutrient has its own special function in keeping the body healthy. There are about fifty different nutrients, and they fall into major categories – proteins, carbohydrates, fats, vitamins, and minerals. Water is another substance that is very important to good nutrition.


Proteins build and repair body tissue. Proteins also help make hemoglobin, the red substance in the blood that delivers oxygen to and removes carbon dioxide from cells. Finally, proteins help form antibodies to fight infections.

Food sources rich in protein are beef, lamb, pork, poultry, fish, shellfish, eggs, and milk. These are called animal proteins. Food sources that are not as rich in protein are lima and kidney beans, chick peas (garbanzos), split peas and black-eyed peas, peanuts, and peanut butter. These are called vegetable proteins.

Larger quantities of vegetable protein foods must be eaten in order to provide the same amount of protein present in animal protein foods. In meal planning, animal and vegetable proteins can be combined to furnish the proper amount of protein. Some of these popular combinations are macaroni and cheese, beans and rice, cereal and milk, rice and fish, spaghetti and meatballs, baked beans and brown bread, vegetable stew with meat, and a peanut butter sandwich.

The amount of protein a person needs is determined by his or her size, age, amount of activity, and the state of health he or she is in.


The primary function of carbohydrates is to provide energy. When we eat foods that contain them, our bodies become able to use the energy from proteins for growth and maintenance. There are simple carbohydrates, the sugars, and complex carbohydrates, starches and fibers.

The starches include all grains and the products made from them (flours, bread and other baked goods, macaroni, spaghetti, noodles, and breakfast cereals), potatoes, sweet potatoes, beans, and peas. Fiber (sometimes called bulk) does not provide any energy, but it does assist in digestion. It is found in grains, vegetables, and fruits, but not in sweets.

Fat is a part of our cell structure. It forms protective cushions around our vital organs. It lets proteins go about their work of building and repairing by providing food energy, and, in a thin layer under the skin, it insulates the body and prevents loss of heat.

Fats are a concentrated energy source. They digest more slowly than proteins or carbohydrates. Therefore, they delay a feeling of hunger. Meat, fish, chicken, eggs, nuts, milk products, butter, margarine, salad oils, and mayonnaise all contain fats.

Are you familiar with the term polyunsaturated? Polyunsaturated fats are found in products made from corn, soy, safflower, sesame, and sunflower seeds. (Olive, peanut, and cottonseed
oils do not contain these fats.) Polyunsaturated fats are believed to have a desirable effect on the heart and blood vessels by helping to reduce cholesterol, a waxy, fat-like substance that can
build up inside the blood vessels. Research suggests that cholesterol is found only in the fats of animal foods, such as meat, milk products, eggs, and shellfish. It is very high in “organ" meats (liver, sweetbreads, and kidneys).

Saturated fats increase cholesterol in the blood. Beef is high in saturated fats, as are whole milk, butter, cream, coconut, palm oil, and lard.


Vitamins are essential to life and well-being. They help our bodies make use of the other nutrients (proteins, fats, carbohydrates, and minerals). Vitamins are necessary for the proper functioning of many of our body processes. They promote tissue growth, allow the nerves and muscles to function as they should, help the reproductive and digestive systems to work properly, and may help the body resist infections.

Since our bodies cannot manufacture most vitamins, we must get them from a variety of foods. The most important vitamins are Vitamins A, B, C, and D.

• Vitamin A helps keep the skin in good condition, facilitates normal bone growth, and allows the eyes to adjust to dim light. Liver, eggs, butter, whole milk, and cheese, as well as yellow and dark green vegetables and fruits, supply Vitamin A.
•  Vitamin B is actually a group of vitamins (Riboflavin, thiamin, and niacin are well-known B vitamins.) B vitamins help the nervous and digestive systems function properly. They are also good for the skin. Milk, whole grains, peas, beans, meat (especially lean pork), and some breads or cereals are sources of B vitamins.
•  Vitamin C helps the healing of wounds and bones. It plays a part in forming and maintaining the material that holds living cells together and strengthens the walls of blood vessels. Citrus fruits, like oranges and grapefruits, and such vegetables as tomatoes, broccoli, green peppers, and potatoes provide Vitamin C. Cantaloupe, orange juice, and strawberries are Vitamin C sources that contain other nutrients and provide fiber, which is necessary for digestion.
•  Vitamin D builds strong bones and teeth. The action of sunlight on the skin causes the body to make its own Vitamin D. Milk with added Vitamin D is the most common source of this vitamin in the diet. Some Vitamin D is also found in egg yolks, butter, and liver. Certain fish, particularly sardines, salmon, herring, and tuna, are excellent sources of Vitamin D.


Minerals are the substances our bodies require to strengthen certain tissues and to help in many bodily functions. Some important minerals are:

•  Calcium, which is needed for strong bones and teeth. It also helps blood to clot and nerves and muscles to react normally. We have a lifelong need for calcium, which can be obtained from milk and milk products, fish bones (such as those eaten in salmon and  sardines), and dark green leafy vegetables (collards, mustard, turnip, kale, and dandelion greens). People who cannot digest milk or milk products should not overlook the other sources of calcium.

•  Potassium, which works with calcium to keep the heart functioning properly. It is found in bananas, prunes and oranges, as well as potatoes that have been cooked in their skins.
•  Iron, which combines with protein to make hemoglobin (as mentioned earlier, the red substance in the blood that carries oxygen from the lungs to the entire body). Iron helps cells use oxygen.

When people do not get enough iron, iron-deficiency anemia can result, causing lack of sleep, reduced energy, and poor appetite. Studies have shown that iron deficiencies are a particular problem for infants, children, and the elderly. Women need extra iron to replace the iron lost in blood during childbirth and menstruation. Extra iron is also essential during pregnancy or when nursing.

Module XII

Unit B: Personal Care Skills

In this Unit, you will learn the personal care skills that you will perform as a Home Care Worker. First, you will learn nine general principles that are important to follow whenever you provide
personal care services. You will also learn how to properly wash your hands before and after personal care tasks. Then you will learn how to use proper body mechanics.

In the remainder of this Unit, you will learn how to properly perform the various personal care skills – bathing the client in bed, tub or shower; the back rub; grooming, including care of the
hair, shaving, nails, teeth and mouth; the use of elastic supporting stockings; toileting, including use of the bedpan, urinal, condom catheter, indwelling and straight catheters; transferring
and positioning a client; weighing a client; measuring intake and output; and assisting with changing a clean dressing.

General Principles of Personal Care

During training, Jessie's instructor often reminded the trainees of nine general principles that are important whenever personal care services are provided. These principles should be used with
all the personal care skills you will study in this Unit.

They are:
•  Safety: The client's safety should be a priority for both you and your client in all personal care tasks.
•  Comfort: Make every task as comfortable as possible for you and the client. For example, the client should be asked whether the water temperature for a bath is comfortable.
•  Organization: Assemble all necessary equipment prior to performance of a specific task.
•  Economy: Save time, effort (yours, as well as the client's), and supplies. Sometimes all the supplies and equipment you need may not be available, and you may need to use and find substitutes.
•  Neatness: The client's appearance and home environment should be well-maintained. Neatness and organization also save time and effort.
•  Effectiveness: Every task should be evaluated to make sure that it has accomplished its purpose, which is to promote or maintain the client's health. Personal care should give the client a feeling of comfort and well-being. Explain all tasks to the client before they are performed.
•  Independence: Encourage clients to care for themselves as best they can. Assist only in tasks the client cannot perform.
•  Privacy: The client should be given as much privacy as possible during the performance of personal care tasks. This shows your respect for him or her as an individual.
•  Cleanliness: In the health care system cleanliness means more than the absence of dust and dirt. It also means the absence of disease-causing germs.
•  Proper handwashing: This is the most important activity you can perform to promote cleanliness.

Finally, Jessie's instructor reminded the trainees that the client has the right to refuse personal care. If this happens, do not argue or insist that tasks must be done. Instead, try to find out the
reason why the client is refusing, and attempt to settle the situation. If this does not work, call your Supervisor and discuss the situation.

Handwashing and Infection Control

Cleanliness means many things to different people.

We all have our own ideas and values regarding how clean our person or our possessions must be. Home care clients are no exception to this rule.

Germs are everywhere – in our air, our food, our water, on our skin, even inside our bodies.

Usually we can't see these germs because they are too small. They can only be viewed with a microscope and thus are sometimes called "microorganisms."

Most of these microorganisms are harmless to healthy, normal persons. Many even help us. (Organisms in the intestine help digest food; other organisms assist in wine, cheese, and
bread-making; some form the basis of antibiotic drugs).

There are some germs, however, which can cause people to become ill. We call these disease-producing organisms "pathogenic organisms". Often, these are transferred from
person to person in ordinary daily activities.

Infectious diseases continue to be a problem among certain high-risk groups in our population. Sometimes these individuals can even become ill from organisms that are harmless to normal,
healthy persons. It is important for you to recognize the potential that may exist for infectious disease development, and to take steps to prevent it.

Pathogenic organisms can be spread to other persons in different ways.
•  Direct person to person spread can occur as the result of sneezing, coughing, and even speaking. Germs are transferred directly in the secretions through the air or on hands that touch the secretions. In addition, stool, urine or wound discharges can soil hands which in turn can directly spread germs to another person through touching.

•  Indirect spread occurs when food or water becomes soiled with discharges from an infected person. That is why people should always wash their hands before handling food. Soiled tissues, linen, and personal laundry can also spread disease.

Methods for preventing the spread of infectious disease include:
1. Don't come to work when you have an infectious disease yourself. Although you may not feel very sick, you could cause the client to become ill.
2. Wear a uniform, cover-up, apron or other special clothing which is used only for work. Keep this clothing clean (daily washing is preferred).
3.  Maintain proper control of the environment through an understanding of "clean" and "dirty" areas and objects.

A clean object is one that is free from pathogenic (disease-causing) organisms. (Note: if something is free from all organisms, it is called "sterile.")

A dirty object is one that has been in contact with disease-causing agents. The floor is always considered  dirty and therefore, anything that comes in contact with the floor always becomes dirty.

Other dirty objects include:
    •  saliva and other discharges from the mouth and nose; also included would be anything that comes in contact with these discharges such as hands, sinks, toothbrushes, handkerchiefs, napkins, pillowcases, cigarettes, cigars, pipes, and eating utensils
    •  stool and anything that comes in contact with it, such as toilet paper, underwear, bed linens, and toilets. (Note: urine is normally sterile and does not contain any organisms, but it quickly becomes dirty when exposed to the air and should be treated the same as stool.)
    •  drainage from wounds and objects that come in contact with drainage such as dressings, tissues, cloths, clothing and bed linens
    •  spoiled food and such contact objects as other food, dishes, cooking utensils and kitchen working areas

Keep objects and areas clean. Handle and throw away objects appropriately, or keep them in carefully designated areas.

Your agency will identify its policies on when to wear protective gloves.

4. Wash your hands before and after personal contact with the client, and after handling any dirty object.

Handwashing is an activity which you must perform frequently. Of all the measures you can take to prevent the occurrence and spread of pathogenic organisms, proper handwashing is the most important. Even when wearing protective gloves, proper handwashing technique is still important.

When should you wash your hands?
•    before and after any personal body contact with a client, such as assisting with personal care
•    before assisting with medication
•    before assisting with eating
•    before you eat
•    after handling soiled materials such as:
    -  bed linens and towels
    -  personal laundry
    -  dressings
    -  tissues, handkerchiefs, napkins
    -  dentures, toothbrushes
    -  anything that has been on the floor
    -  cleaning materials – mops, pails, cloths
•    after assisting the client with toileting
    (Note: The toilet should always be considered a dirty object.)
•    after cleaning or doing laundry
•    after you use the bathroom
•    after you eat or smoke

Unit C



In your past experience, you learned how to help clients plan, shop for and prepare tasty, nutritious meals.

You learned about the five basic food groups:
•  milk and dairy products
•  meat and meat substitutes
•  fruits and vegetables
•  grains
•  "others," such as sugars and fats

You learned that well planned meals:
•  contain a variety of foods from the five basic food groups
•  suit the client's cultural and personal preferences
•  should cost no more to prepare than the client can afford

You also learned that when you assist a client in preparing meals, you must be sure that you:
•  cook the foods so that the greatest number of nutrients remain
•  prepare the food in ways that are appetizing and tasty
•  serve the foods in an attractive manner
•  store food properly for safety and to retain the nutrients

You learned to recognize some simple modified diets. Many times, clients are advised by their doctors to modify their diets in order to improve their health. They may be advised, for instance, to increase the fiber in their meals to relieve a constipation problem. Or they may be advised to cut down on calories in order to avoid gaining weight. They might also be advised to reduce salt intake. These are examples of simple modified diets with which you have become familiar in your studies and your work.

In this unit you will be given background information essential for assisting a client with the preparation of complex modified diets. You will learn what complex modified diets are. You also will learn the reasons why these diets are important and ways to make these diets more enjoyable for the client. You will learn your role in assisting a client with a needed diet. You also will learn what an exchange list is and how it works.


Some physical conditions require specific diet modifications. Diabetes requires a careful balancing of foods in order to maintain good health. Some heart conditions require a strict limit of salt (sodium) in food intake plus lower cholesterol levels. Sometimes kidney or liver problems require a complex, carefully controlled diet.

Complex modified diets are of three general types. They may be:
•  measured or weighed carefully in order to control amounts of various nutrients, such as in a diabetic diet
•  two or more simple modifications combined, such as a low salt/high protein diet
•  a simple modified diet with supplement added for extra nourishment


By now you have had some experience in assisting clients with simple modified diets. You may have been assigned to assist in planning meals according to the diet restrictions and to find alternatives that met your client's preferences as well as dietary needs. You probably have prepared shopping lists and purchased food for your client. You also have had experience in recording and reporting problems you observed. These same activities will be part of your role when assisting with more complex modified diets.

As part of your role in assisting with the preparation of complex modified diets you should know the activities you are allowed to do. These activities are only to be performed if they appear on the client's Care Plan.

•  plan meals in cooperation with the client or with a family member
•  prepare shopping lists appropriate for the diet
•  purchase special foods and foods appropriate to the diet
•  assemble or set up necessary equipment, diet utensils and supplies for meal preparation procedures
•  prepare meals and/or special foods
•  add nutritional supplements and stool softeners to food
•  serve meals
•  clean cooking areas, equipment and utensils
•  store uneaten foods properly
•  observe, record and report changes and problems

You also should know the activities you are not allowed to do.

•  mix oral medications into foods or liquids



If you are assigned to assist a client with a complex modified diet, you need some special knowledge in order to provide the right kinds of assistance. You will need to understand:
•  what the diet means
•  how the diet works in treating the illness
•  how to make the necessary adjustments in planning, shopping and preparation
•  how best to assist the client to follow the diet
•  how to weigh or measure foods
No matter what your assignment is when assisting clients with the preparation of complex modified diets, you should always remember that it is important to encourage them to be independent in every way possible.

You may be assigned to assist with only a part of the food planning or preparation – the part which your client is unable to complete. Your instructions will be written on your client's Care Plan.

An example of a Home Care Case involving a complex modified diet follows. It will help you understand your role.

Case Example: Mrs. Bates
Mrs. Bates is a 70-year old woman who lives alone. She has had diabetes for a number of years. In addition, more recently, she has had problems with hypertension and must restrict the salt in her diet. During her last trip to her doctor she was told that her cholesterol level was too high and the doctor prescribed a low cholesterol diet. All of these special diets together have been confusing to Mrs. Bates.

Fortunately, Jessie, her Aide, had been taught to assist with the preparation of diabetic, low sodium and low cholesterol diets and how to help Mrs. Bates manage all of them together. Mrs. Bates is an example of a client who needs assistance with a complex modified diet.

Helping a Client Understand and Accept a Diet

Mrs. Bates may be similar to other clients you will be assisting. Many clients are confused about their prescribed diets. They hesitate to ask their doctors for explanations. They may come from the hospital or the doctor's office with only a vague understanding of the doctor's orders regarding diet. You and the nurse can help the client better understand the reasons for the diet, how it will affect the client's health and how to maintain good taste and appeal in meals.

Sometimes clients also feel that it isn't fair that they have to give up their favorite foods or seasonings and that a little cheating won't hurt. Often, when a person is elderly or has lost friends and family, or is not healthy enough to be active and useful, eating becomes the most important activity of the day. Restrictions and bans can be depressing or may even cause anger. You can emphasize the variety of foods that still remain possible. You can use your imagination to create tasty and interesting foods, even with limited choices. You can assist in making mealtime a happy time, and this will greatly increase the willingness of the client to follow the diet.

Diets are individually prescribed to meet the needs of a specific person. Each client should have a written diet sheet from the doctor detailing his or her own instructions. Be sure to read this carefully and to be sure your client understands it.


Recognizing Your Own Feelings About Diets

Clients on special diets may seem to be unreasonably cautious and sensitive. It may not seem normal to spend so much time thinking about food, planning meals or worrying about it. It may seem boring or the food choices may seem unappealing to you. However, special diets are part of a doctor's treatment plan. You and your client can work together better if you recognize the importance of this kind of treatment and show patience and interest in meeting your client's needs. With this in mind, you will make the food look and taste as appetizing as possible for the client. You will do everything you can make mealtime a happy time for your client.


What is Diabetes?

Diabetes, or more properly, diabetes mellitus, is a disorder in which foods are not used correctly in our bodies. When foods are eaten, carbohydrates, protein and fats are broken down into a sugar called glucose. This glucose enters the bloodstream where it goes to all the body's cells to provide energy and nourishment. An important hormone, called insulin, normally manufactured in our bodies, controls the flow of glucose from the bloodstream into the cells. People with diabetes (diabetics) lack sufficient insulin to do this job properly.

There is no known cure for diabetes. Most diabetics can control the condition, however, with one or more kinds of treatment. Diet control must be followed by all diabetics. Their meals are
carefully measured and timed to provide glucose in amounts that the body's supply of insulin can handle. Some require, in addition, oral medication (pills) to stimulate the body to manufacture more insulin. Still others, besides following a diet, must take shots (injections) of insulin to make up for the body's inability to manufacture its own supply.

When the lack of insulin interferes with the way the body uses glucose, the body's cells become undernourished. The person feels weak, tired and hungry and loses weight. Two of the early symptoms of diabetes are frequent urination and extreme thirst.

Because of the poor health of the body's cells, diabetics may have skin problems, poor circulation, poor eyesight, and low resistance to disease. Diabetes is a contributing factor to many other serious illnesses such as heart disease, strokes and kidney disease.

In a person without diabetes, the body adjusts the insulin level depending on the person's level of activity, when he or she chooses to eat, and how much the person feels like eating. However, when a person has diabetes and has to be given insulin as part of the treatment, it must be given in set, pre-determined amounts. Diabetics on insulin must adjust their eating to fit the strength and amount of insulin. For this reason, diet control is very important.


Unit F



In this unit, you will review routine skin care. You will learn what is meant by special skin care. You will learn that your attitude toward assisting with special skin care is important. Your role in
assisting with special skin care will be discussed. Two specific skin conditions, stasis dermatitis and decubitus, will be described. Measures you can take to prevent these conditions will be discussed. You will learn what to observe, record and report when assisting with special skin care.


The skin is the outer covering of the body. It consists of hair, nails, oil and sweat glands and mucous membranes. The skin has two layers. The outer layer is constantly shedding and replacing itself. The inner layer is thicker and contains blood vessels, nerves and nerve endings. Hair follicles (roots), and sweat and oil glands are in this layer of the skin.

Normal skin is warm, smooth, slightly oily and elastic (if gently pinched it will return quickly to its original shape). Skin color varies from person to person.

The skin serves many purposes.

•  protects the body from infection and injury
•  eliminates body wastes through perspiration
•  insulates the body from heat and cold
•  senses heat, cold, pain and pressure

When the skin is injured, it cannot serve its disease-producing organisms to enter the body. To protect the skin from injury, it must be kept clean, dry and lubricated.

Routine skin care is important in preventing injury to the skin. Routine skin care includes all activities normally performed on a regular basis to maintain the skin in good condition. Routine skin care may include assisting the client with:
•  bathing
•  showering
•  giving a back rub
•  fingernail care
•  toileting
•  hair care
•  changing position
•  applying cream or lotion

Bathing keeps the dirt out of the pores of the skin and removes dust, bacteria and substances that cause allergic reactions. It is the time to note any danger signals such as rashes, infected areas, bruises, or cuts on the skin surface.

Certain non-prescription products are used, such as lotions, creams and oils, to lubricate the skin and help keep it moist.

Proper nutrition is important to routine skin care. The color and texture of the skin depend a great deal on good, nourishing food.

Obese clients may have skin that has lost its elastic nature or they may have poor circulation. They may have folds of skin. Cleaning under these folds may be very difficult and the skin may show signs of irritation. Elderly or frail clients have thin skin that may be very dry. These characteristics make the skin easy to injure. Gentle handling must be used to care for these clients.

Very thin clients may have poor nutrition. This often means their skin is thin and easily injured. Gentle handling is important for these clients.

Observing, recording and reporting are also part of routine skin care. When observation skills are used, danger signs of skin breakdown can be recorded and reported early. Skin can be treated promptly and breakdown can be prevented.

Proper hand washing technique is an important factor to consider when assisting with routine skin care. Hand washing helps protect you and your clients from infections or diseases that can be spread by germs carried on the hands.


Special skin care includes activities performed as needed to protect a wound or to prevent skin problems from occurring. For example, the skin may have to be washed with a special soap, or
a scrub brush may have to be used.

Special skin care is only done on a stable skin surface. A stable skin surface may have a wound but the wound is not open, infected or draining.


The attitude you have toward a client or toward assisting with special skin care is just as important as your skill at performing the task. When you demonstrate a positive attitude toward assisting with special skin care, you improve the client's outlook. It comforts a client to know there is someone to assist who has a caring attitude.

Always attempt to provide as much privacy as possible when assisting the client with special skin care. You should make the client as comfortable as possible. Be sure linens are free from wrinkles. Use support equipment such as sheepskins or cushions.



As part of your role in assisting with special skin care, you should know the activities you are allowed to do. These activities are only to be performed if they appear on the client's Care Plan.

•  assemble necessary equipment and supplies
•  position client
•  apply prescription and/or non-prescription topical medications to stable skin surface
•  clean reusable equipment
•  store reusable supplies
•  observe, record and report

As part of your role in assisting a client with special skin care, you should know the activities you are allowed to do under special circumstances only. These activities are only to be performed if they appear on the client's Care Plan and you have been shown how to do them by your supervising nurse when you are in the client's home.

Dos, Special Circumstances Only  
•  cut nails

You should also know the activities you are not allowed to do.

•  apply prescription and/or non-prescription topical medications to unstable skin surface


Stasis Dermatitis
One type of skin condition you may encounter in home care is stasis dermatitis. Stasis dermatitis occurs mostly on the lower leg and is usually caused by a problem in circulation. The early signs of a stasis dermatitis may be a rash or a scaly, red area or itching. Stasis dermatitis can occur and continue for many years without affecting the surrounding skin or it can become more severe and become an open wound. Stasis dermatitis is the first step in a severe skin condition that leads to a stasis ulcer or open wound.

Stasis dermatitis is common in the elderly and may be due to:
•  tight stockings
•  tight shoes
•  casts
•  braces
•  splints
•  injuries

Unit H



The beginning of this unit gives an overview of ostomies. You will learn what an ostomy is and why an ostomy may be formed. You also will begin to understand your own and your client's feelings about an ostomy and ostomy care.

Following the overview, four specific ostomies are explained in detail. Ileostomy and colostomy are discussed together because they are similar. Gastrostomy and tracheostomy are discussed also.



An ostomy is a surgically formed opening in the body. Each ostomy is formed for a different purpose. Usually it is done because the client has a disease (such as cancer), an illness that interferes with the normal functioning of a part of the body or an injury.

Each ostomy functions in a particular manner that will determine the care the client requires and the equipment that is used.

Included in the discussion of each type of ostomy is a description of the ostomy, why it is usually done, the effect the ostomy has on the functioning of the body and the feelings of the client, the specific equipment that may be required to care for the ostomy and the care the ostomy client may require. In addition, your role in relation to each type of ostomy is explained. Problems you should observe, record and report are included.    


There are many types of ostomies. This unit will discuss four types of ostomies.

They are:
•  ileostomy – a surgically formed opening in the small intestine
•  colostomy – a surgically formed opening in the large intestine
•  gastrostomy – a surgically formed opening in the stomach and through the abdominal wall
•  tracheostomy – a surgically formed opening in the windpipe (trachea)

Each of these types will be described and discussed in more detail.


Your role in assisting the client with ostomy care will depend on the type of ostomy the client has. Many of the tasks you will perform for clients with different types of ostomies will be similar, even though the location and functioning of the ostomies may be quite different.

When you are assigned to assist a client who has an ostomy, the ostomy will always be mature and stable. This means that the ostomy is not new and is not changing. The client will have acquired a certain technique and routine for managing the ostomy. The client also will have selected the equipment or accessories that work best.

Often a client experiences better health and well-being after ostomy surgery than he or she had before. However, all clients will need to make adjustments. For some clients, these adjustments to ostomy care may be hard to make.

A client might be concerned about what a spouse or friends will think about the ostomy, especially when an appliance is worn.

Some clients even show concern about their diets. They may be hesitant to eat the foods they enjoy. Clients often have concerns about the possibility of the appliance leaking or having an offensive odor. In time, most clients usually work through their concerns as they adjust to their ostomies.

A client's psychological adjustment to an ostomy refers to his or her attitude or feelings about the ostomy. The attitude a client has about the ostomy will have an effect on the client's ability
to be as independent as possible. Any adjustment takes time. You should report your observations to your supervising nurse.

Report such things as:

•  language (verbal and non-verbal)
•  interest in personal appearance
•  willingness to do ostomy care
•  attitude toward socializing with others

Here are some questions you can think about when trying to determine how the client is adjusting.

Does the client:
•  follow a regular routine for ostomy care?
•  take an interest in how the equipment is functioning?
•  have to be prompted to do ostomy care?


One of the functions of your role, as you work with clients, is to give emotional support. You may find that when assisting a client you may need some reassurance. Why? You are facing a very new and different responsibility. Sometimes it is difficult to put your feelings into words. Be conscious of the tone of voice used, your facial expression and the manner in which you assist
a client. Your verbal and non-verbal expressions should relay the same caring and helpful message. Whenever you feel you need clarification about any part of ostomy care, seek the advice of your supervising nurse. You can also talk to your Supervisor about how you feel about ostomy care. You want to demonstrate an accepting attitude. Remember that the clients you will be assisting have had time to deal with their feelings. You may also need time to deal with your feelings.


Ileostomy and colostomy will be discussed together because the care involved and your role will be very similar.

An ileostomy is a surgically formed opening in the small intestine. It usually is done because the client has a disease that has permanently damaged most or all of the large and/or small
intestine and prevents it from working the way it should. The entire large intestine may be surgically removed.

A colostomy is a surgically formed opening in the large intestine. It usually is done because the client has a disease or other problem in a part of the large intestine. A section of the large intestine that is diseased or injured must be surgically removed.


When food is taken into the  mouth, it is chewed, swallowed and goes through a tube-like structure called the esophagus into the stomach. In the stomach the food changes as it mixes with special digestive juices.

The mixture then goes into the small intestine which is a very long tube coiled upon itself and has several different sections. The food mixes with different digestive juices in the small
intestine. In addition, the nutrients from the food pass through the wall of the small intestine into the blood stream and are carried to different parts of the body where they are needed for

The food mixture then goes into the large intestine. This is also tube-like in shape but it is not as long as the small intestine and it is bigger around. The large intestine also has several
sections. The main purpose of the large intestine is to remove water from the food mixture and return it to the body. When the mixture first enters the large intestine it is very liquid. By the time it reaches the rectum (the end of the large intestine), the mixture is formed into the consistency we know as stool.

Stool is stored in the rectum until the person has the urge to move the bowels. It then goes through the anus, which is the opening between the buttocks through which stool passes, to the outside of the body.

Choose a chapter

  • Module VI

  • Module VIII

  • Module XII

  • Unit C

  • Unit F

  • Unit H

  • image3094
  • image3037
  • image30397
  • image930397
  • image3081
  • image3004
  • image3015
  • image3105

What’s Inside…

Volume One PCA Topics include:
• Introduction to Home Care
• Working Effectively with Home Care Clients
• Working with the Elderly
• Working with Children
• Working with the Mentally Ill
• Working with People with Developmental Disabilities
• Working with People with Physical Disabilities
• Food, Nutrition and Meal Preparation
• Family Spending and Budgeting
• Care of the Home and Personal Belongings
• Safety and Injury Prevention
• Personal Care Skills

Volume Two HHA Topics include:
• Orientation to Health Related Tasks
• Performing Simple Measurements and Tests
• Assisting with the Preparation of Complex
  Modified Diets
• Assisting with a Prescribed Exercise Program
• Assisting with the Use of Prescribed Medical Equipment,   Supplies and Devices
• Assisting with Special Skin Care
• Assisting with a Dressing Change
• Assisting with Ostomy Care

load more

Our Clients and Testimonials

A partial list of agencies that have used our books:


• Able Health Care Services, Merrick, NY

• Aides At Home, Hicksville, NY

• Allen Health Care Services, Forest Hills, NY

• All Metro Health Care, Lynbrook, NY

• Beacon Healthcare School, Brooklyn, NY

• Family Home Health Care, Tarrytown, NY

• Jzanus Home Care, Floral Park, NY

• MetCouncil, New York, NY

• People Care, New York, NY

• Personal Touch Home Care, Jamaica, NY

• Premier Home Health Services, White Plains, NY

• Robynwood Home for Adults, Oneonta, NY

• Progressive Home Health Services, New York, NY

• Self Help Community Services, New York, NY

• Special Touch Home Care Services, Brooklyn, NY

• Summit Home Health Care, Brooklyn, NY

• Unlimited Care, White Plains, NY

• Utopia Home Care, Kings Park, NY

• VIP Health Care Services, Richmond Hill, NY

and many more!

These are the only books that follow the flow of the NYS curriculum. Our teachers prefer them over any other books out there.

The students love these books. Very easy to follow and they don’t have to flip back and forth to find the material we’re discussing.

They’re so affordable that we can easily give them away to our students. With all the cutbacks we’re facing these days, this is such a huge savings for our company.

So much supplemental information, illustrations, and charts in addition to the required material. Really a great value for the price.

Students are testing better than they have with other books we’ve used in the past.

To Place an Order

All information is required to fulfill your order

Company Name
Your Name
Phone #

First Location

# of PCA Books

# of HHA Books

Class Start Date (00/00/00)

Ship to:

Second Location(Optional)

# of PCA Books

# of HHA Books

Class Start Date (00/00/00)

Ship to:

Third Location(Optional)

# of PCA Books

# of HHA Books

Class Start Date (00/00/00)

Ship to:

Any Questions or Instructions

Free Trial Offer

If you’ve been thinking about trying a different textbook for your HHATP classes but just haven’t had the time to explore your options, we have an offer for you.

We’ll provide you with twenty sets of books, FREE OF CHARGE, for your next training class. If you like them, we’ll bill you upon completion of the class. If you find that you prefer your old books, just return ours in the same condition that you received them in, no questions asked. We’re so sure that your teachers and students will see the benefits, as well as the savings, of using our books that we can make this offer to you with total confidence.

Just give us a call at 516-377-4949 and let us know where to send the books.

Questions regarding our books?

Contact us