Pushin' On: UAB Spinal Cord Injury Model System Digital Newsletter Volume 36 | Number 2 | Page 2
Personal Care Attendants and Spinal Cord Injury
What is a personal care attendant?
A personal care attendant (PCA)
is someone who provides help with
daily living activities.
Do I need a PCA?
Most people with a cervical spinal
cord injury needs at least some help
with daily actives. Those with higher
levels of injury will need more help
than those with lower levels of injury.
What help does a PCA provide?
• Self-care – might be clearing
secretions, bathing, grooming,
dressing, feeding, and bladder and
• Mobility – might be transferring,
pressure relief movements,
pushing a wheelchair, and
• Set-up – might be setting up
assistive devices so that you can
do daily activities for yourself or
setting up a computer to use for
work or school.
• Light housekeeping – might be
food preparation, dish washing,
laundry, and home cleaning.
Is there a difference between a
caregiver and a PCA?
Both are often thought of as the
same because they provide help in
assisting with daily living activities.
But a caregiver is a term often used
for an unpaid person who’s in your
family, like a parent, spouse or
sibling. A PCA is usually someone
who isn’t in your family and is paid to
Is there a benefit to having a PCA
instead of a caregiver?
Some people simply have to
rely on family for daily care. If
so, you might want to talk with a
psychologist, counselor or social
worker about stress relief and
ways to separate family roles from
But there are benefits to relying
more on a PCA than a caregiver.
• Helps avoid blurring the roles of
caregiver and family member.
• Helps reduce stress on the
relationship, especially if a spouse
is the caregiver.
• May allow greater independence
for you and your family member,
allowing more opportunities to live
an active, productive life.
• May reduce the chances of a
spouse becoming depressed.
How do I find a PCA?
There is no “best” way to find a
PCA, but here are some suggestions.
• Department of Rehabilitation
Services - Many states offer
programs to help find and, in some
cases, pay for a PCA.
• Center for Independent Living (CIL)
– each state has at least one CIL
that provides an array of services.
Your nearest CIL might help with
information and referrals related
to personal care services in your
• Online - Social media posts let
friends and family know you are
searching for a PCA. Someone
in your social network who’s
interested, or they may know
someone. Also, some websites
let you advertise for help or a list
of people who are interested in
• Be very careful with any online
activity. You might avoid giving
out any personal information until
you first meet and get to know
• Flyers – posting flyers in areas
that might catch the eye of person
who’s in the field of providing
personal care. For example, you
Participate in UAB Research
Low Carb/ High Protein Diet to Improve Metabolic
Health in Individuals with SCI
This study aims to determine the effects of an 8-week
high-protein low-carbohydrate diet on metabolic health
and gut function.
Criteria to Participate
• Have a SCI (tetraplegia or paraplegia)
• Live in central Alabama and visit UAB 3 times
• Willing to undergo lab tests (blood glucose, insulin
and lipid levels, gut function, and body imaging)
• Complete activity and food intake questionnaires
Participants will earn between $250 and $450 for
completing the study. Call 205-500-8180 or 205-996-
6896 or email [email protected] for information.
Scale Up Project Evaluating Responsiveness to Home
Exercise And Lifestyle Tele-Health (SUPER-HEALTH)
This study evaluates the effects of an exercise program
on improving pain, fatigue, physical activity, and physical
function. The program is delivered through a tablet app in
the convenience of the home using exercise videos.
Criteria to Participate
• Ages 18-64
• Mobility Impairment/Disability
• WiFi Internet access in Home
Participants receive a tablet and Fitbit to use during study
and are eligible to keep all equipment at the completion of
last study visit. Visit superhealthstudy.org, call (205) 403-
5509, or email [email protected].
might put a flyer on a hospital
or skilled nursing facility bulletin
board. You might post a flyer at
a local college with schools of
nursing, occupational therapy or
• Advertise – you might try to pay for
a classified advertisement in your
local newspaper. It usually cost
money, but an ad is one option to
reach job seekers. If you do an ad,
do it on weekends because that’s
usually when you will reach the
• Commercial Agency – there are
some agencies that provide
personal care services. You might
search for agencies using terms
like “personal care,” “caregiver” or
“home health” services.
• Many commercial agencies
have restrictions on the types
of services offered. This might
include limits on services
considered to be “medical,”
which might include bowel and
What do I do when someone is
You might first speak to the person
over the phone. Give the person a
brief overview of the type of help you
need. Then, schedule an interview if
What do I need to know about
Have a plan
Prepare a list of questions to ask
before you set up any interviews.
Think of questions that help you
find the best match. Ask the same
questions to everyone so you can
judge everyone on equal terms. Here
are a few examples.
• What’s your work experience?
• Can you provide references?
• Do you have a criminal history?
• Do you have physical problems that
prevent you from lifting or pulling?
• Do you cook and do housework?
• Do you have a driver’s license and
Hints for interviewing
• Clearly explain in detail every task
that you need your PCA to do.
• Explain your schedule and the
importance of staying on schedule.
• Outline the education and training
you will provide.
• Explain any special rules you
want them to follow. This might be
things like no smoking, what to do
if running late or can’t make it, and
any limits on personal telephone
use and texting.
• Describe the work environment.
Make sure the person knows if
you have pets or need the room a
• Invite the person to ask questions.
Some tasks can be very personal.
This helps to better understand
what is needed and become more
comfortable doing these tasks.
• Get to know each other. Questions
and answers are only one part of
an interview. Interviews are also a
good way to find out if you both feel
comfortable with each other and
get along well.
Making your choice
You select the person who best
fits your needs. If you are having
problems deciding, you might make
a checklist of your needs and list the
person that you think will best fit your
needs. You want to also consider
good qualities for any employee.
• Did the person pass the
background check of references
and criminal history?
• Do you think the person is
dependable and will be on time?
• Do you think the person is
trustworthy and honest?
• Do you think the person is able to
• Do you think the person is someone
who is friendly and someone you
want to spend time with?
What education and training do I
need to provide?
Most PCA education and training is
done with hands-on experience. This
means it’s up to you to provide the
education and training to meet your
unique needs, even if you find a PCA
with a lot of experience.
• Download factsheets from the
Model Systems Knowledge
Translation Center. You can
highlight and discuss those parts
that fit your unique needs.
How do I pay for a PCA?
The average pay for a PCA is about
$10 per hour, and few people can pay
out-of-pocket for services. You might
contact a local social worker for your
individual options, but here are a
couple of common resources.
• Some states help pay for a PCA
through a medical assistance
program or the state’s Department
of Rehabilitation Services.
• In some cases, private insurance
and workers’ compensation
insurance will pay for a PCA.
What can I do to help keep a PCA?
It can be hard to keep a good PCA
even under the best of conditions.
But you can make sure your PCA is in
pleasant work environment.
• Develop a professional, but fun,
relationship. Humor can help create
a more relaxed work environment.
• Be polite and show appreciation.
Say “thank you” and “please,”
and, if you can, pay raises or small
bonuses are always welcome.
• Do as much for yourself as
possible. This shows your PCA that
you are partners in your care.
• Be assertive without being rude.
You are in charge of your personal
care, but treat your PCA like a
person and not like a servant.
• Avoid major changes in your routine
that disrupts the work schedule or
• Respect your PCA’s views, opinions
and personal life.
• Be honest about the hours worked
and pay on time.
• Don’t ask for special favors or
expect your PCA to work for free.
• Be flexible and understanding.
Avoid being too strict and
understand that honest mistakes
can happen. Also, be midful that
sometimes people can’t avoid
being late or sick.
What do I do if I experience abuse?
Verbal or physical abuse is never
acceptable. This includes someone
abusing you and you abusing others.
If you experience abuse, report
it to your family and your local
law enforcement at the safest
opportunity. Then, follow the advice
of law enforcement on taking action.
UAB Spinal Cord Injury Model System