When we learn someone is a licensed caregiver, aide, or direct care worker, one might assume that all of their clients are bed-bound, terminally ill, or otherwise 100% dependent on someone else to help them carry out ADLs, or activities of daily living. For the most part, it is true that if a client needs long-term care or home health services, there are likely a few daily tasks that they are unable to perform without assistance. If an aide works 8 hours for a bed-bound client who wears adult diapers, they can count on having to clean and change them multiple times, and diapering 150+ lbs of fragile dead weight is no easy feat.

There are some cases, however, that don’t require as much literal heavy lifting as they may require some softer skills, such as active listening and empathy. Senior companionship is specialized work, and that fact is backed by science and social studies.

Firstly, companionship can treat depression. According to the CDC, 13.5% of older adults qualifying for home healthcare suffer from depression, and more cases may go undiagnosed. Individuals of all ages with depression may suffer to the degree of having a risk of self-harm. In many cases, a companion’s mere presence each day is saving a person’s life.

Healthcare is one of the most diverse workforces, especially in the United States. Depending on where a patient or client is located, the demographics of the healthcare workforce could be totally homogeneous, or it could be dominated by immigrant populations. For example, in the Washington, DC, Metropolitan area, the vast majority of home health professionals and paraprofessionals are non-white immigrants. It would be hard to build a genuine connection with your white American client when you two don’t share an understanding of the same cultural references and etiquette (and those come in handy). This cultural barrier only comes second to the commonly large age gaps between aides and their clients. Finding common ground with a client so different from yourself is a challenge that requires a professional who is adaptable and emotionally intelligent.

In many other cases, being physically present isn’t enough. Keeping a client entertained is another element of companionship that should be acknowledged. Even an experienced stand-up comedian might find it challenging to keep a room full of people entertained for a whole hour. Imagine having to keep that same room full of people entertained day after day for 6 to 9 hours. No comedy school is that good. Anyone who has ever worked with someone with dementia knows that if one fails to tap into some creativity, they can expect to have the same conversation. Every single hour. Every single shift. Every single day. Successful caregiving requires creativity and patience.

“Encouraging positive conversation” and providing “emotional support” is a part of most clinical nursing job descriptions as well as healthcare aides’. These companionship skills are important, not just for passing the time; they are essential to individuals’ quality of life.