High-Acuity In-Home Caregiver (Health Maintenance Activities) – Adams County

Job Overview

We are seeking an experienced in-home caregiver to provide high-acuity support to a non-verbal young adult client under the Health Maintenance Activities program. This role is based in the Denver Metro Area and requires a skilled provider to deliver delegated complex care in a private residential setting.The caregiver will execute a structured care plan focused on airway management, enteral nutrition, and skin preservation to support a stable chronic condition.

Core Clinical Responsibilities

  1. Enteral Nutrition and Medication Support
    • Administer all medications and nutrition via Gastrostomy tube, including flushing, venting three to four times daily, and crushing medications.
    • Prepare food and liquid modifications strictly adhering to mechanical puree and pudding-thick guidelines to prevent choking or emesis.
    • Position the client upright during enteral feeding and maintain this position for at least 30 minutes post-feeding to mitigate reflux and aspiration risks.
  2. Respiratory and Seizure Intervention
    • Perform daily and as-needed oral or airway suctioning to manage secretions, particularly during or after seizure and vomiting episodes.
    • Perform continuous monitoring of respiratory status, tracking oxygen saturation levels and ensuring safety during rest periods and nocturnal oxygen therapy.
    • Identify, monitor, and document seizure activity, noting specific characteristics and durations while implementing prescribed safety protocols.
  3. Complex Positioning, Mobility, and Joint Health
    • Execute maximum-assistance pivot transfers up to eight times daily between bed, shower chair, manual wheelchair, couch, and vehicle.
    • Perform full-body manual repositioning every two hours (14 times daily) in bed using wedges and pillows to prevent tissue damage and preserve skin integrity.
    • Conduct daily passive range of motion exercises and manual stretches, targeting upper extremity stiffness to manage spasticity and joint health.
    • Manage wheelchair mobility, securing safety belts and ensuring proper limb alignment while maintaining a tilt angle of 100 to 120 degrees for comfort.
  4. Incontinence and Integrated Skin Management
    • Provide total assistance with bladder and bowel hygiene, conducting prompt incontinence care at least six times daily and monitoring for signs of urinary tract infections or GI distress.
    • Perform comprehensive skin inspections four times daily during brief changes, applying prescribed moisture barriers and cleaning the G-tube site to prevent gastric acid erosion.
    • Deliver detailed physical hygiene, including twice-daily shower-chair bathing, daily hair washing and braiding to prevent tangles, daily shaving with head and neck stabilization, and weekly nail trimming for spastic extremities.
    • Provide meticulous oral care twice daily using water-soaked or juice-soaked toothettes to maintain hygiene without triggering choking or aspiration.
  5. Clinical Supervision and Equipment Maintenance
    • Conduct twice-daily health checks, monitoring vital signs, checking the G-tube site, and assessing non-verbal cues for medical distress.
    • Provide continuous clinical accompaniment during twice-weekly community outings and medical appointments to manage suctioning, positioning, and care in transit.
    • Sanitize and perform structural safety inspections daily on essential durable medical equipment, including the manual wheelchair and shower chair.

Required Qualifications and Key Skills

  • Active CNA license or equivalent verified experience in high-acuity in-home care.
  • Demonstrated clinical competency in managing medical devices, including Gastrostomy tubes, suction machines, and oxygen equipment.
  • Physical capacity to execute repetitive maximum-assistance pivot transfers and frequent manual repositioning safely.
  • Superb observation skills and responsiveness to non-verbal cues, facial expressions, and communication tablet devices.
  • Absolute compliance with client safety mandates, including a strict restriction on all latex products due to a severe allergy.
  • Current CPR and First Aid certifications are required.

Available Shifts

Care requires consistent multi-shift coverage. Please share your availability for our morning and afternoon/evening shifts, seven days a week. Specific hours are confirmed during the interview.

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