I ask this question b/c I work for an agency that provides in-home non-medical services to the elderly of whom we are contracted to serve by a state funded agency. Our job/goal is to keep them in their homes by providing the services that they can no longer provide for themselves. We give baths and grooming, clean their residences, do their shopping and laundry. We also provide a service called respite care which relieves the caregiver (i.e., daughter, son, etc.,) so they can have time to do what they need to do. My problem is that the state funded program does not always give enough hours for the employees we send to do the work in a timely manner. For example: a 300+ lb woman who cannot wipe her behind after using the toilet smears her feces all over the bathroom. When the aide arrives to give her a bath which is only for ONE hour and sees that the bathroom needs cleaning will not get paid if she stays to clean the bathroom after the woman is given a bath. Should she leave the bathroom in the condition it was in when she arrived? Or should she stay and clean the bathroom knowing she will NOT GET PAID for the overtime she spent? The state agency says she should leave b/c they are not going to pay for the time she spent after giving the bath to clean the bathroom. So, should the elderly depend on the state government funded program to help them, do it privately which is very costly or go to a nursing home? What do you think about this?