Two things are fundamentally in tension here: The people who care for the elderly need to be paid fairly for difficult and important work (I also don't think you want to underpay the person keeping your mom alive and healthy). But paying someone else's full-time salary is beyond the means of most Americans. Which is why, obviously, this is a place government needs to step in to help with the burden. Ditto childcare. None of this can, or should be, managed alone.