What is disconcerting here is that with a move toward aging in place, these are the exact people that will be caring for your loved one. If employment screening programs are not in place by home care providers you risk the possibility that anyone desperate for a job could fill these roles and then exploit elders. Then when you do get someone who truly cares for those in their charge, you risk them leaving for any other higher paying job. And that is at the core - caring for our elderly should be a noble cause and occupation. And it should be paid accordingly. Not to do so sends a statement about how we value our elders.