Home care services are facing the biggest recruitment crisis in the history of the sector, an Oireachtas committee has been told.
Representatives of the industry issued a stark warning about pressure within the system caused by the ongoing struggle to find staff.
The Oireachtas Health Committee was also told on Wednesday that a cross-departmental Workforce Advisory Group, established to make recommendations on the recruitment crisis, has not yet met.
The advisory group, set up by Minister for State Mary Butler last year, is due to make interim recommendations by May.
Agencies involved in providing care said contracts between private providers and the HSE should be reviewed, and wages should be increased to help prevent people leaving the sector.
Bereneice O'Rourke, director of Home and Community Care Ireland (HCCI), said: "We're 17 years in business, we've seen huge change. I've never, ever, ever seen a crisis as we have now in recruitment.
"But we do have solutions and we want to make caring a protected profession, like nursing and social care workers.
"We need to move on that fast. So I think there's a real opportunity here.
"I'm very hopeful if we strip it back and look at what needs to be done, and be practical about it.
"But without the staff, we're at nothing."
Joseph Musgrave, chief executive of HCCI, said while the Government has boosted funding for the sector, he told the committee that no workforce strategy has been provided.
"What (the Government) hasn't done is explain or set out how we can hire the necessary staff.
"Although the Government has announced a cross-departmental working group, nothing has happened.
"It hasn't met, we've not been invited to attend the session, we've not been told the timeline.
"We've been talking about this for 18 months to two years."
He said the urgency has been recognised by the HSE.
"I met with Anne O'Connor on Monday. And when the deputy head of the HSE is meeting to talk about homecare recruitment, you get a sense of the HSE understand the depth of the problem," he added.
Mr Musgrave said the sector is in the "midst of the most acute recruitment crisis" in its history.
"In the autumn of 2021, the Government was quoting waiting lists for home care of some 800 people," he added.
"As of the end December 2021, the national waiting list was over 5,000. This is an astonishing, and worrying, rate of growth."
He said its members will need to hire 3,000 additional home care workers in 2022 to reach the goal of providing 24 million hours of care.
"What this means is that thousands of people, with conditions ranging from dementia to post-fall rehabilitation, must appeal to the kindness of friends or family to get them out of bed in the morning or suffer the indignity of asking for help to shower or use the bathroom," he added.
"For others it means being forced to leave their home and local community and be admitted into a nursing home against their wishes."
Sinn Fein's David Cullinane asked that the committee send a letter to the HSE and Ms Butler about the working group, its composition and to confirm it terms of reference.
Representatives have also called on the Government to allow workers from non-EU countries to work in the sector.
Home care providers are currently not allowed to recruit workers from outside the European Economic Area (EEA).
Catherine Cox, of Home Care Coalition, has also called for a change in the rules governing social welfare payments.
Ms Cox said home care workers are prohibited from claiming social welfare as they work around 22 hours over five days, as opposed to three days.
"If it calculated on hours rather than days it would improve the quality and continuity of care," she told the committee.
"A home care worker could go in every morning, get somebody up and go in every evening and put them to bed.
"It's about a better quality and continuity of home care as well as allowing that worker to get more hours. It's a win for everybody and it could be changed and should be changed.
"The other one is around the non-EEA workers. They can work in nursing homes but cannot work in the home care sector.
"They're being encouraged into nursing homes, and are sometimes getting less pay, but they're doing it because they cannot get work in the home care sector."
