The home care component of our long-term care system is increasingly being recognized as the preferred alternative to institutional care for the frail elderly and disabled. Dwindling resources, both human and financial, are likely to have a deleterious effect on home care. Findings from a 1987-88 survey of paraprofessional home care workers of the frail elderly in New York City are used to draw implications for the home care industry. The scope of problems inherent in the industry imply that changes are necessary on both the micro and macro levels; the article concludes with recommendations for both levels.