More than 6,400 elderly and disabled people are now on waiting lists for HSE home supports as the service faces a crisis due to an exodus of carers.
Staff are abandoning jobs that can pay them as little as €11 an hour with no mileage or car allowance, even though they may have to travel long journeys to see a client.
Allison Metcalfe, founder of Healthcare Assistants and Carers Ireland, said staff were being paid a "pittance" with "if and when" contracts which left them with no guarantee of work.
If an older person is given just half-an-hour's service the carer may have to travel a long distance at their own expense for a fee of €5.50.
"These types of contracts enable providers to treat their most important asset, their carers, as a variable cost to be turned on and off at their whim," she told the Oireachtas Health Committee.
She added many carers were limited by the rigid social welfare system and were prevented from taking on more hours for fear of facing a sharp drop in benefits.
The meeting was told the most common complaint the HSE receives is that a carer did not turn up.
Many elderly people are now confined to just half-an-hour's care which was likened to a "drive-by" form of service in which the carer hardly has time to provide basic supports before moving on.
The worst waiting lists are in north Dublin, Galway, Mayo and parts of the midlands.
The Government has promised a statutory form of home care but this will be means tested. It would take years to implement and would not currently be possible due to the severe lack of carers now opting for other kinds of jobs in the improving economy.
Despite additional money being given to home care, the service is deteriorating for many of the most vulnerable in the community who want to remain in their home but have no option but to go into a nursing home.
Many people either have no service or an inadequate level of support, the meeting was told yesterday.