She keeps them independent and out of hospital, but her hours are constantly being cut and her future is unstable.

This is the life of a home help.

"There's no support and you're really on your own, " says Jackie Moulds, who has worked as a home help in Celbridge, Co Kildare for the last 14 years. "I can't afford to be sick, because I'm the only person with the key to their door and they're relying on me to be there. I've been with most of my clients (and I hate to use that word) for three, or five or seven years and they have almost all had their hours cut back. It's terrible."

Although Moulds' hours are cut back any time her clients are hospitalised, she inevitably works over her allocated work period and without pay because of the needs of her clients. "There are elderly people who aren't capable of being left on their own, yet they're only allocated three short visits a week, " she says.

"Just this week I came in to one of my ladies to find her on the floor. She'd fallen and been lying there all night. Getting her straightened out, cleaned up, dressed, bed made, comforted, breakfast cooked and house cleaned took up most of the day. You can't just walk out because your hour is up, these people are relying on you. If the HSE would actually come out and see what we're doing, then they'd understand."

Like most home helps in the country, Moulds is employed on "zero hour" contracts, which means her pay can be reduced to nil in circumstances where a client is hospitalised, put in respite or even dies. According to Siptu, an agreement that was made with the HSE in April 2004 to end "zero hour" contracts has not been honoured and home help workers are "at breaking point." The dispute culminated last week in a demonstration outside the Department of Health.

"Giving priority to home care is stated government policy, " says Darragh O'Connor of Siptu. "However, instead of adequately supporting the home help service, the government has stood over a massive decline in home help provision with a massive reduction of 730,000 in the number of service hours from 2002 to 2004. It clearly remains the "Cinderella of the health sector."

After Anne Slattery had a brain haemorrhage at age 50 in 2003, and was paralysed all down her left side, she wouldn't have been able to cope but for the homehelp service. "They are angels from heaven, godsends, " she says, recalling the day she fell to the ground and couldn't get back up again.

"I was put on life support and my family were told to make funeral arrangements for me. In the end I spent most of 2003 in hospital and when I came home I could do practically nothing. Jackie was assigned to me; I already knew her slightly and she was easy to talk to. She always does far more than she's paid for, she's just so dedicated."

Anne Moffit has been a home help in Dublin for the last 10 years and she too finds it difficult to cope with the lack of stability. "Right now one of my clients is in hospital, " she says. "Next week, another person could be in respite and there could be no work then. What it means is that I can't say to my children that I will definitely have the money there if they need it for college fees or books. I might only have half my wages. It's hard to live that way."

In practice, all HSE areas provide the home-help service directly or make arrangements with voluntary organisations to provide them. However, there is great disparity between organisations providing home helps. One centre in Clontarf, known as the HLO7 office, successfully fought for better training and support for their home helps, who are now classed home-care workers.

While they do not have contracts, they have more than enough hours to go around and could be looked to as a model of what all home helps should be getting.

"I had the opportunity to do manual and first aid courses, " says Thomas Morran, who has been based in Clontarf for the last five years.

"I also do a lot of hoist work [patient handling] and have been trained in the use of various pieces of equipment. If a client goes to hospital, we lose those hours, but we were warned about that from the start. But there's a lot of work and I can end up working up to 50 or 60 hours a week."

For the vast majority of home helps however, the situation is quite the opposite. "Many home helps end up leaving and going into nursing, " says Moulds.

"And yet we're keeping these people out of hospital and freeing up beds. It doesn't make sense that they won't put more money into it."

For the people receiving care, the solution is obvious. "Jackie is so important and valuable to us, " says Anne Slattery. "She's nearly one of the family.

These are valuable members of the community. Why shouldn't they be given a contract like they deserve?"

"A contract would make all the difference to us, " says Moffit. "We're in this job because we love what we do and it is very rewarding. It's just hard to live on ifs, buts and maybes. No one can do that but we have to, every day."