A RECENT report in the medical journal The Lancet estimates that half the babies born in the United States this year will live to age 100. That means plenty more work for people like Evelyn Coke.

Coke was a home care aide who spent more than three decades taking care of elderly shut-ins on New York’s Long Island. She bathed, dressed, and cooked for them, kept an eye on their prescriptions, and saved the health care system millions by keeping them out of nursing homes. For this the Jamaican immigrant was paid roughly $7 an hour.

Like most home care aides Coke worked for an agency on an hourly wage, and was not compensated for driving time between appointments. Nor did the job include health care or other benefits, nor overtime, sick days, or holidays.

This is all perfectly legal. In 1974, Congress amended the Depression-era Fair Labor Standards Act in order to cover domestic workers. But it explicitly exempted “home companions’’ such as babysitters or caregivers for the elderly, who were often relatives.

That might have made some sense in the early 1970s, when families stuck close together and women were not working in great numbers. But the US Department of Labor chose to include even aides hired through commercial agencies in the “home companions’’ category, and never updated the regulations. Thus workers laboring 10 or more hours a day are not covered by overtime laws or the minimum wage.

If demographics is destiny, many thousands of Evelyn Cokes will be added to a home care work force that already numbers about 1.5 million - 32,000 in Massachusetts alone. This overwhelmingly female army of workers answers to a bewildering array of titles - home health aide, personal care attendant, homemaker, custodial care giver - with different regulations in each state. In Massachusetts, for example, a homemaker is allowed to cook for her client, but not to feed her.

The one thing they have in common is low pay. A study by the Direct Care Alliance, an advocacy group, says wages for personal and home care aides - a national median of $9.22 an hour - have not kept up with inflation and are falling in value. An advocate succinctly described the system as “poor young women taking care of poor old women.’’

Many home aides love the work and some love their elderly charges. But make no mistake: it is a job, and the workers deserve a decent wage.

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