PROVIDENCE, R.I. — One recent morning Antonia Antonaccio, a home care aide, got a call to help an elderly couple whose regular aide could not make it. The regular aide, who is 68 years old, had thrown out her back.

Ms. Antonaccio said she empathized. Sometimes her legs hurt from going up and down stairs. "But it's nothing I pay attention to," she said. "I don't have the time."

Ms. Antonaccio is 73.