Health and hygiene workers who care for Hawaii’s elderly in their homes make substantially less money than their western U.S. counterparts — even as demand for the occupation grows.

A report released Thursday by the community group Faith Action for Community Equity said there were about 4,730 home care aides in Hawaii in 2010, and the figure is expected to increase to 7,230 by 2018.

"Employment for home care aides is projected to be the fastest growing occupation in every county in Hawaii through 2018," the report said, "and home care aide job growth is projected to be 7 percent higher in Hawaii than the national average."

But low pay for the aides remains an issue, said the report, "Help Wanted: A Future for Hawaii’s Home Care Aides."

In 2011, aides in the state were paid the lowest among other states in the Pacific region. The average hourly wage for aides in Hawaii last year was $9.08, compared with $13.83 in Alaska, $10.53 in Arizona, $10.58 in California, $9.13 in Idaho, $10.70 in Oregon, $10.21 in Nevada and $11.14 in Washington state.

"I think it should be higher because of the work we do," said Tiala Toetu‘u, 58, of Palolo Valley, who has been working steadily as a home care aide since 1999. "We are there for them."

She earns $1,200 a month working at a private home in Manoa, with duties that include sponge baths, brushing the client’s teeth and preparing his breakfast.

"This is work, to care for our parents, and we’re paying them the least," remarked Cullen Hayashida, long-term care coordinator and professor of the Kupuna Education Center at Kapiolani Community College.

FACE Policy Director Kim Harman, who prepared the report, said the low wages are compounded by the lack of full-time hours available to aides.

"In order to secure enough hours, many home care aides in Hawaii report ‘piecing together’ several part-time home care jobs, working some hours through one or more agencies and working with additional patients on their own," Harman said in the report.

Toetu‘u, who works at the Manoa home three days a week for a total of 20 to 30 hours, said it has been a challenge to pay rent and bills with her monthly earnings. Her sons pitch in to help with the bills.

But even a full-time home care aide in Hawaii with a $9.08 hourly wage earns $18,880 per year — $3,080 below the poverty level for a family of three.