For more, check out the rest of America Tonight’s special series “Aging America”

As more Americans live longer and longer, 79 percent of people who need long-term care live at home or in community settings. By 2050, the number of elderly people who will receive long-term care is expected to reach 27 million, up from 13 million in 2000.

So, who's providing all this caretaking?

Many of the people who care for all these seniors receive low pay, often below their state’s minimum wage. Few receive health benefits, and most states offer no protections for harassment, abuse or unsafe and unsanitary conditions. Hours can be long and irregular, and client turnover may suddenly cut off their incomes. The need for caretakers is urgent, their work intimate and demanding, but the median pay is just $16,800 a year.

On Tuesday, America Tonight’s special series "Aging America" continues with a profile of Marlene Champion, a 68-year-old Barbados native who has worked as a caregiver for the elderly for more than 30 years, and in domestic care since the age of 14.

"I cook, wash, clean, vacuum, shopping, [help with] doctor visits," she said. "If there's a nail to nail, I'll nail it. If something's being undone, I'll try to fix it."

Working with the elderly can be a huge challenge, she said, as the people under her care have early dementia, Alzheimer’s, or both.

"Some of them spit on you. Some of them hit you. Some of them deliberately do dirty things,” she told America Tonight. “You have to put yourself in the same frame of mind as they're in, because if you are not strong enough as a caregiver – mentally you're not strong enough – you'll break."

Champion's first job in the U.S. was caring for an 89-year-old doctor. By the time the man died seven years later, she could barely get by on her salary.