Are there rules for fairly compensating home health workers?

Hello, I have been a caregiver for about five years. I usually have consecutive 24 hour shifts and some clients talk all night and/or have frequent attended bathroom breaks throughout the night. I also have had assignments with multiple clients to care for - at the same rate. This often means that I spend a 72 or 96 hour period with very little sleep. My agency just offers to cut my hours, but, I need to work to pay my bills, and I have seen that my clients with dementia have a very hard time adapting to frequent caregiver changes. Is it legal to pay us 8 hours for a 24 hour shift - especially with an active client or multiple clients? I recently had an assignment of two elderly dementia clients - which was extremely difficult since there were no accommodations in the home - the doors were not safety locked so I was afraid to sleep - and one had Parkinson's and was unable to ambulate. But, this was made even more abusive when their son came home from the hospital after quadruple heart bypass - and suddenly I had three difficult clients but I WAS ONLY PAID FOR ONE. Is there a part of evaluating client needs that takes into account the needs of ALL the clients being cared for? Shouldn't we be paid for each client we are RESPONSIBLE for? Shouldn't we be paid above the 8 hour level for hours of sleep lost taking care of the clients in the home? Shouldn't we be paid for more than 8 hours when we are racing about 20+ hours per day? This is extremely unfair.