Hi, concerned daughter ...
I'm 73 and not frail, so I think your mom might have more trouble than me. I manage to do the flushing part without help when necessary. The flushing is very easy ... it's only a question of pouring water in the tube. But one problem I have is that my fingers and thumbs, especially, are weak, and I struggle to undo the clamp with one hand while holding the tube filled with water up in the air with the other hand.
Also, they recommend taking the feedings lying down, and so you have to juggle a hand mirror to see what tape you're undoing ... the tapes holding the dressing in place, or the tapes holding the little tube itself.
If your mother is motivated and still has strength in her hands, she might be able to manage, but even the flushing involves several steps. I haven't tried a solo run with the Ensure because I'm a klutz.
I'm also in the process of looking for in-home care, and you're right ... people back off really fast when you mention feeding tube. There must be some kind of insurance issue. I don't see why a general home aide couldn't help with the feeding. Certainly anyone could ask a friend or relative to help out, so why not an aide?
Good luck in solving this. Having the tube in will really benefit your mother down the line, I'm sure.