Compare your typical working households at most levels of the social scale: In European countries, both partners will be working out of necessity, making it impossible to care for someone at home unless one leaves their job. In the DR, even if both partners are working, employing a live-in carer is entirely within their reach. Experience is anecdotal but I do know of families here in the DR who have put their elderly mother in an "asilo" when the care she needed was beyond the capacities of their domestic staff. All her adult children and their spouses have jobs. I also knew an elderly man whose children had emigrated to the US and used to send him money, but had stopped. He was destitute and depended on the generosity of neighbours and friends. Once a week he would go to my mother-in-law's for lunch. The former case is comparable to many people's situations in Europe; the latter even more callous IMO than putting your elderly parent in a home and never visiting.