[MannoFr]

"When done right at home care is cheaper, gentler and more humane."

Severe dementia due to Alzheimers coupled with other physical problems can often require 24/7 awake, fully-dressed caregivers ready to respond.

How much elder care have you personally done under what circumstances? Paying a nursing service is often comparable to paying nursing home care, and the nursing home has equipment and resources rarely available in-home. I've managed both types of care as my parents aged, as appropriate to their situation.

In-home care was appropriate to my fathers medical problems, and he was well-off enough to cover nursing assistants. He was organized and had a living will/medical POA, etc. In my mothers case, she preferred assisted living, which preserved her location near other relatives. When she went downhill it required nursing home-level care. The transition was easy because the facility she lived at provided both.

The DIY option often destroys marriages, as when the wage earner is out working their spouse it trapped with a not-sane. demanding old person who cannot help themselves. If you have a docile, semi-functional easy-to-care-for elder count your blessings, but don't generalize.

(..I meant) At home hospice care. Been there done that. Twice. Much better than the alternatives. Once for CNS lymphoma and once for Alzheimers. I figure that for the vast majority of people hospice is the only humane choice.