Just putting my two pennies in as someone whose day job it is to assess for and organise care for the elderly leaving hospital…
There are levels of infirmity that you cannot imagine unless you have had personal experience of them. Obviously i see the worst cases so this may have skewed my viewpoint. Those without family support undoubtedly have the absolute worst time. As previous posters have said, if they can afford private care (and a live in carer costs £2k+ a week) then they can in many ways replace the million and one little physical care needs that a family might provide, but a care package provided by social services funding will cover the absolute basics, and often not even that. Showers are considered a luxury, as an example, so thousands of elderly people across the country haven’t had their hair washed for months. Meals provided will be microwave meals only. Shopping is done from the local corner shop, so they can’t have their favourite items from Sainsbury’s or wherever. Cleaning will involve a very brief tidy and maybe a crap hoover irregularly. They will turn up when is convenient for the Care Company’s schedule, so “bedtime” calls start at 5pm, and visits can vary between days so you quite know when people will arrive. It’s not the carers’ fault- they are given impossible tasks to do in tiny amounts of time. 30 minutes to get someone out of bed using a sling and hoist, give incontinence hygiene, flannel wash and dress them, give breakfast and leave them settled and happy. Absolutely no time for a conversation or getting a reluctant elderly person to open up about what is troubling them, or explore that sore stomach/notice that rash on their back and encourage them to make a GP appointment, take out the bins, investigate why the tap is dripping in the bathroom, clean the carpet where a sticky drink has been spilled…. Etc etc…. And this is all presuming they are alert and assertive and still have all their cognitive facilities. When cognitive decline comes into it, things can be really pitiful. People don’t know what’s going on, or who these (often different each time) people are who are entering their home and grabbing them and taking off their clothes etc. Or they don’t remember that they are too unsteady to do their own tasks, so fall trying to make a cup of tea on their own. So many times in my job I think “they just need a loving family involved”. Nothing can really replace it. Some people truly have no one, but many are being cared for by kindly neighbours etc who can’t bear to leave someone so unsupported. So you might find others step in to that “family” role in your place and you have to decided if you are ok with someone else reluctantly taking on that burden on your behalf and judging you for that. All this to say, I think it’s one thing to make a statement that you won’t be getting involved, and another to actually stand by and bear witness as your parent struggles with needs that can’t be met by carers and do nothing. And I don’t blame you for this- there’s no way you can know how bad things can get unless you’ve had that experience. Extreme old age is hidden away in our society.
I have seen how hard life can get for those caring for their elderly family members. It can be akin to the hardest days of baby raising, but with none of the hope and joy that things are moving towards life. I’ve seen it seriously damage people’s mental health, let alone take years of their life, just when, as you point out, you are becoming aware of how finite your own years are. But I am gearing up for the possibility of caring for my own parents/ in-laws as they head towards infirmity. The alternative is not something I would inflict on those who have loved me so well for so many years.
Maybe you will be lucky. Maybe they won’t need much help, and will go quickly when their time comes. It’s the best outcome for all really.