As has been mentioned before, the problem with care in the home is the lack of consistency. You seldom get the same person on a regular basis and this can be confusing and distressing for the person needing the care, especially if they have dementia. There also needs to be a family member or friend regularly checking that the care is appropriate and being properly carried out so someone needs to pop round several times a week. My mother-in-law simply wouldn't let the carers do anything that was needed, like helping her have a bath or shower and they certainly didn't check whether she had eaten and drunk enough. In the home they monitored her much better and her health improved enormously in the first few weeks.
Live in carers are very,very expensive and they still require time off each week that needs to be covered.
I think it is important to do a little planning if you want to stay in your home as long as possible. When my mother moved nearer us here in Suffolk the house she bought needed renovating, so I insisted she had a walk in shower with support bars etc. all the stairs have rails both sides, we planned the kitchen so it was easy for her manage and her second bedroom got a small shower en suite and loo ready in case she needed a live in carer or I had to stay overnight when needed.
I do think it is sensible to have plans in place or at least your wishes for the later stages of life.
A local friend came round today and her 98 year old mother in America is in hospital as her heart is failing. Her mother had done a DNR a year or so before but is now saying she wants to be revived if her heart stops. Her mother is surrounded by many friends who are visiting and supporting but my friend, who goes over regularly to spend time with her, has to decide when to go over now it look like the end stage. She is horrified that she may have to make a decision as to whether to have her mother revived or not. The doctors have said she could die tomorrow, in a month or it could be many months. This 98 year old women has stayed in her home till now but has had a great deal of support that has cost a fortune. She has remained very active and is still quite good mentally considering her age. It is still quite unusual to get to 98 but it won't be long before this isn't unusual and the amount of care and support is going to be crippling for society. DG x