This subject is yet one more train wreck facing 21st Century 1st world nations. We can now keep folks alive well past their "sell-by" date (been waiting a long time to use that term, heh, heh.
) But seriously, "rich" folks can hire good (bonded, trained, etc.) assistants when they can no longer care for themselves fully. The "poor" will become dependent on "some" gummint program (yet to be determined?) paid by the rest of us (or our kids.) The idea of finding a symbiotic relationship (I think that's what imoldernu is suggesting) COULD work, but is fraught with so many possibilities for abuse that the gummint almost certainly will eventually make such relationships illegal or else regulate them out of existence - especially if any money changes hands.
For the past year, we have sort of adopted a 90 year old lady in our building. She is in very good shape for her age, but lacks companionship. Additionally, she gets a bit confused. She's also a bit unstable on her feet - but refuses to routinely use her cane. She fell into a stucco wall and tore the skin on her arm, so I took her to the urgent care and watched them clean the wound and super-glue her skin back (cool!) While she was visiting on the mainland, pigeons moved into her lanai and the landlord refused to have it cleaned (and put in screens). We found a guy who had worked for us to do the work - cheap by HI standards. We take her out to lunch (either dutch or she might pay occasionally as a thank-you - Costco hot dogs/drink are $1.50!). We have become a significant part of her support system without any remuneration BUT without any liability or official responsibility. It's just enough help to make her existence more fulfilling. On our part, we enjoy her company and the WEALTH of stories she has to tell about the generation before ours. I DO consider this relationship symbiotic though it is occasionally inconvenient to us.
One of the reasons at (pushing 70) we don't spend 5 or 6% is because we "fear" needing to pay for home care (to avoid a "facility") and not being able to afford the equivalent $25/hour to get good reliable (bonded) help. When the time comes we need help, I would be surprised if we have a neighbor willing to assist us as we have our new (old) friend. Actually, I guess I'm hoping to just wake up dead some fine sunny morning and bypass the whole business. YMMV