My mom had advanced dementia for 9 years and my dad had heart failure for 17 years (although he did remarkably well and didn't suffer a lot). I was in charge of their health care, especially for the last 9 years. My mom was in a rehab place for a few months and was mostly neglected, so I pulled her out of there and took her home and vowed to never ley her go to another home. The agency home health aides were ridiculously expensive (and the aides were not getting much of that money! It was all "administrative cots"), so I decided I would handle their health care privately and cheaply and at home where my parents would feel comfortable. Since I was still working full-time, I hired live-in home health aides from Africa and Haiti for about 65k per year which is actually dirt cheap for dementia care where I live. Dealing with aides was annoying and stressful, but they took better care of my mom than she would have gotten in a home. I took care of my dad as best as I could. This whole experience was the most stressful thing I have ever been through, but I am so glad I kept them out of homes and let them live their final years with some dignity. It's also really good that I can live the rest of my life without guilt (at least not from that!) and know that I did my best.