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Yes, the amount of effort it takes to care for someone with dementia and/or mobility issues is huge. You end up needing a full time care giver to either keep them from wandering away or taking them to the bathroom and feeding them 5-10 times a day. Doing that in a humane fashion is quite challenging... and at some point you realize it's largely for their surviving relatives.

In the old days we just let them wander off or wallow in bed until they died.

Call me callous but that's the point at which it's ok to die.

There is very little quality of life and very little sense in being alive in a hospice, surrounded by strangers, hooked up to machines, living a lonely existence.

The problem is that we don’t want to die. That instinct can be ruthless, even when it doesn’t make sense.

Plenty of people want to die. The reason end-of-life care is extended as far as possible usually has little or nothing to do with the people themselves. They may rarely be lucid or even conscious.

How ever did we cope all the time before the recent few years of modern medicated ageing incarceration?

The elderly died earlier.

Yep. Before social security and medicaid, the USA had a ton of homeless and suffering elderly people.

still does