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[quote=Anonymous]I'm following this discussion with interest, and particularly appreciate those who are familiar with the various institutions and types of differences to look for. My parents are both 93, in their own home, and until this year fairly independent and relatively healthy--so we could live in denial. 
Well, my vaccinated and boosted Dad got COVID, seriously, and after recuperating at Sibley Hospital (a great place), came home, much weakened and with COVID brain. He always said "Every man wants to die in his own bed." His wishes were clear. He's at home, with a revolving carousel of nurses. Some are quite fine. Others are just on their phones until he needs to use the bathroom. 
Well, that's fine for HIM. But my Mom is slowly being worn down with his care. Worse, she is very social (he never was) and misses the movies and lunches and art galleries. (Yes, she's 93 and can walk laps around the National Gallery.) He doesn't like when she leaves and she's worried he'll die when she's gone. She's starting to leave him, but it's hard on them both. 
I do some shopping for her and my siblings fly in, but it's very hard on all of us. I truly wish they'd go to a nice assisted living facility--there are some very fine ones, like Maplewood in Bethesda-- where Mom could pop down and see friends, play games, join a reading group, whatever, and Dad would be well taken care of. But she won't go against his wishes. There is a nice support network on their street, I tell myself, and their house is a candidate for "Hoarders" so we can clean it slowly. 
They both worked well into their 70s and have the money to live in a nice place, with assistance and company when they need it. I'd go there, in their place! Like you, OP, I think they are trapped in images of poor facilities (and there are many of those). Each place is different. Humorist Art Buchwald went into hospice care and recovered! https://www.washingtonpost.com/archive/lifestyle/wellness/2006/10/03/kissing-hospice-goodbye-span-classbankheadart-buchwalds-case-is-unusual-but-leaving-end-of-life-care-without-dying-is-notspan/0d9e38d8-1d2e-4409-bbdd-0a754fbc27ca/
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