Perhaps the family members are afraid they will break down if they relax too much? Not making excuses, just thinking out loud. It's hard to see a person who you love and remember when they were younger be in such a situation. It makes you very sad.
After the first of the year, I plan to do more at the Veteran's home and hospitals. Nursing homes will still have to pay if they want me, because they do have the budget. They just won't use it around here because so many well-meaning people do it for free or for peanuts. I was offered "top dollar" to do one last summer. Top dollar was $30.! This is at a place where the residents pay thousands a month to be there.