I believe everyone does what they think is best..a bigger home would allow a paid carer to stay in the house too and avoid the care home situation.
If the older person has emotional connection to her belongings more upset would be caused by downsizing .A paid cleaner is often the best idea..an eighty something relation manages very well in a two story home due to employing a cleaner (A male) and enjoys light gardening but has twice yearly whole garden tidy and regular grass cutting.She has worked hard invested her life and energy in a beautiful home ..we are always in contact and share many days out and short holidays.