I didn't get that either - it's not like Steenburgen's character was in denial, or was adjusting slowly to it, or didn't have the money for it - they should've had someone in weeks (if not months) ago to asses the situation and make recommendations. That's what home health care is for. If he were ambulatory and he had only gotten to this recently, sure - but from how they have said it, he went from mild symptoms, to six (?) months later, where he is having difficulty swallowing.
And if Paul couldn't get him up the stairs (admittedly it was new for him so possibly more awkward), how did tiny little mom get him up there every night, and back down every morning? Until this episode, I thought they had a downstairs bedroom. I just assumed, I guess, because he was always on the couch or in his chair and not in a bed.