From what my Mother says after working as a nurse in some retirement homes, living in a guest house/room would be a vast improvement.
I guess I should also point out that Pelosi probably thinks ALL Americans have guest houses. (I noticed her words were "guest room")
My mom was in a nursing home part of her last year, and it was actually a nice (expensive!) place, but she wanted to be at home when she passed. I didn't want to roll all nursing/retirement facilities into one barrel, but was more looking at Rs turning the tables on "pushing grandma off the cliff" and talk about what an gov run ACA facility would be like while at the same time turning the tables on dems for family values.
I know other people besides me have had to deal with putting parents in facilities and I by no means wanted to imply that making that decision versus keeping the parent at home was a bad thing.