Why would these people be ashamed to hire someone?

We know a couple in their sixties. They have their house paid for and live in a low property tax area. They have a substanital amount in the bank. They have a substantial stock portfolio. They will be each getting the maximum amount of social security in a few years. They have antiques and collectibles that they could sell off if they needed too.
The man is working at non physical high paying job, but probably will retire in the next few years. He has physical impairments do to diabetes and stroke damage. His wife helps him do everything like getting dressed, bathing, and almost every other activity. She has carpal tunnel, severe anxiety, and other health problems and is having a hard time taking care of him.
They refuse to hire someone to help. They claim that would be shameful. I don't get it. Many upper middle class people hire people for a variety of services: nanny, cleaning person, yard person, ect. Why would that be shameful? The woman is from a working class background. Is this a class issue? A generational issue? Are they just weird?
My husband and I would hire someone if we were in their position.

It hurts to admit that you might not be able to as you get older.

Even though, hiring someone would seem easy on the surface. I guess that it isn't because it means a lot of other things to them emotionally.