I think you may have hit on something very interesting. The caring industry is exactly that 'an industry' my experience of working backs up what you say about isolation, the segregation of groups of people goes against all aspect of permaculture (interdependant and interactive zones/people). all that said the solution can be worked out in the problem, first we need to observe what is going on then we can see quick and sustainable wins. By that i mean if you can find out what people want to grow/do you then have a starting point. Growing plants/food is such a great achievement, nurturing and looking after, sharing the joy and the falls. Who ever you are you can deepen your relationship with extended family/friends choose some plants and grow together...
