Your questioning is logical but doctor is not like he gave the letter to get the fee as their family doctor. Doctor statement mentioned is
Patient is suffering from chronic recurrent low back pain, sciatica and bilateral osteoarthritis of knees. It is recommended that she avoid bending and heavy lifting, and therefore, requires assistance with many aspects of activities of daily living, such as cook\ng, house cleaning, laundry and groceries, to name a few issues.
A home support worker, or house keeper would help her in avoiding future back problems, as well assist her in her activities of daily living.
Rest in 2020 care was taken by son and spouse. Son got married in 2020 and living other state. There is no such statement in entire CIC website that caregivers are not allowed from family or there is restrcition to bring.
These are duties in job offer
Provide Care & Companionship, Assist in regular exercise, Help in using heat and cold pads during back pain, Assist with other aspects of personal hygiene, Assist in exercise for the osteoarthritis of knees, Massage therapy during pain in knees, Daily Prepare Meals, Assist in shopping, Launder clothing and household linens, Wash dishes and making beds, Assist in other daily routine activities which includes weight lifting and other stressful activities.