There seem to be a lot of assumptions here that I don’t agree with. So perhaps this comment isn’t for me, in which case feel free to ignore the following.
People seem to add so many values into the mix when it comes to sex work. If these old lonely people paid carers to visit them at home, would that be somehow different? Are these old lonely people somehow exploited because there is sex involved? If they cannot make rational choices because sex is involved then I’d say that is the problem.
Also, where does being able to “have” someone figure into any of this? There is no ‘you must be at least this hot to enter’ scale, people get together for all kinds of reasons. Plus, “have” sounds a lot like possession of someone, which I think we all think is bad? Right?
I think there are a lot of values encoded in the above comment, but I also know it wasn’t intended negatively.