Republication: In That Case

Abstract

Vera and Bob had been married for 50 years when Bob had a stroke and was left with multiple deficits. He could not walk or talk and did not recognize Vera. After three weeks in hospital Bob was discharged home. Bob and Vera live in a major Australian city in a comfortable family home. Vera will become Bob’s “carer”. She is not sure what that means but she promised to look after him in sickness and in health, so she is willing to try. She will not be alone. Carers have been identified and counted for some time by the Australian Bureau of Statistics. In 2003 there were nearly 1 million people over 65 years of age requiring care and of those, 47% were being assisted by partners who were likely to be older themselves (ABS 2003). Vera is given a great deal of advice from numerous home care experts who seem to be able to come into her home at any time. Various policies underpin the support of carers via services such as delivered meals, house maintenance, home cleaning, laundry services and carer respite. These services help maintain the stamina of carers and enable them to provide most of the direct care work, including basic nursing care, and allow them to perform the role for the longest time possible. The home visitors provide Vera with information about her rights as a consumer of their services, and of course her responsibilities. Vera thinks about this most carefully. She is now a consumer and a carer. She worries whether she can provide the best care possible for Bob. The standards appear to be very high and she is not a trained nurse. She is (or thought she was) Bob’s wife. Meanwhile the experts have assessed their family home. The rugs have gone, as Vera may trip and injure herself and then be unable to care for Bob. The bath has been removed and a large shower installed. The hot water tap has been regulated to prevent scalding and rails have been attached to the wall. The floor is now non slip. The experts explain to Vera that she now qualifies for the carer’s pension and she receives a Carers’ Kit that contains all sorts of useful information including a relaxation tape. Bob is awake and confused most of the night. Vera begins to feel frazzled. Now where did she put that relaxation tape that the Australian government had so thoughtfully provided free of charge? The experts are concerned. Their regular assessments of Vera show that she is not coping well. Could Bob be at risk of elder abuse? Was the best standard of care being given in this situation and if not what should they do about it? They consult their databases Bioethical Inquiry (2010) 7:267–268 DOI 10.1007/s11673-010-9238-2