Eight years after Mr and Mrs Doherty’s care package was introduced, Mrs Doherty’s health has regressed significantly. She has had a myocardial infarction, with subsequent severe symptomatic heart failure. She recently fell. She fractured her right wrist in the fall. To make matters worse, Mr Doherty was in hospital for a cataract operation. Mrs Doherty has left sided weakness from a previous stroke and was unable to get up, spending most of the night on the floor before being found by her neighbour. Mr Doherty states that his wife has also been more forgetful of late, and with his poor vision, doesn’t think he will be able to look after her. He is worried that she needs 24 hour care and has asked the ACAT to visit again to discuss other care options.