Case Study Lydia and John were a couple in their nineties who lived in their own home and had been married over sixty years. Both were confused and forgetful. They had two sons who were in their seventies and lived in nearby towns. One son was estranged from them. The other was somewhat involved in their lives, but he had a mentally ill wife and health problems of his own to deal with. The couple first came to the attention of a protective service worker when John was hospitalized after a fall. When left on her own, Lydia’s confusion became more pronounced. A referral was made for home care services, but, when a worker went out to assess the couple, their son was present and refused services. Based on concerns of benign neglect, a protective services report was issued. A case worker investigated and substantiated the report, citing the son’s interference with services and the couple’s own inability to provide adequate care for each other. The protective services worker found both John and Lydia to be very forgetful and somewhat confused, though Lydia was the more impaired. Due to their increased physical frailty, they had been using only the first floor of their home. Since the bedrooms and bathroom were upstairs, the living arrangement presented several problems for the couple. Lydia had a regular bed, but John was sleeping on a cot. The low height of the cot caused him to lose his balance easily, resulting in several falls. Since there was no toilet downstairs, they were using a bucket in the kitchen and emptying it outside. They were unable to maintain their home and conditions became unsanitary. The son tried to help, but he had his own limitations. The elderly couple was well able to afford assistance, but they did not want to spend the money. Furthermore, even though the son who helped with paying the bills was not taking advantage of his parents financially, he was obviously concerned with “preserving his inheritance.” Meanwhile, John and Lydia were extremely conservative in terms of how they chose to spend their money; they insisted they could not afford help.