AbstractAmy's excellent home care was the only reason she was doing as well as she was. There was no one better at taking care of Amy than her husband. When she had a respiratory infection, Steve managed the necessary increased suctioning, nebulizer treatments, and ventilator, in addition to all the other intimate personal assistance she needed on a routine basis. Yet by law he could not be paid to be her personal care assistant. After a revolving door of unreliable, inadequate assistants and recurring medical crises, Amy and Steve made the painful decision to divorce so he could quit his job and be paid by the state to care for her.