Bill’s carer gives us insights into Bill’s story. Since his accident personal and sexual relationships haven’t worked out so well. Seeing a sex worker didn’t work well for Bill the first time.
NB: All names have been changed for privacy.
Bill is a 37 year old male who was working for a large firm until he had his accident three years ago. As a result of his accident he lost his speech and has problems with the left side of his body.
Bill was an aspiring real estate developer and was studying at night to achieve this. He was also having elocution lessons as he was of a non-English speaking background. He is the only son of five children and culturally there was an expectance that he would carry on the family name. Bill had an apartment, which he was paying off with his fiancé as a start for their future; he had a great deal of friends and was popular with the girls.
In 1999 Bill wrapped his work vehicle around a telegraph pole. He was in coma for six to eight weeks and there was talk of switching the life support off.
Today Bill lives at home with his elderly parents. He has carers 24 hours a day, be it family or paid. The carers are all female as are the therapy staff he sees. Bill has had a great number of “behaviour modification programs” designed to curb what has been seen as aggressive and often violent behaviour. These behaviour programs have been in place for the last two years. He left hospital two and a half years ago.
Communication aids have been purchased for him in the past but his parents don’t understand how to operate them and neither do his sisters. Bill has never been shown how to use them either and has often destroyed them as he has seen them more as a hindrance than a help.
Bill reports to have had satisfying sexual relationship with his fiancé. They broke up in June 2000. This was due to a number of issues but revolved around care and sexuality. Since then Bill has resided with his parents. Two years of behaviour modification programs, visits to psychologists, psychiatrists and a number of medication trials could not curtail this aggressive behavior nor what some of the carers labeled as sexual harassment.
Three months ago a team of rehabilitation specialists from a rehabilitation centre interviewed Bill again and managed to talk to Bill and get from him his goals. Bill’s main drive and goal in life was to return to some sort of meaningful employment. This was achieved one month later and the behaviours diminished for a few weeks then escalated.
Again the rehabilitation team was consulted except that this time two interviews were conducted separately on the day, one with Bill’s sisters and one with Bill. Issues about personal hygiene and reasons for “tantrum behaviour” were sought from both groups and then recommendations made.
It was during the time that the team was interviewing Bill for the second time that Bill refused to listen at all but pulled out his penis and started getting quite obsessed with it. He would not discuss anything but kept pulling his penis. This was a behaviour that had not been seen previously. Through much prompting and a process of elimination it was ascertained that Bill was referring to wanting sex.
This was conveyed to his carers and sisters and a promise was made to Bill for one of the team members to look into it. Extensive negotiations were undertaken by Bill’s case manager with the family, the carers, the carer’s employer as well as the case manager’s employer. There was also extensive consultation with Bill as far as defining what type of sex service he wanted and then negotiating with the sex worker to provide the service.
Once the sex worker was found none of the family members nor the carers (all female or older generation) would do the final arranging for the sex worker to visit Bill. Being non-verbal and having limited range of motion Bill could not arrange the meeting himself hence the case worker had to then arrange the meeting between Bill and the sex worker and then ask the family and carers to leave the house once she arrived. Bill was so excited that he was finally able to meet with the sex worker that once undressed and his session had begun, he ejaculated early and did not get to feel much more than embarrassment and feeling of lost pride. No matter how hard the sex worker worked with Bill, he was unable to get a full service. Hence something that Bill had tried to access for years proved to be a negative experience for him.
Bill is now seeking to get into a relationship and the option of using the services of a sex worker again is not currently an option. The frustration of this experience, together with his acquired disability and limited social contacts and the fact that he has been unable to find and get into a relationship has had a compounding effect and the family and carers are seeing the return of the behaviours.