Racked with nausea and unable to leave the bathroom, Acey Hofflander muttered in confusion. Her husband tried to press a damp washcloth against her neck, his hands trembling and weak from Parkinson’s disease. “What’s happening? What’s going on?” Acey mumbled. Their roles had unexpectedly reversed. At 85, Acey is the healthy one, the organized, energetic caregiver for husband, Tom, 88. But when a grueling day of showering, dressing, feeding and transporting him to medical appointments pushed Acey beyond exhaustion in July, she wound up in the emergency room — a health crisis the Hofflanders blame in large part on a lack of professional, in-home care.