My mother (now 94) took in my brother (now 67) about 12 years ago when he was diagnosed with cancer. (fully recovered) He had no real job, and was in massive debt (proclaimed bankruptcy a year after diagnosis) and has been living with her and off her dime ever since. (she was his caregiver through his cancer treatment and beyond) About 5 years ago, she had a serious illness that sent her into a bout of anxiety and depression that has not lifted to this day and she is slowly declining in terms of health, in general. He, for obvious reasons, has been her caregiver ever since. He has done a really great job until recently, because I believe it is overwhelming him. They are both very independent and somewhat reclusive, so both reject the idea of someone coming into the home to help. Any suggestions on how to step in to help?
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But if he is holding out for a "perfect" solution, then he doesn't understand that with aging and decline, often the solution is the "least bad option".
I personally don't understand people who are angry and resentful about their circumstances but then don't do anything to solve it. Maybe he is also having cognitive issues? At his age, it is not out of the realm of possibilities that he can have early onset ALZ (like my cousin was finally diagnosed at age 68, after several years of "curious" behavior).
In the final analysis, if he is resistant to any suggestion, then you should probably take over managing your Mom's care if you think she's no longer able to make decisions in her own best interests.
Does she have a legally assigned PoA?
What I don't see is that 'deal' excludes all other forms of assistance, for all time. This I see as a lack of trust issue.
"both reject the idea of someone coming into the home to help"
So the task before both your Mom & Brother is *accept non-family help* (on top of what Brother chooses to do).
"Any suggestions on how to step in to help?"
Don't step in. Seriously.
If YOU step in, you will prevent or further delay them accepting non-family help.
Instead (based on my lived experience of stepping..);
* ADVISE them both to add extra help. (Adding does not mean Brother has failed btw.. this is just ADDING extra help).
* Let them decide.
* Let the consequences be theirs.
At some point one will give in. If not, one will fall or collapse. Then around again... you advise again, let them decide again, let the consequences be theirs again.
* Ask "Why not?" to every refusal for support/services if you like. This may help identify the barriers.
* Remind them they can CHANGE their mind at any time to accept new help.