I am primary caregiver for my 66 year old brother. He had an accident last May and almost died. Afterward he spent 5 weeks in the hospital, 2 months in a nursing facility, and the last 7 months in assisted living.
There were indications of mental illness prior to the accident, including that he was living in a dilapidated, filthy house, which needed extreme repairs - and was unconcerned with the situation. His kitchen and bathroom were barely functional (if that).
He has now recovered enough to adamantly (and constantly) insist on going home, but not enough to understand that that is not a good decision. In addition to the condition of his house, he now has a catheter, which is likely permanent, and I seriously doubt that he will take care of it appropriately.
I currently have power of attorney, but he is threatening to revoke that. I know he is making plans to go home, though I don’t know if he can actually pull it off. I have contacted Adult Protective Services and met with the staff and care team (who are great!), but there is no real answer to how to deal with him in this situation. What should I do if he is able to make his way home?
But you will need to back completely away: no loaning money; no going over there to clean his house; no managing his catheter or health. You keep reporting him to APS until they get him a court-assigned 3rd party legal guardian.
I'm so sorry, I know he's your brother and you care deeply about him but sometimes this is the only solution and the more you insert yourself (and exhaust yourself) the longer it takes for a permanent solution to be put into place. In the end he will still most likely go down this path regardless of how much effort you put into propping him up.
May you receive clarity, wisdom and peace in your heart as you move through all of this with boundaries in place.
Just what does that mean?
Have you asked if you can be his temporary guardian in order to keep him in care?
Are you POA or guardian at present?
Do they consider your brother competent to make his own decision?
Either YOU can make the decision legally after a diagnosis or you cannot.
Hoarding and bad housekeep won't be enough to keep him in care.
If your brother is judged competent enough to discharge himself I would withdraw from contact with him and would let his doctor and the facility and APS that you are doing so.
If you have no rights to make this decision then that is that; it's over. Put a period at the end of the sentence and let brother have emergency numbers for his problems as they arise.
Be certain that one of those number is NOT your own.
You cannot possible manage care for someone uncooperative, non-compliant and mentally ill.
I recommend you read Liz Scheier's book, a memoir called Never Simple. It is about a daughter who attempted to manage her mother's care for several decades, despite the woman's mental illness. She had the full cooperation of the auspices of the social workers of the city and state of New York, and it was all to no avail. The woman died alone and in a total mess, just as she had lived her entire life.
Not everything can be fixed.
I would not want to live that way, but I recognize we are all different and some people are comfortable living the way your brother has.
Unless he is deemed incompetent and unable to make decisions for himself, he can decide to live any way he wants. You only have POA if he is unable to speak for himself.
What you do if he is able to make his way home? - Let him. You do not need to continue to be his caregiver. Having POA does not obligate you to be his primary caregiver.
Take care of your own life. Let him live his as he wishes. You can step in and help him and you can make decisions for his care needs when he no longer is able. You can call APS again once he is home and have them inspect and make a decision. He may be forced to leave his home. You have to decide if that is really in his best interest and what he wants.
He may die in a filthy house with an infection from an improperly maintained catheter. You know your brother. Is that how he wishes to live out the rest of his life? It seems cleanliness is not something he is concerned with.
Would he rather be in a skilled nursing facility with all his physical needs taken care of for the rest of his life? Or are you simply trying to extend his life and take charge of how he lives it - to your standards?
You can't control how anyone else lives. You can only control how you manage your life.
You may also seek help from a professional organizer or de-clutterer if he is a hoarder. They can do clean outs, and sometimes help you list for sale if proceeds are needed for care.
I would have his home condemed, then he has nothing to go back to.
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