Sibling with mental health and housing issues, far away
May 25, 2024 1:26 AM Subscribe
I need a whole lot of help on a whole lot of levels. This touches on sibling relationships, homelessness, mental illness and logistics. There is so much
I have a much older sibling with fairly severe mental health issues. He is now 75. He never married or had children. 8 years ago (after a family death and a very contentious estate battle and a lawsuit and some other trauma, like him having a psychotic break and having to be hospitalized and my son wrecking his car, etc., etc.) he cut all family ties, saying he wanted nothing to do with me or our other brother ever again. Fine, okay. I moved across the country. He moved across the state to be near his best friend of 40 years.
Eight years later, that friend has passed away. The friend’s widow, also his friend, is older and disabled. Over the last year, sibling began to have serious mental health issues again (or still) and ended up hospitalized. Each hospitalization involved ever more frantic phone calls from the friend’s widow. There were also several basically incomprehensible phone calls and emails from sibling, which, boiled down from multiple pages basically said, “I need someone to come live with me and take care of me.”
Sibling’s living situation seems, from 3000 miles away, to be pretty dire. He is apparently living in the country on someone else’s property? Like in a trailer or other house? Things got extremely dicey in February when he was hospitalized without his phone or wallet and it seemed as if the landlords were taking advantage of him –his friend called to say that they had suddenly acquired both health care and financial powers of attorney. I opened an elder abuse case with the county but they closed it without ever reporting back to me. The POAs went back to his friend and the landlords seemed to back off and he moved back in. This is a rural county in a southern state. He has now been hospitalized again, briefly, and is accusing the landlords of trying to kill him. Are they? Probably not. Are they ripping him off? Quite possibly. The hospital says he is too sane to be committed; they have discharged him with nowhere to go twice now. I cynically suspect that he reached his insurance limit and I question whether someone who apparently left the hospital without checking out and with an IV attached to wander down the highway is too sane, but, hey, what do I know.
His friend called me in tears after the above happened, saying she can’t cope with this anymore. I told her I would come and see what I could do. My work schedule is insane. I managed to get 3 days off next week – I won’t have another window like this for months. I booked a plane ticket and a hotel room and a rental car. This is costing a fortune I do not actually have. Now I am second guessing myself, like, what exactly do I hope to accomplish in 3 days? Is this just a waste of time and money? My adult children don’t want me to go. They say he chose to walk away from the family and I owe him nothing. They also say there’s nothing I can really do. I say I don’t want to see a family member end up on the street, which is what I am afraid this is coming to.
He might have some money in the bank, but I don’t know. His friend says he does. I think he has a pension – he had a union job for years – but again, I don’t know. Obviously, that affects what happens next and my feeling was that there is no way for me to find out that key information unless I’m there. Talking to him on the phone is just an exercise in frustration and now he has lost his phone again. Not only does he not make much sense, he has apparently had all his teeth removed, so he can hardly talk. However, I don’t know if he will even see me and/or if he does, if he will be coherent enough to even understand.
His friend says she told the landlords he would be out by June 1. Nothing, of course, has been done – nowhere for him to go, nothing done with his stuff, nothing. She also said they were trying to get him to sign some papers and she told them he would not be able to sign anything until I got there. I don't actually know where he is right now. I suspect he's holed up back in the place he's been living.
I have so many questions, here are some of them:
Do I bother going at all or cancel this trip? I’d have to eat the plane fare but honestly that’s the cheapest part. I think I have one calendar change built in, so I could postpone it but, as above, it would be August before I could do it again. I'm freaking out now but then I could just be freaking out about the plane - I hate flying.
If he isn’t making any sense at all, what do I do then? The hospital has already booted him.
He obviously has to be moved out of the house where he is living but to where? Should he stay in the same town/ state? I’m thinking I could hire Craigslist movers, get a Upod and put everything in it, then send it off to storage. Or something like that. Then I could maybe get him into a short term rental while this all gets figured out? Or should I try to find a more permanent apartment or house for him, set up meals on wheels, arrange for his stuff to be delivered and hope for the best?
Or should he be in a facility of some kind? What kind? And, of course, who’s paying for this? I’m assuming he is but if not, well, then the options narrow very far indeed, because I do not have enough money to rent an apartment or house. In that case, how do I get him into some kind of facility? Is it even possible? His friend will not let him move in, she has made that quite clear.
I am thinking that he needs to be in assisted living but are they going to be able to cope with someone with bipolar and possibly schizophrenia? (that is what his friend says the most recent hospital report said.) Or should he be in a memory care facility? Or a group home? How does this even work?
Or, should I try to move him across the country to a facility or apartment here? I also live in a rural area and there are not a lot of options either place. I feel like that’s the best long-term option - if he’s here at least I can be involved in his care while if he stays I’m not going to be able to fly back to help out again - but the logistics seem insurmountable. Like, how can I move him across the country anyway? If he’s not coherent, I can’t imagine trying to take him on a plane. This is literally 3000 miles; driving is not an option. Once he’s here, how do I get him set up to even get into a care facility? He would need a new doctor, new everything. The mind boggles. And the housing issue remains: I do not have room for him at my house even for a weekend - we're overcrowded as it is.
I need a plan of action, some priorities, some suggestions. I am just overwhelmed and can't even figure out if the smartest thing for me to do would be to walk away. I mean, it probably would, but I would feel so guilty. I don't imagine that if the tables were turned he would lift one finger to help me out, so there is also that.
Thank you for listening and I appreciate any help you can offer. I have already spoken with the social worker at the hospital, she gave me a list of care homes and group homes and clearly felt that should be sufficient. I reached out to his lawyer - or, well, she used to be his lawyer - and she refused to speak with me or offer any help at all. I have tried to reach the council on aging for both his current county and the one I am in and have left messages, have not heard back. There is no NAMI Friends & Family chapter here - believe me, I have looked so many times.
I have a much older sibling with fairly severe mental health issues. He is now 75. He never married or had children. 8 years ago (after a family death and a very contentious estate battle and a lawsuit and some other trauma, like him having a psychotic break and having to be hospitalized and my son wrecking his car, etc., etc.) he cut all family ties, saying he wanted nothing to do with me or our other brother ever again. Fine, okay. I moved across the country. He moved across the state to be near his best friend of 40 years.
Eight years later, that friend has passed away. The friend’s widow, also his friend, is older and disabled. Over the last year, sibling began to have serious mental health issues again (or still) and ended up hospitalized. Each hospitalization involved ever more frantic phone calls from the friend’s widow. There were also several basically incomprehensible phone calls and emails from sibling, which, boiled down from multiple pages basically said, “I need someone to come live with me and take care of me.”
Sibling’s living situation seems, from 3000 miles away, to be pretty dire. He is apparently living in the country on someone else’s property? Like in a trailer or other house? Things got extremely dicey in February when he was hospitalized without his phone or wallet and it seemed as if the landlords were taking advantage of him –his friend called to say that they had suddenly acquired both health care and financial powers of attorney. I opened an elder abuse case with the county but they closed it without ever reporting back to me. The POAs went back to his friend and the landlords seemed to back off and he moved back in. This is a rural county in a southern state. He has now been hospitalized again, briefly, and is accusing the landlords of trying to kill him. Are they? Probably not. Are they ripping him off? Quite possibly. The hospital says he is too sane to be committed; they have discharged him with nowhere to go twice now. I cynically suspect that he reached his insurance limit and I question whether someone who apparently left the hospital without checking out and with an IV attached to wander down the highway is too sane, but, hey, what do I know.
His friend called me in tears after the above happened, saying she can’t cope with this anymore. I told her I would come and see what I could do. My work schedule is insane. I managed to get 3 days off next week – I won’t have another window like this for months. I booked a plane ticket and a hotel room and a rental car. This is costing a fortune I do not actually have. Now I am second guessing myself, like, what exactly do I hope to accomplish in 3 days? Is this just a waste of time and money? My adult children don’t want me to go. They say he chose to walk away from the family and I owe him nothing. They also say there’s nothing I can really do. I say I don’t want to see a family member end up on the street, which is what I am afraid this is coming to.
He might have some money in the bank, but I don’t know. His friend says he does. I think he has a pension – he had a union job for years – but again, I don’t know. Obviously, that affects what happens next and my feeling was that there is no way for me to find out that key information unless I’m there. Talking to him on the phone is just an exercise in frustration and now he has lost his phone again. Not only does he not make much sense, he has apparently had all his teeth removed, so he can hardly talk. However, I don’t know if he will even see me and/or if he does, if he will be coherent enough to even understand.
His friend says she told the landlords he would be out by June 1. Nothing, of course, has been done – nowhere for him to go, nothing done with his stuff, nothing. She also said they were trying to get him to sign some papers and she told them he would not be able to sign anything until I got there. I don't actually know where he is right now. I suspect he's holed up back in the place he's been living.
I have so many questions, here are some of them:
Do I bother going at all or cancel this trip? I’d have to eat the plane fare but honestly that’s the cheapest part. I think I have one calendar change built in, so I could postpone it but, as above, it would be August before I could do it again. I'm freaking out now but then I could just be freaking out about the plane - I hate flying.
If he isn’t making any sense at all, what do I do then? The hospital has already booted him.
He obviously has to be moved out of the house where he is living but to where? Should he stay in the same town/ state? I’m thinking I could hire Craigslist movers, get a Upod and put everything in it, then send it off to storage. Or something like that. Then I could maybe get him into a short term rental while this all gets figured out? Or should I try to find a more permanent apartment or house for him, set up meals on wheels, arrange for his stuff to be delivered and hope for the best?
Or should he be in a facility of some kind? What kind? And, of course, who’s paying for this? I’m assuming he is but if not, well, then the options narrow very far indeed, because I do not have enough money to rent an apartment or house. In that case, how do I get him into some kind of facility? Is it even possible? His friend will not let him move in, she has made that quite clear.
I am thinking that he needs to be in assisted living but are they going to be able to cope with someone with bipolar and possibly schizophrenia? (that is what his friend says the most recent hospital report said.) Or should he be in a memory care facility? Or a group home? How does this even work?
Or, should I try to move him across the country to a facility or apartment here? I also live in a rural area and there are not a lot of options either place. I feel like that’s the best long-term option - if he’s here at least I can be involved in his care while if he stays I’m not going to be able to fly back to help out again - but the logistics seem insurmountable. Like, how can I move him across the country anyway? If he’s not coherent, I can’t imagine trying to take him on a plane. This is literally 3000 miles; driving is not an option. Once he’s here, how do I get him set up to even get into a care facility? He would need a new doctor, new everything. The mind boggles. And the housing issue remains: I do not have room for him at my house even for a weekend - we're overcrowded as it is.
I need a plan of action, some priorities, some suggestions. I am just overwhelmed and can't even figure out if the smartest thing for me to do would be to walk away. I mean, it probably would, but I would feel so guilty. I don't imagine that if the tables were turned he would lift one finger to help me out, so there is also that.
Thank you for listening and I appreciate any help you can offer. I have already spoken with the social worker at the hospital, she gave me a list of care homes and group homes and clearly felt that should be sufficient. I reached out to his lawyer - or, well, she used to be his lawyer - and she refused to speak with me or offer any help at all. I have tried to reach the council on aging for both his current county and the one I am in and have left messages, have not heard back. There is no NAMI Friends & Family chapter here - believe me, I have looked so many times.
I agree with your adult children.
I would rather live with thinking of myself as a heartless prick than drown in a quagmire of somebody else's making that I had no power whatsoever to drain.
posted by flabdablet at 2:38 AM on May 25 [5 favorites]
I would rather live with thinking of myself as a heartless prick than drown in a quagmire of somebody else's making that I had no power whatsoever to drain.
posted by flabdablet at 2:38 AM on May 25 [5 favorites]
You can't solve his problems in 3 days, but hopefully you can get some answers to key questions:
1. Who really has those POAs?
2. Does he have that pension or bank account? Social security, Medicare? You will need the person with POA to find out.
3. Maybe find his phone, or get him something cheap. A Tracfone can be prepaid and easily replaced.
4. Talk to the "landlords"? You might hear a very different story from them. Given the story, it sounds like he might be difficult and they want him out. But there are big advantages for a confused person to stay in the place they already know, especially if the alternative is the street.
Don't expect to get him a new place to live in your visit. But knowing what his resources are, and how coherent he is in person, are essential first steps.
posted by zompist at 2:56 AM on May 25 [16 favorites]
1. Who really has those POAs?
2. Does he have that pension or bank account? Social security, Medicare? You will need the person with POA to find out.
3. Maybe find his phone, or get him something cheap. A Tracfone can be prepaid and easily replaced.
4. Talk to the "landlords"? You might hear a very different story from them. Given the story, it sounds like he might be difficult and they want him out. But there are big advantages for a confused person to stay in the place they already know, especially if the alternative is the street.
Don't expect to get him a new place to live in your visit. But knowing what his resources are, and how coherent he is in person, are essential first steps.
posted by zompist at 2:56 AM on May 25 [16 favorites]
This is sooooo hard. Part of the problem seems to be you get many emotional, distressed appeals from the friend and have limited/no factual information. And your brain is just running through scenarios. So start by taking some of the scenarios off the table.
Before you get there ask yourself what you are willing and able to do for him that is not going to cause your own life to implode?
Take anything else off the table as options you are willing to explore/pursue. For me that would mean no attempt to move him cross country for example. For you, it may be something else.
I would make the trip to do fact finding. You won’t be able to resolve anything. But you can learn a lot. If he is willing to cooperate get access to his bank account, figure out what income he has, who his medical providers are, perhaps get him to nominate you as someone they are allowed to talk to. Even if he doesn’t, if you know who they are you can call them and tell them about your concerns. Formal POA would likely take more than the time you have.
Talk to the landlord and get their view of things. Get a look at his living situation. If he is in a trailer there is a good chance there is nothing much to pack up and store if he has to leave (either now or in the future) may just need clearing and dumping, etc.
Talk to the friend. Are they lucid? Do they have any in home support themselves? If so who provides it?
Meet with the social worker at the hospital. Get them to point you to any and all local support services.
Is there a local church. Even if he has never attended they may have information on support options.
You won’t be able to resolve anything much during your visit but what you learn will allow you to be more targeted in your efforts from a distance.
posted by koahiatamadl at 3:17 AM on May 25 [10 favorites]
Before you get there ask yourself what you are willing and able to do for him that is not going to cause your own life to implode?
Take anything else off the table as options you are willing to explore/pursue. For me that would mean no attempt to move him cross country for example. For you, it may be something else.
I would make the trip to do fact finding. You won’t be able to resolve anything. But you can learn a lot. If he is willing to cooperate get access to his bank account, figure out what income he has, who his medical providers are, perhaps get him to nominate you as someone they are allowed to talk to. Even if he doesn’t, if you know who they are you can call them and tell them about your concerns. Formal POA would likely take more than the time you have.
Talk to the landlord and get their view of things. Get a look at his living situation. If he is in a trailer there is a good chance there is nothing much to pack up and store if he has to leave (either now or in the future) may just need clearing and dumping, etc.
Talk to the friend. Are they lucid? Do they have any in home support themselves? If so who provides it?
Meet with the social worker at the hospital. Get them to point you to any and all local support services.
Is there a local church. Even if he has never attended they may have information on support options.
You won’t be able to resolve anything much during your visit but what you learn will allow you to be more targeted in your efforts from a distance.
posted by koahiatamadl at 3:17 AM on May 25 [10 favorites]
Forgot to say - as a result of what you learn you may also decide to walk away - that is a valid option. If you do it as a result of what you learn, you will hopefully feel less guilty. You tried to help, assessed the situation and had to realise it requires more than you can give. Clearly, that is also a valid conclusion if you don’t go on the trip. But it sounds as if part of the problem is lack of information. So I’d find it helpful to get that information and then re-assess.
posted by koahiatamadl at 3:31 AM on May 25 [5 favorites]
posted by koahiatamadl at 3:31 AM on May 25 [5 favorites]
I have a brother who is younger but very similar. He has been in institutional care for decades, varying from full on hospitalisation to halfway-house sorts of placements depending on how he is doing. There's a lot about that that isn't ideal, but at least it keeps him fed and sheltered and with medical care and not in jail where he would be incredibly vulnerable. Key to this arrangement was my parent managing to get him on SSDI. Like your brother, mine had worked a well paying job for a while when he was younger and more functional, and my understanding is that means his SSDI payments are pretty good, so that together with Medicare/Medicaid pays for his institutional care. So I would suggest looking into that route for your brother, perhaps start by discussing with social worker? It could be the best bet for long term support for him that doesn't require you to be trying to do continual crisis management.
posted by Rhedyn at 3:54 AM on May 25 [11 favorites]
posted by Rhedyn at 3:54 AM on May 25 [11 favorites]
Let me first say that I heartily second CMcG's comment. You feel the desire to do something so *do a little something.* Don't overextend yourself and go beyond your capacity to help, but also don't ignore this little voice inside you that's saying "but he's my brother, I want to help him." IMO that voice is sacred, it's the divine in humanity. Don't ignore it.
I think one aspect of this which you need to think about and address is the dynamic of your brother's friend who takes care of him and keeps calling you to come help. This is not a healthy dynamic. All three of you (brother, this woman, and you) are caught up in a an ugly triangle of abdicating responsibility for self.
Let me explain what I mean.
- your brother is obviously unable to care for himself and has completely fucked up his life by ruining relationships with everyone who might be able to care for him. He had years and years and years to make a phone call to you while he was still lucid .. and he didn't. He could have asked for help years ago... And he didn't. He abdicated all responsibility for making his own life right. Now he wants others to rescue him from himself.
- your brother's friend has thrown responsibility for herself away and overextended herself, and is now feeling overwhelmed. Instead of taking this as her cue to step back and do less for your brother, she is still driving herself crazy and is now desperate to push this load off onto someone else, so she keeps calling you and pressuring you to take the burden off her. She has abdicated responsibility for managing her own obligations and wants you to rescue her from herself.
- you feel an urge to abandon yourself and rush to the rescue of BOTH these people. You're spending more money than you can afford already, even just at this very first stage of trying to help! WHAT ARE YOU DOING?! You're becoming like them: abdicating responsibility for your own self, making sacrifices you can't afford, overextending yourself to rescue other people (your brother and his friend). You're well on your way to turning around and blaming others in your family for leaving you alone to manage your brother, and pressuring them to come rescue you from yourself.
Listen to me. Don't do that. Don't fall into the trap of self-abandonment. Take care of yourself first. Be thoughtful about what you need to do and what you CAN do.
What you need to do:
Have boundaries. (no need to set boundaries "with others" but have them for yourself.) Boundaries like:
- I have this much money and this much time to spare to help my brother. I will think of ways to stick to this budget and aim for the greatest impact within these limitations.
- I will no longer accept calls from my brother's friend. Instead I will call her on a monthly basis to get updates. There's nothing I can do to help her. She is the master of her own fate. I will encourage her to have boundaries for herself but that's all I owe to her. Her pressure tactics will not work on me.
Use your resources wisely to help your brother. Work to multiply your brother's sources of help, within your means.
- Use some of your budgeted time and money to reach out to other members of the family and ask for their help. Make it easy for them to help by setting up a GoFundMe or just a venmo or whatever that they can donate to.
- Use some of your budgeted time and money to get Medicaid and other state/local/federal government case workers involved. (Make it clear to them that your brother is estranged from everyone and has nobody to help, and that you're just doing bare minimum for exactly three days. Otherwise they will factor you into their support plan for your brother.)
Step back and step away. Remember that you're brother is estranged from your family. That was his choice and his decision. Honor the divine humanity inside you by reaching out *a little* to help *a little*, but respect yourself too. He's not actually your brother, by his choice. Keep that in mind if you start feeling overwhelming pressure to rescue him.
posted by MiraK at 4:11 AM on May 25 [15 favorites]
I think one aspect of this which you need to think about and address is the dynamic of your brother's friend who takes care of him and keeps calling you to come help. This is not a healthy dynamic. All three of you (brother, this woman, and you) are caught up in a an ugly triangle of abdicating responsibility for self.
Let me explain what I mean.
- your brother is obviously unable to care for himself and has completely fucked up his life by ruining relationships with everyone who might be able to care for him. He had years and years and years to make a phone call to you while he was still lucid .. and he didn't. He could have asked for help years ago... And he didn't. He abdicated all responsibility for making his own life right. Now he wants others to rescue him from himself.
- your brother's friend has thrown responsibility for herself away and overextended herself, and is now feeling overwhelmed. Instead of taking this as her cue to step back and do less for your brother, she is still driving herself crazy and is now desperate to push this load off onto someone else, so she keeps calling you and pressuring you to take the burden off her. She has abdicated responsibility for managing her own obligations and wants you to rescue her from herself.
- you feel an urge to abandon yourself and rush to the rescue of BOTH these people. You're spending more money than you can afford already, even just at this very first stage of trying to help! WHAT ARE YOU DOING?! You're becoming like them: abdicating responsibility for your own self, making sacrifices you can't afford, overextending yourself to rescue other people (your brother and his friend). You're well on your way to turning around and blaming others in your family for leaving you alone to manage your brother, and pressuring them to come rescue you from yourself.
Listen to me. Don't do that. Don't fall into the trap of self-abandonment. Take care of yourself first. Be thoughtful about what you need to do and what you CAN do.
What you need to do:
Have boundaries. (no need to set boundaries "with others" but have them for yourself.) Boundaries like:
- I have this much money and this much time to spare to help my brother. I will think of ways to stick to this budget and aim for the greatest impact within these limitations.
- I will no longer accept calls from my brother's friend. Instead I will call her on a monthly basis to get updates. There's nothing I can do to help her. She is the master of her own fate. I will encourage her to have boundaries for herself but that's all I owe to her. Her pressure tactics will not work on me.
Use your resources wisely to help your brother. Work to multiply your brother's sources of help, within your means.
- Use some of your budgeted time and money to reach out to other members of the family and ask for their help. Make it easy for them to help by setting up a GoFundMe or just a venmo or whatever that they can donate to.
- Use some of your budgeted time and money to get Medicaid and other state/local/federal government case workers involved. (Make it clear to them that your brother is estranged from everyone and has nobody to help, and that you're just doing bare minimum for exactly three days. Otherwise they will factor you into their support plan for your brother.)
Step back and step away. Remember that you're brother is estranged from your family. That was his choice and his decision. Honor the divine humanity inside you by reaching out *a little* to help *a little*, but respect yourself too. He's not actually your brother, by his choice. Keep that in mind if you start feeling overwhelming pressure to rescue him.
posted by MiraK at 4:11 AM on May 25 [15 favorites]
Also, if you want to try to get a long term sustainable solution in place, you probably need to get an appropriate lawyer and apply for conservatorship so that you have financial and healthcare decision making authority. Whether you choose to take that on is a decision only you can make. I would not do it for my brother based on my own family experiences, but I give my father some credit for taking it on given that he has not been a very good father otherwise. In your situation maybe I would, but you are the only one who can evaluate what you can manage and what feels right to you.
posted by Rhedyn at 4:29 AM on May 25 [1 favorite]
posted by Rhedyn at 4:29 AM on May 25 [1 favorite]
So much if this is going to depend on factors outside of your control. And you are right that moving someone 3000 miles is not a good idea.
Big picture things to concider or ask questions about:
- is this mental illness or is there a neurodegenerative component involved such as forms of dementia. This will significantly impact treatment options, placement and outcomes
-Is there a co-occurring substance use or alcohol user disorder component? This will also impact facilities that he can go to. If there is long term alcohol abuse you have to be aware of things like Wernicke-Korsakoff Syndrome which can impact cognition.
-previous treatment, had he been evaluated by anyone in Geriatric psychiatry?
- what are his other health issues?
It is possible at this age he may qualify for facility placement of some kind but it is really going to depend on the factors above.Also though many facilties aren't locked units. So if he decides he wants to go he can litterally walk out front door.
Other things:
The HcPOA is fixed unless your brother is well enough to revoke it. Or the person who is the poa and all named alternates refuse. Who has decision making rights in that situation depend on state law. But you may never actually be his legal decision maker. Even if you move him across the country residual if the POA wants to remain involved.
Insurance will play a big role and litteral healthcare access based on how rural he is. Depending on the location there may just not be options.
If he doesn't have medicaid he doesn't have insurance that covers long term care.
You don't have to rescue your brother from his choices. You can try to create a coherent summary of what's going on, who is involved and what resources may or may not be available.
* This is a US perspective
posted by AlexiaSky at 6:51 AM on May 25 [3 favorites]
Big picture things to concider or ask questions about:
- is this mental illness or is there a neurodegenerative component involved such as forms of dementia. This will significantly impact treatment options, placement and outcomes
-Is there a co-occurring substance use or alcohol user disorder component? This will also impact facilities that he can go to. If there is long term alcohol abuse you have to be aware of things like Wernicke-Korsakoff Syndrome which can impact cognition.
-previous treatment, had he been evaluated by anyone in Geriatric psychiatry?
- what are his other health issues?
It is possible at this age he may qualify for facility placement of some kind but it is really going to depend on the factors above.Also though many facilties aren't locked units. So if he decides he wants to go he can litterally walk out front door.
Other things:
The HcPOA is fixed unless your brother is well enough to revoke it. Or the person who is the poa and all named alternates refuse. Who has decision making rights in that situation depend on state law. But you may never actually be his legal decision maker. Even if you move him across the country residual if the POA wants to remain involved.
Insurance will play a big role and litteral healthcare access based on how rural he is. Depending on the location there may just not be options.
If he doesn't have medicaid he doesn't have insurance that covers long term care.
You don't have to rescue your brother from his choices. You can try to create a coherent summary of what's going on, who is involved and what resources may or may not be available.
* This is a US perspective
posted by AlexiaSky at 6:51 AM on May 25 [3 favorites]
I'm astonished that you took the narrative about the landlords taking advantage of your relative at face value.
It sounds to me like the landlords are his de facto caretakers now, and have been extremely accommodating of him. I can't possibly imagine these people are making enough money off of him to make all of this trouble worthwhile, when they could presumably just get another tenant.
I strongly, strongly suspect they are doing what they can to help him, and because of his mental illness he is misinterpreting their efforts as nefarious. I have no doubt your relative is calling his older disabled friend and pleading for her help and she is buying his story, probably because she herself is elderly and confused and doesn't understand what's going on.
In actuality, the landlords sound like the most able, responsible people in this situation. I don't see how they could possibly be benefitting in any way from this situation and strongly encourage you to question that narrative and make allies of them. Perhaps wresting back control from them was a huge mistake.
posted by stockpuppet at 10:57 AM on May 25 [5 favorites]
It sounds to me like the landlords are his de facto caretakers now, and have been extremely accommodating of him. I can't possibly imagine these people are making enough money off of him to make all of this trouble worthwhile, when they could presumably just get another tenant.
I strongly, strongly suspect they are doing what they can to help him, and because of his mental illness he is misinterpreting their efforts as nefarious. I have no doubt your relative is calling his older disabled friend and pleading for her help and she is buying his story, probably because she herself is elderly and confused and doesn't understand what's going on.
In actuality, the landlords sound like the most able, responsible people in this situation. I don't see how they could possibly be benefitting in any way from this situation and strongly encourage you to question that narrative and make allies of them. Perhaps wresting back control from them was a huge mistake.
posted by stockpuppet at 10:57 AM on May 25 [5 favorites]
My sister has schizophrenia and has required much family assistance.
I think there is quite a bit of prep-work you can do before your flight:
You mentioned that you have doubt that your sibling was fit to be released from the hospital. Most hospitals have client advocates. You could call the hospital and talk to the client advocate. They might not be able to tell you much without an ROI (release of information signed by the patient), but it might still be worth contacting them. You could even have them email an ROI form to you and you could fill it out and, when you see your brother, see if he is willing to sign it. ROIs don't need to be notarized.
When my sister was in the hospital, I found a financial power of attorney form online and printed it out. I then signed it and mailed it to the hospital, where my sister signed it, and the hospital's notary notarized it, and then they mailed it to me. Once I had it in hand, I was able to gain access to my sister's bank account. (Eventually, I replaced this with a POA.)
Have you tried phoning NAMI's main information line? 800-950-6264. Also, there are online NAMI meetings.
Is there a mental health agency located reasonably near you that you could contact for general advice?
You could contact DSHS for the state you live in or he lives in to see if they can provide assistance or advice.
I also recommend that you go ahead and contact those on list of care homes and group homes that was given to you. Perhaps they can provide some advice and point you in the direction you need to go.
You might try googling "behavioral health ombuds" for your state (for example, "behavioral health ombuds Oregon" [or whatever state]) to get their contact information, and then browse their website for information, and contact them to see if they can offer advice or resources.
I got POA for my sister via a one-time visit to a lawyer. For this, you wouldn't need to use to the uncooperative lawyer that you mentioned in your ask. You could probably do this in your town. The lawyer I used wrote up the document without my sister needing to be there or even needing to know that I was meeting with a lawyer to have the document written up, and then my sister and I went together to a notary to sign it and have it notarized. The whole process was not complicated and did not take much time. (However, my sister was cooperative, which may or may not be the case with your sibling.) It wasn't cheap (around $500), but it certainly has paid off.
posted by SageTrail at 12:06 PM on May 25 [6 favorites]
I think there is quite a bit of prep-work you can do before your flight:
You mentioned that you have doubt that your sibling was fit to be released from the hospital. Most hospitals have client advocates. You could call the hospital and talk to the client advocate. They might not be able to tell you much without an ROI (release of information signed by the patient), but it might still be worth contacting them. You could even have them email an ROI form to you and you could fill it out and, when you see your brother, see if he is willing to sign it. ROIs don't need to be notarized.
When my sister was in the hospital, I found a financial power of attorney form online and printed it out. I then signed it and mailed it to the hospital, where my sister signed it, and the hospital's notary notarized it, and then they mailed it to me. Once I had it in hand, I was able to gain access to my sister's bank account. (Eventually, I replaced this with a POA.)
Have you tried phoning NAMI's main information line? 800-950-6264. Also, there are online NAMI meetings.
Is there a mental health agency located reasonably near you that you could contact for general advice?
You could contact DSHS for the state you live in or he lives in to see if they can provide assistance or advice.
I also recommend that you go ahead and contact those on list of care homes and group homes that was given to you. Perhaps they can provide some advice and point you in the direction you need to go.
You might try googling "behavioral health ombuds" for your state (for example, "behavioral health ombuds Oregon" [or whatever state]) to get their contact information, and then browse their website for information, and contact them to see if they can offer advice or resources.
I got POA for my sister via a one-time visit to a lawyer. For this, you wouldn't need to use to the uncooperative lawyer that you mentioned in your ask. You could probably do this in your town. The lawyer I used wrote up the document without my sister needing to be there or even needing to know that I was meeting with a lawyer to have the document written up, and then my sister and I went together to a notary to sign it and have it notarized. The whole process was not complicated and did not take much time. (However, my sister was cooperative, which may or may not be the case with your sibling.) It wasn't cheap (around $500), but it certainly has paid off.
posted by SageTrail at 12:06 PM on May 25 [6 favorites]
p.s. I picked a random southern state, did a google search, and found this list of regional offices. I bet you could do the same for whatever state your sibling lives in. (Once you open the link, scroll down past the search field to see the list.)
posted by SageTrail at 1:45 PM on May 25
posted by SageTrail at 1:45 PM on May 25
I don’t know of anything quite as demoralizing as saying out loud that you want to voluntarily help someone who is suffering or in danger and getting as a response a string of people pointing out that you don’t HAVE to help him. it may be that you can’t. but anybody trying to convince you not to care is not your friend and will do no good for your mental state.
I do not know a lot of the specific legal answers you need. however if the son who wrecked his car (??) is one of the children telling you you don’t owe him anything, disregard his opinion in particular. for the rest of them…even the best of adult children start to think ugly private thoughts about ‘their inheritance’ when they see a parent of a certain age spending large amounts of money on someone they don’t like who is not them. it doesn’t mean they don’t care about you and doesn’t even mean they’re wrong. but there is a conflict there even if they are good people.
probably the best thing for you would be to get help from your other brother if he is a person with a guilty conscience that can be manipulated and money or time to spend. failing that, try to support his friend who’s actually there with such money as you can spare as long as she’s there doing her best for him. there is not much use in flying out there to move him with no place to move him to and no way to make him go.
in the worst case he may die or disappear before you see him again, no matter how hard you try. that will not be your fault. if that happens, the best possible thing for you will be to have someone to talk to who won’t congratulate you for not getting too involved or tell you that only suckers feel guilt or moral obligations. you are in an impossible situation but it is much easier to get through pain and irrational guilt when you are not being chided for listening to your best human impulses.
posted by queenofbithynia at 3:25 PM on May 25 [13 favorites]
I do not know a lot of the specific legal answers you need. however if the son who wrecked his car (??) is one of the children telling you you don’t owe him anything, disregard his opinion in particular. for the rest of them…even the best of adult children start to think ugly private thoughts about ‘their inheritance’ when they see a parent of a certain age spending large amounts of money on someone they don’t like who is not them. it doesn’t mean they don’t care about you and doesn’t even mean they’re wrong. but there is a conflict there even if they are good people.
probably the best thing for you would be to get help from your other brother if he is a person with a guilty conscience that can be manipulated and money or time to spend. failing that, try to support his friend who’s actually there with such money as you can spare as long as she’s there doing her best for him. there is not much use in flying out there to move him with no place to move him to and no way to make him go.
in the worst case he may die or disappear before you see him again, no matter how hard you try. that will not be your fault. if that happens, the best possible thing for you will be to have someone to talk to who won’t congratulate you for not getting too involved or tell you that only suckers feel guilt or moral obligations. you are in an impossible situation but it is much easier to get through pain and irrational guilt when you are not being chided for listening to your best human impulses.
posted by queenofbithynia at 3:25 PM on May 25 [13 favorites]
I have been in this position. Including a trip under a lot of pressure to get a lot done in a short time. My heart goes out to you.
1. Call up the landlords and ask for their assessment of his living situation and ability to manage his own affairs (finances, etc). You'll at least get more info than you have now.
2. If you want to, and if he agrees, think about getting durable power of attorney so you can do some things for him if needed. For example, you could use POA to pay bills from his accounts on a storage place, or rent at an assisted living place. Online sites have POA templates for every state. In many states, no lawyer is needed. Just a notary. If you go this route, learn what it takes for your brother to revoke any prior POAs. Make a laminated card for his wallet that has your contact info and lists you as durable POA.
3. Whether or not you have POA, another option is to accept that he's not emotionally or cognitively in a place to accept the kind of help you're able to offer him. In that case, you/he would be waiting for the next emergency to happen in order to get him into a safer and more stable living situation. This is common with ornery older folks. I had take this approach with my mother who refused to stop driving or accept help or move out of her huge house, even though she was unable to pay bills and hallucinating due to dementia, but not yet deemed by her county's aging services or sheriff to be a danger to herself or others. If you choose this option, you can still be helping him at your pace from afar while enduring this often agonizing wait, doing things such as using a geriatric social worker in his area to research appropriate assisted living/memory care places in his area and their criteria.
If it were me, I would be doing a combination of all 3 above.
posted by ImproviseOrDie at 9:09 AM on May 26 [4 favorites]
1. Call up the landlords and ask for their assessment of his living situation and ability to manage his own affairs (finances, etc). You'll at least get more info than you have now.
2. If you want to, and if he agrees, think about getting durable power of attorney so you can do some things for him if needed. For example, you could use POA to pay bills from his accounts on a storage place, or rent at an assisted living place. Online sites have POA templates for every state. In many states, no lawyer is needed. Just a notary. If you go this route, learn what it takes for your brother to revoke any prior POAs. Make a laminated card for his wallet that has your contact info and lists you as durable POA.
3. Whether or not you have POA, another option is to accept that he's not emotionally or cognitively in a place to accept the kind of help you're able to offer him. In that case, you/he would be waiting for the next emergency to happen in order to get him into a safer and more stable living situation. This is common with ornery older folks. I had take this approach with my mother who refused to stop driving or accept help or move out of her huge house, even though she was unable to pay bills and hallucinating due to dementia, but not yet deemed by her county's aging services or sheriff to be a danger to herself or others. If you choose this option, you can still be helping him at your pace from afar while enduring this often agonizing wait, doing things such as using a geriatric social worker in his area to research appropriate assisted living/memory care places in his area and their criteria.
If it were me, I would be doing a combination of all 3 above.
posted by ImproviseOrDie at 9:09 AM on May 26 [4 favorites]
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I don’t think you’re going to be able to solve any of these big problems with a three day visit, but you don’t have to solve these problems to be a comfort and support to your sibling.
posted by CMcG at 2:38 AM on May 25 [12 favorites]