My brother is 65, has been on disability for many years due to diabetes and severe depression. He lives alone in a two story home that is falling apart. You can't even see the floors in his house because of all the trash and papers he throws around. He has old food containters everywhere and the house is roach infested. We live 2 hrs away. We have arranged (twice) for him to go into a retirement home and both times he has turned it down. We have tried to get him counseling which he tried for two sessions then gave up because they would not do what he wanted. He is very selfish and manipulative. He does not go out much, stays home, watches TV, eats alot and sleeps alot. We are very concerned about him, but he refuses all of our suggestions. To talk to him, he sounds competent enough, but he is neglecting his own care. He rarely bathes and doesn't clean up after himself. His house is filthy! Is there anything we can do to get him some help or intervention? We have actually tried to clean his house and even had others come in to clean and it stays that way for a short time but because he does not clean anything, it quickly becomes a trash site again. We are at a loss as to how to help. He has gained a lot of weight and often talks about wanting to end it all. Sometimes he sounds serious, but most of the time he jokes about it. He is very difficult to be around. He has no social skills and does not do well around crowds of people.