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Unfortunately there is not much you can do at this point.
You wait until there is a "health crisis" then maybe you can step in. If he is hospitalized you might be able to say that to discharge him to his house/home is unsafe and he does not have an acceptable care plan for his recovery. This would not prevent him from signing himself out "AMA"

In order to "force" him to do anything you would have to have him declared incompetent. Is he? If not then there is not much you can do.
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Do you think he has a sound mind? The bar for this in legal and medical terms is pretty low. If he does then you can’t make him accept help or do anything to change his situation. Hard as iti is to watch and not be able to help, you’ll have to wait for a crisis to be able to step in
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Hoarding is a mental disorder. I think it would help to speak to a therapist who specializes in hoarding and get perspective and advice on how to approach him. Like Grandma1954 said there's not much you can do from afar and if he's not diagnosed as incompetent. I wish you all the best as you try to help him.
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What do you want to do?

Not everyone wants to be rescued from their chosen ways.
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Shell38314 Jun 2020
Ain't that the truth!!! Some people are just happy as a clam to lay into their own crap!
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I hear you!

My sister suffered a stroke & cannot care for herself but she does not realise her level of function - Doctor called it *lack of insight* medical name Anosognosia.

(Definition: Anosognosia is a lack of ability to perceive the realities of one's own condition).

One family member organises home aides which she has accepted. If that person becomes ill, or she refuses the aides, I will be in your position. This has caused me great stress & I have sought help from many professionals. They all agreed. It is an unfortunate situation but she has rights. Can make good or bad choices for herself unless proved incapable by a Psychiatrist (using in-depth psycho testing). If so, a legal Guardian would need to be appointed by the court.

In order to help myself I sought councelling & spoke with her Doctor, both of which helped. By realising what I can & can't do I am now better at living my own life. The plan worked out is for me to be an ADVOCATE for her needs when a crises comes. I may/may not be able to avert or save her from sinking but can call in professionals to help her.

In a nutshell, the Doctor called it *the right to rot*. She said I was *awaiting a crises* to effect change. So go live my life. Be her advocate when she needs one.

I don't know if I can help you, but I understand. (((Hugs)))
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There is nothing you can do for your brother if he is competent. Not a damn thing you can do. I’m living this hell right now with my almost 96 year old mother. She is a hoarder and a gambling addict. She spent all of my fathers retirement money. All gone. She lives in her hoarded mess alone in her house. She wants no help. I was told by social workers and adult protective services that there is NOTHING and I mean NOTHING I can do about getting her out of that hell hole she lives in by herself. She won’t bathe and she won’t let me help her. I see her once a week and my son goes over 3 days a week to take out her garbage, bring in her mail, and go grocery shopping for her. I stopped doing it for her because I don’t do it “right”. I do everything “wrong”.
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