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I'm sort of borrowing this topic from a recent post from MSA1163, where the bipolar sister lives with mom. Thank you for sharing your story.

I hadn't seen this particular dilemma discussed on this forum and wanted to explore this family dynamic further.

My family is in a similar situation. My sibling moved out of our parents' home as an adult, had a breakdown, moved back home. Moved out, had a breakdown, moved back home, etc.. For decades.

(I suppose 'breakdown' could be substituted with any number of health concerns--basically someone who cannot take care of himself.)

Finally when our parents grew too old to help him, they came up with the plan that my brother could be 'useful' to them in their home. So he moved back home one last time, and was trusted to 'help' with our parents. In trying to defend their long troubled son, they assured everyone that he was taking care of them. He wasn't. I discovered that he was taking advantage of them, treating them terribly, being verbally abusive, etc.

Now he's 66. My mom is 92, on hospice, has dementia and late stage CKD. My dad who was 92 w dementia passed recently. My mom used to cry about my brother, worrying what would happen to him when she passes. Now her dementia keeps her blissfully unaware. She is mostly bedbound and receives full time care.

I have another brother who is his POA. He has agreed to care for this other brother after our mom passes. But...we are not sure what that looks like yet. He can't live alone. That brother's wife does not want the mentally unstable brother to move in with them. The POA brother thinks he will be disruptive should he move into an apartment alone, possibly being kicked out, arrested, living on the streets...any and all of these are possibilities. Oh and this brother refuses any kind of treatment and doesn't take his meds.

So, we are still figuring things out. Our mom declines each week.

If anyone can share their experiences, what worked, what didn't, general thoughts on the subject, I would appreciate it very much.

Your brother, POA, does not have to physically care for or bring your 66 yr old brother into his home. Thats not the purpose of a POA. The POA allows your brother to help the other brother. Help him with finances, find him resources to help him live on his own. You brother needs to be evaluated. There are group homes for your brother. Here where I live the State buys up houses. Then they put people who need a place to live in them. They get a room and the kitchen and living room are a common areas. They come and go as they please.

What you need to realize is that your brother has a mental illness that he is unwilling to treat. You can't spend your life dealing with him if he won't do for himself. You may have to walk away at sometime for your own sanity and wellbeing.
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Reply to JoAnn29
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The mentally unstable brother needs to be aided by social services and medical professionals. Enabling/rescuing him does none of you any good. He may never learn to look after himself but he certainly won't when other people are doing it for him. And he has a disease which needs treatment.

As someone has mentioned there are group homes for people with mental health problems. If he refuses treatment or help then he suffers the consequence's. Your family/POA bro do not have to shore him up and prevent the consequence to him.

I know that seems harsh. Mental illness is very difficult to deal with and very hard on the family. In some ways it is like addictions. The afflicted person has to take responsibility for their actions. As family you play a part in that by setting appropriate boundaries and not allowing yourselves toi be used or to enable.

Wishing you the best in this difficult situation.
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Reply to golden23
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In addition to the answers you get her and MG8522 has some good thoughts on this...
You might want to talk to the Hospice Social Worker and see if they have any ideas that m ight help the family in this respect.
I suppose what might help in some respect is that he is a "senior" so he may qualify for some services.
Check with your local Senior Service Center and see if there are programs available.

I am afraid that with your comment that he refuses any kind of treatment and he will not take his meds there is not much you can do.
You can not help someone that does not want help...
I am sorry to say that you steel yourself to the fact that this will probably not end well.
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Reply to Grandma1954
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Here's the two choices for your mentally ill, abusive brother who cannot live on his own.

He agrees to your other brother being appointed as his legal conservator/guardian (you DO NOT want this) and he agrees to move into a group home, or a supervised-living apartment situation. The rent will be based on his income. If he is mentally ill he should be on disability.

Or he can get tent and find a bridge to live under.

These are the choices. Don't allow yourselves to be guilt-tripped or pulled into his manipulative games like your parents did. He weasled his way back in with them over and over then behaved abusively to then when they gave him a home and provided for him. Your bedbound mother is still taking care of him.

He refuses to take meds? Throw him out. Get him served with eviction if you have to. People like your brother manipulate and intimidate others to get what they need and want. They think everyone and the whole world owes them when it doesn't. Your mother deserves to have some peace in the last days of her life. When he acts up or gets verbally abusive, call 911 and tell the police he's making threats against you, your mother, and himself. This will let him know that you and your other brother are serious and that his manipulative games will not be tolerated.

I believe I told MSA1163 something similar that I will tell you now. Even adults with mental illness have to take some responsibility for themselves and be pro-active in their own lives. Your brother is a 66 year old adult who I am going to assume is not special intellectual needs (I'm not sure what the new and proper term for 'retarded' is these days). He can take some responsibility for himself, his bi-polar disorder, and his own life.

Your brother and yourself need to sit him down and tell him what I just posted for you. If he refuses, let he chips fall where they may because he cannot be moved into either of your homes.
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Reply to BurntCaregiver
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Because your brother is POA does not mean he is obligated to physically care for his brother or have him in his house. I would not want someone like this in my home. You may want to call Adult protection services in and have the State take over brothers care. Any money he inherits will keep him from getting any services until its spent down. You may want to talk to an elder lawyer about this. People with mental problems usually have Dementia later on. This mixed with mental problems is not a good thing.

I have a nephew who was born with multiple physical problems and a neuroligical problem. He, for now, is living on his own with the help of the State. They pay 70% of his rent. He has a coordinator and an aide once a week that cleans and helps him run errands. I am still his POA and oversee his money. I am sure though, if I was not POA, that a conservator would be assigned to him. He receives Social Security Disability, Food Stamps, Medicare and Medicaid. I am 76 and got him set up with the State because one day, I am not going to be here. He needs people. The State will eventually take over his care and that is what the POA needs to let happen.
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Reply to JoAnn29
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The most practical "solution" might be for your brother to resign his PoA (since you can't get an uncooperative adult to do things they resist anyway) and report the mentally unstable brother to APS until his condition warrants intervention by them. They will move to get a court-ordered 3rd party legal guardian to manage all his affairs and make decisions on his behalf. They will get him facility care, and it will be paid for by Medicaid and what little SS income he makes, if any.

I would call his county's social services and have this discussion.

This is a distressing situation and I"m sorry everyone in your family has to suffer through it. I wish you clarity, wisdom and peace in your hearts as you make decisions.
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Reply to Geaton777
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Basically, as someone whose extended step family deals with a mentally ill younger family member I can tell you that there is almost no answer for mental illness in America. Our streets full of homeless, who are often mentally ill and self medicating with alcohol and drugs, prove this. And I see it constantly. Many people suffering mental illness don't want to take medications. And they are not stable without them. And as they are adults with choices, asylums being long a thing of the past, the repercussions on families is enormous. Parents are left with a decision to see their child ill and homeless OR to attempt to help. The attempts are almost always without a lot of success.

Along with children is the fact that in some cases, where heretofore a diagnosis of dementia would come for a spouse of an troubled elder, now it is often a dx. of "bipolar" for which there is little help and no ability to intervene as guardian of said ill spouse. We currently have this situation with a dear friend.

I tell all to read Liz Scheier's memoir, Never Simple. It shows a woman who worked along with the auspices of the social services of city and state of NY to intervene for her mentally challenged mother for decades and until the mother's death.
TO NO AVAIL.

While it will help no one, this memoir will set in stone in your brain that in dealing with mentally ill members of our society in America there is almost ZERO help, and very few answers.
I wish I had better news. I spent my life as a nurse, and I saw a lot, and the devastation of mental illness changes families drastically, and always for the worse.
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ShirleyDot Oct 10, 2025
I was about to post almost exactly what AlvaDeer did here. There is no true interventional help for the mentally ill in this country until they become violent, and then they may simply end up in jail because there are so few spaces available in psychiatric facilities for long-term patients. It is a travesty and a shame that we allow people to "choose" to live like animals because they are mentally ill.
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Perhaps your other brother will find a way to find care for you mentally ill brother. I hope so, but I really don't know what will work. I witnessed a situation next door to me where the mom died and the mentally ill son was given a caregiver by his guardian sister who lived out of state. That caregiver invited his homeless druggies over a lot and eventually they moved into the house and yard. Police were there a lot. After a few years of that mess, the house was raided, condemned, and all were arrested. The son turned up at my door several times over the next year, thought that house was still his, was totally confused, filthy, and asking me to help him. I would not let him in my house, as he was known to be violent and inappropriate. His sister apparently resigned as his guardian. He did know his social worker's phone number who told me the son was supposed to be living in a homeless shelter, but kept leaving or getting kicked out for his behavior and wouldn't take his meds. The social worker picked him up. I haven't seen him since the last time he was here. Even though the house next door was sold to a realtor, interior torn out, fumigated, remodeled, and sold again to a very nice young couple, for me that house will always stand for a complete failure of the system.
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SnoopyLove Oct 10, 2025
Wow. So sad for him and awful for the neighbors. We need to bring back the asylums again, unfortunately.
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Your brother’s inheritance should go to a special needs trust, not to him directly. To qualify for Medicaid as an aged person, he can only have $2000 in liquid funds. Also, he will be entitled to $987 in combined SSA/SSI monthly funds if he meets certain factors (less than $2000 liquid assets, is paying his fair share of HH expenses or fully funding his HH expenses-which will happen after Mom dies). See an elder care attorney to be sure that you are setting things up correctly for him to benefit from social programs that would benefit him.
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Reply to SSAretired
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Many thanks again to all who have responded.

The POA brother actually asked the unstable brother the other day "what are you going to do when mom passes?" The POA is not forceful enough, not for me anyway. The POA should have said, "This is what is going to happen after mom passes." The unstable brother would have whined and fussed. But if it were me, I would just stick a for sale sign in the yard.

Brandee, you make an excellent point: In the US it is legal to have unmedicated mental illness. That is exactly what is going on here.

I do wonder if there is autism going on as well. He seems unaware of the magnitude of the situation. He lives in his own world, thinking about his own life.

And I do feel my role in all of this is protecting my mom and giving her peace. She only seems to recognize the POA brother. When she sees anyone else she just looks at them. But last week, to the POA brother, she perked up and asked, "Where's dad?" meaning our dad who passed at the beginning of September. So seeing the POA brother triggered memories of my dad.

The POA had a repair man to look at the roof of our parents' house, plus the overall exterior, just yesterday. So that is promising. I do feel the POA wants to sell the house.

And I don't know if the unstable brother's dr has determined him "officially mentally ill" to get disability. From what I understand, he was only given meds for depression, and he's probably not taking them. Depression is not even 1% of the problem.

But I know he thinks no matter where our brother ends up, group home, apartment, under a bridge, he will cause trouble.

Mom is still bedbound and coughing more. But still has a hearty appetite, which confuses me, because her mind and body continue to decline. She is 92 w dementia and chronic kidney disease, stage 3-4. One leg is swollen but not bothering her. She's only taking Seroquel, anti-depressant, and as needed Haldol. Every 5-6 weeks she has an "episode" where she talks to no one non stop for hours. And occasionally she will talk in her sleep, once a night.

But the good thing is that she has no idea what is going on outside of her bedroom. She no longer worries about the unstable brother. She used to cry her heart out over him. Now she is not concerned. I'm glad for her.

Thanks again.
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