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We have been taking care of him for four years and we really need help.

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What kind of help you need depends upon where he lives. With you? Alone? What are his needs? How progressed is the dementia?
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Hi DiamondD
How old is your brother? Is he retired? Does he live with you and your husband?
Tell us more about the situation.
You can contact the area on aging and ask for a needs assessment and where you can get the help they suggest he needs.
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