Hello everyone:
I am new here. I have read various articles, posts and comments. They have been helpful.
My situation:
I am 61. No spouse/children. I have been a caregiver twice in my life. My mother for 13 years and middle brother for a year or two. Both are deceased.
My remaining relative is my older brother, 73. He was living in his house. His wife died 2 years ago and his son in 2020.
He was not taking care of himself. The house was in decline (no hot water, refrigerator and stove not working, not able to do maintenance, mold and electrical issues, pest issues and a dog (my nephew's) he did not want.
Due to covid, I did not visit very much. We spoke several times a week. I asked him if he needed help. Answer, no, I am fine. His decline became more noticeable late summer.
Ordering out all the time, needing bug spray, etc.
I did not realize how bad it was until he was sent to the hospital as he could not breathe.
He had an issue with a weak knee/leg and unable to put weight on it. He was struggling to care for self. Not allowing groceries to be delivered, etc..
Once sent to hospital, I was able to get into the house.
It is not fit for him to return to unless extensive work is done. Just to clean, sanitize and gut house is $3,400.00.
Needs a plumber, electrician, stove/refrigerator before he can return. House is locked up and I cleaned what I could. The dog was given to a no kill shelter for rehoming.
The house is too much for me. Only hoarding professionals can clean that house. He has no savings for this, just SS.

Currently he is in short term rehab for the past 20 days.

Rehab wants to discharge as it does not have Medicaid beds.
He needs more time in rehab than he has been given. He is just being able to bear weight on leg for a brief time, then it gives out on him. He cannot live at his home at this time.
Maybe in a few months but not now. The house is in his deceased wife's name. There is still a large mortgage. Only 5 years equity. He was paying his bills and is capable of understanding and making decisions.
His options as I see them:
1. Go to back home-not good (needs work)
2. Live w/me TEMPORARILY while he gets in home rehab to strengthen the knee. Then search for senior living options (waiting lists for senior housing)
3. Go to a NH that takes Medicaid for more rehab until a senior living arrangement can be made. He is under the limit.
4. Pay co-pay at rehab for 21-100 days under Medicare (this may not be affordable)

Frankly, I do not want to be his caregiver in my home. He was not there for Mom, brother nor me. I have been working on my resentment. He calls when he wants something. I help some but set boundaries. He has lost his support system (sis in law did everything) so I do not want to turn my back on him. I must also take care of self. I have issues too.
Our personalities do not mesh. I wanted to do some work on my house now that I am retired. He comes here, it will not get done. This will be my 3rd go around in caregiving. This would be more difficult because he would be resistant and dismissive.
He could get in here and refuse to move to a place. He can be argumentative. So can I. We do better at a distance.
I have some emergency savings that I was going to use
for work in my house. I also have retirement funds that I had not planned to touch for a while. I do not want to use for this. Even if house is repaired, if he does not care, he will be right where he started and money wasted. I do not have money to waste.
I asked him what does he want to do? He says he wants to be independent. He will be speaking to SW on these issues tomorrow. I have not spoken to SW nor has he asked her to contact me as he makes his decisions.
Any thoughts?

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If he is of sound mind, i.e. he is NOT mentally incompetent, you cannot make him do anything. Most likely he will only want to go back to his hoarder home (and be pissed that you cleaned it) so let him and don't get involved... he doesn't want your intervention (you stated so yourself). It will just be a waiting game. When it is bad enough and he is either no longer able to perform his ADLs or he has a more profound medical emergency, call APS and report him as a vulnerable adult. That's literally all you can LEGALLY do. His crappy life is of his own voluntary choosing. It doesn't matter that you don't agree with it. Let him have it -- and move on to have a happy, healthy life. For some problems there are just no good solutions. Blessings.
Helpful Answer (8)

My brother is now in a nursing home about 20 minutes(up the road) away.
He was denied the appeals for Medicare rehab beyond 20 days.
His NH accepts Medicaid. He privately paid for rehab for 13 days while awaiting his 2nd decision.
He has been in his facility for 2 months. In the last 3 months, he has been covid tested many times, vaccinated, gained weight, his diabetes and high blood pressure are under control. He has a cna who has taken him under her wing. He gets physical therapy(which he enjoys) although the sessions have been reduced due to the limitations of Medicaid. He "works out" in his room. Leg stretches, arm curls...passes the time, I think.
He still cannot walk but so far with the walker.
He has a tv and cd/radio player with all his favorite cd's. Brother's not a reader. He never wanted a cell phone but now is getting used to it. His floor does not have phones in their rooms(weird).
He likes the food for the most part and since he's higher functioning, discusses what he like or dislikes with the dietitian. He is able to make his feelings known to staff and in care meetings.
His NH has reopened to in person visits this week, the dining room, hair salon and outdoor patio are open. In room visits...not
yet. I am vaccinated and he is too. Visits are limited to 30 minutes.
He is still by himself in his things change with the pandemic that will probably change.

Only been 60 days, the staff thinks he has adjusted so far....let's
see at the 90 day, 6 months or a year from now. Take it a day at time.
Will he be able to live on his an apartment, who knows?
Question is, does he want the responsibility?
Meanwhile, his house is being taken over by a niece. She's had it cleaned out and is willing to take over the mortgage payments(brother has paid the arrears) until she is able to assume the mortgage. She is unhappy with the living situation she is currently in. She's raising 2 grandchildren. She wants to keep it in the family.
He now longer wants to live there ...too many memories of loss.

We speak several times a week and I visit when I can. I get him what he needs and asks for... which he pays for. He says he is being cared for. I've said to him to try to stay as independent as possible and speak up. The SW at the NH knows that I am not his POA but I am the person of contact as well has the niece. I am notified of any changes and am present at care conferences.
At this point, I am his sister and advocate.

For me, I am working on my house(projects that need attention).
Getting out and about more and longer. Safely.
Yesterday, a vaccinated friend of over 40 years and I had lunch at my house unmasked on my patio until it rained, then inside. We celebrated our birthdays (mine April, hers May)...both 62.
We ate, laughed and ate some more. Felt good for both of us.
Memorial day, I'll see my brother with some lunch and cake.
Day at a time...
Helpful Answer (8)
Beatty Jun 2021
Happy Birthday MusicLover61.. (now 62) 🎂

That has to be one of the THE best updates I have read. No magic wand, everyone 21 again but real outcomes from real choices.

I love how you say you are his sister & advocate!!

I love that your brother has adapted so far, thinking positive & is making progress with his health & fitness goals.

It also shows that staying in your own home, alone, is not always the answer for everybody. Some thrive in a new setting. With more social connections. For those able to consider CHANGE, to either be brave enough to go looking for change, or brave enough to seize a new direction when offered (even if pushed there by crises) to me, it still shows flexibility & bravery.

I wish you well, ML. Your good clear sense will help you, your brother & many others too.
The only choices that are feasible with the info you’ve given (and thanks for being thorough) are numbers 1 and three, either his home or a NH. Please don’t bring him into your home for anything, you’d likely be trapped as a caregiver and never get him out. And don’t use your money for him. He’s likely going to be of sound mind, the bar is low, and it’ll be his choice on home or nursing home. Sorry it’s not a better situation but it’s not yours to try to fix
Helpful Answer (6)

You are not responsible here.

Do not step in to bring him home or support him financially. The SW will find solutions ONLY of you don't swoop in to BE the solution.

On your shoes, I would call the SW to tell him/her that you are NOT willing to become his support system, his backup plan or his guarantor. He may be telling SW that you will take him in. Make sure SHE knows that you will not.
Helpful Answer (5)

Any thoughts? Yes - run! Hide! Both!

I am very sorry for your brother's situation, but the state has the state's resources to call on in helping him back to his feet, whereas you have only you. Be reasonable.
Helpful Answer (5)

Thanks to all who replied.
It was the strong thoughts I needed to hear and receive.
My brother has appealed the Medicare denial for additional rehab days. It's pending. He has paid for a week. He says he does not want to return back to his house...too many memories of loss.
He has a list of NH that accept Medicaid and have good ratings.

Before he went to the hospital, I contacted Area agency on Aging
(my city's senior services) to ask for meals on wheels and help in the house. Once I saw the conditions he was living in, I called for Adult Protective services and explained his situation. Since he is in a rehab, the case was closed out.

Since he has been in rehab, he is getting supportive services:
physical therapy, meds on a schedule, 3 meals a day, toileting, people to talk to.

He had the wherewithal to call 911 to take him to the hospital
and get out of that house.
He said when he trying to decide whether or not to try for the
appeal, "This for my health and life. I am going for it."

As for me, I have begun the process of getting my downstairs
ready for the work that needs to be done.
Helpful Answer (5)

Don’t use your funds.
Don’t invite him to enter your house “temporarily” (it is NEVER temporarily).

Either he IS capable of managing independently or he is not. In NEITHER SITUATION is he in any way your responsibility.

Let him make his own decisions and let his decisions be entirely his.

You will be making the harder decision by establishing in your own thinking that expecting him to do his own self care is NOT the same as you turning your back on him.
Helpful Answer (4)

Please take the advice of these wise people. They have the experience to give them the credibility to be able to trust them.

Please keep your boundaries. Your own future depends on it.

Best wishes.
Helpful Answer (4)

I'm adding an Option 5;

Brother works out his future needs with his Social Worker.

If he is deemed capable, he can choose from the realistic choices available to him. Usually the least restrictive option is trialled first : home if agreeable to home help services.

If he later dismisses the home services, he will bounce back into crises mode. Meet the SW team again for another round.

If his capability is questionable, SW may request Psych input & neuro testing. Can lead to emergency guardianship (but that bar is pretty low it seems).

I can feel you have his best interests at heart. But you don't need to fix this for him. In fact, he has stated he wants to be independent - so he will appreciate being able to do it his way.

It's OK to just be his Sister. Agree that life sucks sometimes & visit him wherever he lands.
Helpful Answer (3)

Please, do not consider him living with you. And be adamant with the SW that you taking him in or being his Caregiver is not on the table. That you have done your share of Caregiving (with no help from him) now its your time to do what you want. I would suggest that APS look at where he lives. This will put him on their radar. But be firm, it will not work for you to get more involved than you are. You don't want POA.

Do not support him in any way. If he can't afford the house then he needs to sell it. Let the SW figure it out. Thats what she is trained for. Just keep saying No, No, No. You have a right to your life. Your worked and cared for people. You have done your share. He won't change, just bring you down.
Helpful Answer (3)

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