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No one wants to help my brother because he is stubborn. He was in an accident 18 months ago and was usually clean. Since the accident he has become incontinent and wears depends type pants. he doesn't even change them. I go every other day and must force him to change the underwear and clothes - he has diabetes and can't smell himself that much, but he is aware because family has told him. no one wants to go there but I am his sister, and he has a dog, so I try to help. i do his wash (when I force him to change) idk how to get him to change depends. he gives excuses and says he was sleeping, or he hadn't changed yet (it was two days ago I was there and didn't see any depends in the pail he has. Another excuse; the person who drops food off, took the trash (he lies). I am 76 and have health issues of my own and am supposed to not be stressed any more than necessary. I am very stressed! His daughter barely goes because she says he is stubborn, and she is frustrated. His son lives in another state. My brother doesn't want an aide pressuring him and I thought for sure he would listen to me, a close family member. What, if anything, can I do. Help!!

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My definition of "has his mental faculties" would include awareness of the need to change soiled Depends and willingness to maintain basic good hygiene. Your brother's refusal to clean himself or take care of himself is a sign that he does not have "his mental faculties" after all. He's probably not just "stubborn." He might have dementia or some other medical condition that's affecting his mind. Maybe the accident gave him a brain injury. Or maybe it's a side-effect of medications, or after-effect of surgery. Sitting in his own urine for days can give him a urinary tract infection, and the infection could affect his mind too. Can you work with his daughter and son to get him fully evaluated by a neurologist or geriatric psychiatrist?
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Isthisrealyreal Dec 2022
Not to mention skin breakdown and open wounds from this.
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You are not going to like this but if he still has his mind, I think I would just leave him alone. You are a wonderful sister, but your brother is pissed because this is not the future he was counting on! Incontinence for a man is the ultimate indignity!

You two will have more peace between each other. He will be relieved this is not going to be a problem that is up for discussion anymore. I think it will be better for you and you can relax and know your brother is living the life he wants to and NOW, you can too!
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AngieGuido74 Dec 2022
it's heartbreaking and he smells terrible so both of these make me sick to my stomach bc why is he so stubborn i don't get it. he gets infections bc of sores and why would you want to live this way - he has diabetes - maybe he can't feel anything - idk
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Sorry for your stressful situation!

That's just disgusting that he doesn't change his Depend. So, I have to agree with other poster that he does not necessarily have all his marbles anymore. He could be depressed. He could be starting with memory issues - it can be subtle at first. Just because he can have a decent conversation and give somewhat appropriate answers, that really means nothing. He can't take care of himself. I would call his doctor's office and give them some of this info and ask for them to call him in for an appointment. He needs some evaluating.

Give yourself a break. It's nice of you to check on him and try to help him. You can keep doing that BUT you need to change your mind set to not let it get under your skin.

One thing I do with my mom with dementia is to be assertive. You want him to change his Depend. You know it NEEDS to be done. So nicely, but matter-of-factly, tell him "OK, it's time for you to change your Depend. Here you go. Let's head to the bathroom." Don't ask. He'll say no. He can still say no to your gentle demand but it's more likely that he'll go with the flow. Hopefully.

Good luck.
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AngieGuido74 Dec 2022
if only he would go with the flow - his answer is ok i will (i don't live with him and he says when i leave) we have words and i'm too old to argue - i feel like a mother arguing with her toddler it's too much - he use to be a clean nut and dressed nice had great hair etc now i don't recognize my brother. when we speak on phone as times he sounds like the old him. when you see him he looks like a homeless man. his conversation many times is normal to me. the dr said when the accident happened that they couldn't predict what his mind would be like later on bc when he crashed he actually was dead at the scene - the EMT brought him back but didn't know how long he was out. it is very sad and frustrating
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I agree that he needs to be evaluated.

So you are 76, have health issues, and are not supposed to have extra stress.

This situation certainly IS very stressful for you. I would back off from doing anything except to work on getting him evaluated.
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Your brother is lucky to have you looking in. Before stepping in deeper it may be good to see exactly what the situation is.

So first, what do you mean by 'has his mental faculties'?

Do you mean he knows the day, time, where he is, what he wants to do with his day? Or something else?

How independent is he with his activities of daily living (ADLs)? Can he do the following tasks;
Cook, clean his home, wash clothes, body, prepare meals or order in food, groceries, manage medications, magange his bills, get around in the community? Also feed, groom & keep his dog healthy?

If not, can he arrange suitable help? eg deliveries, home services, aide staff, taxi.

Standards vary of course. Some people are very clean & cook all fresh meals. Others shower twice a week & live on delivered takeaway. Freedom of choice is important.

But if you stopped looking in - what would happen? Could he cope? Are his 'choices' actually *self-neglect*?

No-one on a forum can see or diagnose - so trust your gut instinct. You know him best. Get a professional to look him over, look into his mental capacity & living standards if you think it is needed.
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AngieGuido74 Dec 2022
Hi thanks for your response - my brother also has diabetes and a colosomy bag. his legs and feet are swollen - so him getting up and down is a shore but he does heat stuff up - was never a cook and would get things from my brother's store. idk he just wants to sit in recliner and in his wet depends with wet pads under them and on the seat of chair - he is tired alot and doesn't take meds like he should bc he likes to sleep - finally after 18 mos he is going to be evaluated (he does not know as he has denied aides and nurses) bc he is abusing himself. we are hoping this scares him into living a better life - others in family think he should go to a facility - my brother is very aware and adamant that he isn't going and dr said you can't make him go. so this is the dilemna - we shall see the outcome after the POA comes in to speak with him
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I have to agree, a man with all his faculties would not act this way. He needs a full evaluation. Labs to rule out something physical. If he had a head injury, may a Neurologist to run some tests. He probably should not be living on his own. Not that you or his daughter take him in but maybe an AL.

My Mom was showing signs of decline but it was a head injury that took her right into Dementia.
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I think that you are in denial if you think that your brother has his "mental faculties." It sounds more like he is having some mental decline and should evaluated by the appropriate doctor.
And he probably shouldn't be living alone either, But unless someone is his durable POA there really isn't much anyone can do. You will more than likely have to wait for the next disaster to happen, and if he ends up in the hospital because of it, let the social worker know that he cannot return home as it is unsafe for him. It will be at that time that they will have to find the appropriate facility to place him in.
And please don't jeopardize your own health because of him. He is making his choices and will have to live with the consequences.
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If he's still in his right mind, tell him straight that he stinks and it's absolutely disgusting. Then tell him that you won't come in his house anymore if he is not willing to make any attempts at his hygiene.
Really though, when a person refuses to wash or even change their soiled pull-up it's usually not just an issue of personal stubbornness. That's usually an indicator of cognitive decline. Dementia.
What kind of accident did he have 18 months ago? What was the cause of it?
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I am so sorry that you are going through this difficult time with your brother.

I helped my brother out. He also had diabetes and was stubborn too.

My brother had an awful motorcycle accident and needed help with shopping and rides to the doctor and so on but he was able to shower by himself. He didn’t wear depends, so I never went through what you are going through. I had other stuff to deal with my brother who is now deceased.

Does your brother expect you to continue to help him on a regular basis?

I agree with others that he needs to be evaluated.

My brother gave me permission to have access for his medical records. This is good because you will hear the news straight from the doctor and not second hand from a stubborn brother who expects continual help.

I had to back off from helping my brother. I was already caring for our mother.

If you are exhausted and you feel that you aren’t able to care for him on a regular basis, tell him that he has to choose a caregiver at home or a facility.

Best wishes to you and your brother.
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