Brother with paranoid schizophrenia

Hi everyone, my adult brother has struggled with paranoid schizophrenia since he was in his late teens. He is now in his early60’s. We’ve always, with help and understanding have been able to have a family relationship, however, over the last 3 -4 years our relationship has gone from bad to worse. Our parents have both passed 6 years ago. The county takes care of his medication and housing. I am trustee of his special needs trust. He drives and manages his doctors visits. However right now I’m not sure he’s getting his meds or taking care of himself. He will not talk to me in any reasonable tone. He’s belligerent, angry, with confused speech patterns. I don’t know how to reach or help him. He gets into situations that he needs help to get out of, and that’s when I hear from him. Money to get out of his scraps. I don’t know where to turn. I love my brother but the situation is stressing me out in an unhealthy way for me. Any suggestions would be appreciated.

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Hi. I’m a sister of a 60-something brother with schizophrenia, too. Sorry you are going through this.

Will he pick up a phone when you call, or answer the door if you stop by? Not sure what the living situation is… If yes to either, I would prepare a script with a few key points you want to tell him and just keep repeating your message, every time, clear and repetitive. In his case, that might be:

  1. When you don’t take your meds, you often get into trouble.
  2. Please ask your doctor to check your blood sugar levels. (Some meds cause weight gain, which often leads to pre-diabetes and that can really mess with stability)
  3. I manage your funds AND I need to speak with you about your life so I can continue to help you with money.

Or whatever you’d most like him to know. Maybe something will sink in. His belligerent stance is telling you he is not now up to discussing anything with you. If I were in your position, I would just do what I could, which is to tell him what your advice would be, and keep it low-key (even if you’re torn up inside with worry.) Present it so perhaps he can start to think your advice is something he wants to try. If he’s made it to his 60s, is driving and navigating doctor appts by himself, he must have the cognitive abilities to sort through ideas and choose ones he likes.

Maybe he’s trying to get off some or all of his pills all together and is failing and doesn’t want you to know that.

Does he have a case worker he can speak with?

I hope others on this forum have suggestions for you.

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I have a similar relationship with my 40 year old son, it pretty much works for us. He manages himself as best he can, and he appreciates the space and the respect. I can sleep at night knowing that he will contact me when he needs help.

Listening to the siblings on the forum over the years, and in my own relationship with my siblings with bipolar, I have observed that siblings tend to react to each other on a sibling basis. I wonder if your brother had issue with you being named his trustee for his special needs trust.

My older son agreed to do for his brother, ONLY, if I agreed to write a letter to his brother (to be opened upon the death of me and my husband) explaining the situation and that he had not been given choice in the matter.

I can promise you that if my husband and I were to pass before our sons, my younger son with neurodiverse scz would expect the will to divide everything equally without any sort of restrictions or “special needs trust”.

My son would be angry about a special needs trust and a trustee.

At NAMI’s Family to Family class, and here on this forum, we always urge caregivers and family members to work with a therapist. Our job is a stressful job, take it from me, there are times currently that I believe I am going through the ultimate caregiver challenge. I keep reminding myself that I have to take some time for me. Some times it is little things these days, like taking a walk.

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I have reason to believe that my brother is not getting his shots for his illness. After so many years i am familiar how his behavior changes. As far as the trust goes. He has a history of not being able to handle his own . The trust was put into place by our parents. He understands how it can be used and what it can be used on . If he were given money he would go through it and be homeless in a month. It wouldn’t work for him the way it may possibly for your situation . Communication with my brother is the hardest. Like I said his words are constantly confused, not understandable at all, if I asks him to repeat something he’s said in order to understand it, he gets abusive.

Nope, it would never work for my son to be in charge of his own money, that is why we have established a special needs trust for him. What does work for us is knowing he will contact us when he has a problem. We did not put our son’s full “share” in his special needs trust. Our will leaves his brother a hefty portion of his “share”. Any needs outside the special needs trust can be paid for with that money.

How wonderful that your brother understands the money situation so well. My son gets impatient when asked to repeat himself. Does your brother threaten you? Is he physically abusive?

This is quite fortunate - did your parents set this up as well?

My son who is neurodiverse schizophrenia has frequently said that he lives a simple, inexpensive life. I have not found that to be the case, especially when having to deal with the occasional expenses caused by him damaging other people’s property for his political beliefs.

Given that your family has been living with this a long time, you have probably already read, “I’m not sick I don’t need help” by Xavier Amador, but if you haven’t read it I think you will greatly appreciate it.
The book is really helpful in suggesting communication approaches for people with psychosis. The basic idea is that you try not to criticize or argue but instead try to engage from a place that show respect by making it clear that you are listening.
If your brother isn’t making any sense it is clear that his meds aren’t working or that he isn’t taking them. You could contact his doctor or a caregiver at his home and let them know what changes you have observed (?)
If meds aren’t an option, then I think that all you can do is try your best to let your brother know you care about him and take care of yourself. Have you attended NAMI meetings at all?