Family and Caregiver Schizophrenia Discussion Forum

How to prepare to help my brother in the future

I want to apologize if a similar question was asked in the past. I am new to the site, still learning, but very happy I found it. My question/concern is for my brother. After many years of on and off drug use my brother had a psychotic break about three years ago. He is not completely diagnosed, but if I had to guess he is somewhere on the schizophrenic spectrum. He has paranoid delusional beliefs and no amount of rationalizing will make him change his mind. Some of the beliefs include family members are stealing things and money and his old boss hired drug addicts (people that he used to know) to put electronic devices in his ears which do harm to his body. This has been going on for about three years. He was working as a cement truck driver and got hooked on snorting adderall and then Sh*t just hit the fan. My dad and I had him sectioned through the court three years ago and the psych hospital kept him for a week. At that time they agreed there was mental health issues and prescribed antipsychotic medication and out patient follow up care. He never followed up with either recommendation. This all took place in Massachusetts. Fast forward three years, my brother is now living in Maine with my father (I still live in Ma). He still has paranoid and delusional thoughts but does not believe there is anything wrong with his mind (again apologies I forgot the proper term). He is not working and my father is supporting him financial and putting a roof over his head. I do have to say that he is A LOT calmer than when he was snorting the Adderall but he still holds his paranoid thoughts. Actually I can hold conversations with him and it almost seems as if he is his “normal” old self, but then he goes into his paranoid stories. My concern is that my father is 100% enabling my brother. He puts no boundaries in place because, “He just doesn’t want to deal with it” I should also mention that our mother passed away from a 12 year battle with cancer 20 years ago so our family has been through a lot. I try to explain to my dad that you are not benefiting Joe by enabling him. I try to explain that you need to set Boundaries because just because Joe has an illness does not mean he should be able to do whatever he wants. For example, Joe smokes in the home and my dad asks him not to and there are never consequences. Anyway, my fear and concern is that when my dad is too old or passes away what will happen to my brother? My dad is currently 68. I will support him as best I can down the road, but unfortunately I am not in a position to let him come and live with me if/when that time comes. As I mentioned my brother refuses to see there is an issue and will not seek or accept treatment. My question is how can I begin to support/ set him up for the future when my dad is no longer able? As hard as this is I love my brother, I desperately miss the way he was before, and I don’t want to see him end up homeless. I am all that he will have and I know if/when the time comes when my dad can no longer support him that he will most likely come straight to me. I want to be prepared and be able to get him housing but I don’t know where to begin. He does not work. Aside from all this I love my dad but feel angry he is not doing something now and will leave it to fall on my shoulders. I know my dad feels guilty, but when the time comes and it’s my burden I know I am also going to feel guilty and I just don’t think it’s fair. I have a husband and hopefully will have a family and I need to be able to protect my family as well. :disappointed:

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WOW, that was a good write up, I assume the following: your bother is in his 40s, father’s place is paid for and brother is not violent. IMO, Given your distance, this could play out ok, as you know, there’s not much you can do unless your father or another person reports your brother for a crime of violence. Your father will pass and your bother can live out his years in your fathers place. You or your father can’t make him see docs and meds, he will live in a typical SZ squalor until intervention. Now the intervention part, if you have a boat load of money, there is a great deal you can do. Paid place to live with amenities, monthly stipend via electronic transfers to a debit card, pay an agency to look over him from time to time and donate big to a local church and they can try to befriend him for docs and meds that you pay for… and so on…

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My opinion is similar to @GSSP. I think your brother is approaching a window of time where if ‘enabled’ and off of AP medication too long it’s very hard to turn it around. My brother is similar but with bipolar disorder, and his disorganized thinking and paranoid thoughts wax and wane depending on his drinking.

Some suggestions: It sounds like you keep in contact with him which is good. Keeping regular contact by phone and occasional visits can help gauge his state of mind and look for strategic moments for possible interventions or preemptive care. As @GSSP suggests, a likely end game would be to have your father transfer ownership of the house to him, or better yet a trust. I’d personally pay for a housekeeper to come by every two weeks or so to clean for them both, with an eye to continuing it after your father passes. This can cut down on the the disorder of the house and give you ‘boots on the ground’ and so you can see how they are coping. If you decide to do this, I recommend hiring an individual rather than a service. I did this for myself during my recovery (I’m recovered from SZA and am also a caregiver) and it made a big difference. It will take time for your brother to build trust with such people, so starting sooner is better.

I’d look into his social security status, both SSI (disability) and retirement benefits. You have to work a certain number of years to qualify for retirement benefits. My parents made sure my brother had enough work experience to qualify by employing him in various capacities on recommendations of a lawyer. They also made sure he has health insurance and try to get him to see a doctor regularly.

I’m sad to say, if you don’t have buy-in from your father and you can’t either live with them both or have him live with you, I don’t think you will be particularly successful with other intervention strategies like LEAP. These rely on frequent communication, and are very hard to pull off , and nearly impossible remotely.

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id recommend a group hostel…these are places where mentalll ill folk can live in a home which is staffed by psychiatric nurses and social workers…i think this would be ideal after your dad passes away. yourr brother will relate to the other residents as they all have similar issues…you should ask mental health services about this.

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So sorry to hear this. His illness sounds like he has Anosognosia along with whatever diagnosis he has. This is lack of insight that he is even ill and they will REFUSE any type of treatment as they dont believe they are ill. It is the worst and if he is adult, not much you can do unless you make sure you are on All his ROI with Dr.'s, etc. If you could get legal guardianship, this will help you down the road make important decisions on his behalf when he cannot or will not but he has to be willing to do that. Your absolutely right, there has to be boundaries even when they are ill as it gets out of control very quickly and can get scary at times. Please tell your father, boundaries!!! and consequences from his behavior.

In PA we have a program called PA able where people can deposit money into an
Account like a 401k and it can be used for food housing etc for someone on disability. My son still works so I couldn’t set one up sadly. I too worry when I’m gone he’ll have no safety net. I hope he will still get help in Maine and stay on
Meds

Call the department of mental health services. He is eligible for disability benefits. He definitely needs guidance and reinforcment. The house needs to be in your name and your brother as a beneficiary. He wouldn’t be responsible enough because of his cognitive impairment. If he has a another break, which he very well could, the house eould be safe from the state taking it. Once you contact DMH they can get his medical records.My son can’t see the illness of his paranoid schizophrenia but is young enough to not refuse. Its all on the approach and what you say. If he is dependent on your father, he will agree for some help financially and emotionally because he will see that is an issue rather than the delusions. I hope this helps, but be attament because its people likeius that are family members survive. DMH will get him on a waiting list for housing. There are quite a bit of options. Your brother sounds like a very sweet, loving guy. We don’t want to see him fall the the cracks of the system and end up on the street or in jail. It breaks my heart to see them lost touch with reality and denial is very common.

Hello and welcome! I tend to agree with GSSP and the others. My experience is that you cannot make him be compliant with treatment, especially if he doesn’t think there is anything wrong with his thoughts and beliefs. It sounds like things are rather peaceful at the dad’s house, but your dad is probably at a point in his life where he will not confront your brother or set limits because he just doesn’t want the stress or drama; I’m kind of reaching that age. That said, if his house is paid for, he can continue to live there on his own. It’s hard to see your family member in such a decline or demise that is so slow, but that’s probably the most affordable option, as long as his episodes are at bay, and he has some peace, that might be the best place for him right now. And he does give your dad some company.

Hi
Welcome to the forum

I’m not sure about how unwell or well he will be when the time comes. I hope that there is some change in the future

My mum is taking care of my sister. She is 77, my sister (41) has first episode, of 7 years so far duration,
Living back with my mum
If my sister is still unwell there might be nothing left for her

I have schizophrenia too, in remission for 14 years. Our middle sister died while on leave from hospital after a 12 year long deterioration Also schizophrenic

I know that I can’t help my Sister so I’m in the same situation as you are.

As a sibling I am completely powerless
I live with my husband we and have moved an hour away

No matter how sad it is I have almost as little hope for her as my mum

My mum said times have changed in the NHS UK
The move from hospital care to home care while good on paper means fewer resources and less support
Care at home is a 10 minute visit once a day as it is with elderly in home care
Worthless when I see what it took to get me on the right meds in hospital for 9 months In 2006 followed up by very good aftercare

I have lost hope if I’m honest
She has given up drink and tobacco 6 months ago.
This gives me hope but underlying is a schizophrenic spectrum illness and without my mum I have no hope to help

She will die when my mum goes.
Simple really