I have given "advice" to others on this site and now it is me who needs some advice. I am 75 and my brother is 72 - he was in an accident 9 months ago and is homebound. He can walk around slowly in the house, but just sits and watches tv. He has an incontinence problem and I did get him disposable pads to sit on, but there is always a urine smell. He uses the disposable wash cloths and dry hair shampoo (so he says). I buy them for him. His daughter wants to have an aide come in and he refuses. He said he doesn't want anyone in his house. I go there every other day and help keep place in order and take care of his dog. It's the hygiene situation that I don't like. How do you get someone who refuses help with that to listen? We told him he will have to go to a home (used as a threat) and he said he is not ready for that!!! His daughter is there once a week, no other family member goes. I'm at my wits' end! Please help - any thoughts on this? Thanks
Is your brother expected to recover beyond his current condition?
Did he go to rehab after his accident?
He needs a plan to manage his life going forward. That’s the best way for him to be able to stay home alone as long as possible.
He has to use the resources available to him that will help him stay in his home. I assume you and your niece have a life outside of being his caregiver.
Sometimes family has to pull back in order for the one who needs the help to see that they aren’t doing all they can to help themself. When he says he doesn’t want anyone in his home, he is volunteering you and daughter to be his personal servants without any help. He doesn’t get to do that without your permission.
It will only get worse if you continue as you are going. Once your own attitude changes, then it will be easier for him to accept. He has no reason to change if you allow yourself to carry the load.
Each county in the US has an Area Agency on Aging. Below is a link for the Activities of Daily Living which has a link to the Area Agency on Aging. The ADLs are important to help you be able to determine the level of care he needs. They are useful to track his progress in getting better or his decline. Nine months can turn into nine years. I hope you find some help.
https://www.agingcare.com/articles/activities-of-daily-living-why-this-measure-matters-186853.htm
Is he expected to recover?
Has he seen a doctor since?
If it was an accident that caused head trauma he may have what is called a TBI or Traumatic Brain Injury. These can be difficult to recover from AND in some cases can lead to Dementia.
Some injuries take a long time to fully recover if a full recovery is expected but in some cases it might be "this is as good as it's gonna get" scenario. If that is the case then he may no longer be able to make decisions for himself. And whoever is POA may have to assume the role.
IF he fully comprehends what is going on then sitting down with him and telling him that he is not taking care of himself and it is possible that moving to Assisted Living is his best option. This is not to be used as a "threat" but as information that you care about him and are concerned for his well being.
The other distinct possibility depending on the accident is he could be very depressed and needs to see a therapist, and possibly medication for depression might help. Any accident or illness that changes someone's life could be cause for depression. If he was active before the accident I can see this as a possibility.
I advised the Doctor my LO was unable to self-care but refusing home help.
The term *vulnerable adult* was used. I saw the Doc note down *lack of insight*.
Doctor told me sometimes a person has to *fail* before they get it & realise they need to change. Advised me to back out. Basically, to stop doing so much. To tell my LO to arrange alternative help & to call the Doc if in trouble. A social worker would then be arranged, even emergency guardianship if deemed legally necessary.
Since that time, my LO did learn to accept home help & now really values it.
Basically if YOU are the only solution, they won't look for or accept any other solutions.
But once you step back, they are forced to change, one way or another.
When your LO received treatment for his injuries in the ER or hospital, was he ever under anesthesia for any procedures? His behavior could be a reaction to the anesthesia due to his age. It is possible he will emerge from this fog, but I would contact his doctor for guidance.
The suggestions made by 97yroldmom, Grandma1954 and Beatty are all solid. You have lots of good input to help you to help your brother. Let us know how it goes -- updates help all of us to gain wisdom!