Brother Needs Specialized Care

By Kristina Randle, Ph.D., LCSW

I have two parents in their mid-eighties and a 51 year old brother afflicted with schizoaffective disorder, living with them. The stress on my parents is incredible, and even though I have pushed for a group home, my mother refuses. She believes that as family we should take care of my brother.

I work full time and also have kids, and I have my own house. My brother needs care because he is not self sufficient. He does nothing around the house. He sleeps, eats, takes walks or takes his car and drives God knows where.

What do I do to make sure that he is taken care of when my parents are no longer able to care for him? My parents sooner or later will not be able to care for themselves or him, and it will all fall on me. I have no idea what to do, or where to start. No one has guardianship over him. My brother is on medication such as Tegretol, Olanzepine, Carbamazapine. He doesn’t even try. I’ve asked his psychiatrist for suggestions, but he never gives me a straight answer. Any help will be greatly appreciated.

A. If he remains his own guardian, then your options are limited. He would have to agree with any plan that you attempt to implement. Without legal guardianship, it will be difficult to force him to live in a facility or institution.

Ultimately this is a legal question. You should contact attorneys who specialize in guardianship and mental health law. The National Alliance on Mental Illness (NAMI) can assist you in locating legal help. Two other helpful resources include the Treatment Advocacy Center and The Bazelon Center for Mental Health Law. Use the search terms “mental health law” and “legal guardianship” to learn more about this specialized area of law.

A psychiatric advance directive may also be appropriate for this situation. Psychiatric advance directives are legal documents that allow competent individuals to document their psychiatric treatment preferences and leave specific instructions in advance for their mental health care in the event of a psychotic episode.

Psychiatric advance directives are primarily designed for individuals with a serious mental illness who anticipate future periods of inability leaving them unable to make rational decisions due to the recurrence of a psychotic episode. They allow individuals to appoint surrogate decision-makers to make decisions on their behalf, should a psychiatric crisis occur, and if he or she is not able to make logical, competent decisions about treatment.

Contacting an attorney who specializes in these matters will help a great deal. I wish you the best of luck.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Last reviewed: By John M. Grohol, Psy.D. on 18 Jul 2013

APA Reference
Randle, K. (2013). Brother Needs Specialized Care. Psych Central. Retrieved on October 25, 2014, from http://psychcentral.com/ask-the-therapist/2013/07/18/brother-needs-specialized-care/