My brother is not taking care of his physical health. He has lost all his teeth and will not discuss any of is health issues with his siblings. His wife divorced him about 5 years ago. His only child 16 years old, no longer spends time or lives with him. My brother lives alone,works from home, and has very little interaction with other people. At Christmas he did not talk much, couldn’t eat dinner, had an accident and soiled a chair, then left abruptly and was upset because we all were asking if he was o.k.

My sister called him the next day and asked if everything was alright, and wanted to know what was going on with losing his teeth, he said he was fine and had to go to a meeting. She followed up with another call after work hours and he said he was busy and avoided discussing anything with her.

How do we help my brother?

A. It is difficult to help someone who is reluctant to accept your help. Only in rare circumstances can an individual be forced into treatment. Generally, those circumstances include:

  • imminent danger to themselves or to others; or (in many states)
  • grave disability (the inability to properly care for one’s essential human needs due to a mental disorder; an individual’s actions, or lack of appropriate actions, places them at serious physical harm for injury or death).

You did not mention whether your brother is experiencing the type of psychological problems that would warrant forced treatment. If so, you may want to check with an attorney or become familiar with your state’s law regarding involuntary commitment procedures. I’m not suggesting that you should attempt to involuntarily commit your brother but if his deterioration is due primarily to a mental health condition, then it may be the appropriate action.

One potential option is to have a family intervention. Include family or friends who are equally concerned or who share your opinion. If you approach your family member alone, he or she may simply see it as their opinion against yours. Having other people who share your opinion further strengthens your case.

If you choose a family intervention, have a discussion about what each person is planning to say prior to the meeting. It ensures that you are all “on the same page.” Consider excluding any individuals who you think might make the situation worse.

One word of caution regarding family interventions. They do not always go smoothly. The possibility exists that your brother will completely reject your efforts. He may become defensive and angry. Such a reaction could shut down all further communication. Ideally, if you are considering an intervention, it would be best to consult a trained and experienced family therapist/interventionalist. The find help tab, at the top of this page, can help you locate a mental health clinician in your community.

Finally, even if you try every idea that you can think of to assist your brother, realize that your power to effectively help him may be limited. In the absence of a serious mental health condition, leading to his refusal to accept your help, you can do very little. You cannot force someone to accept treatment that does not want it. That reality can be difficult to accept. It is exceedingly difficult to watch a loved one suffer or to make choices that are not in their best interest. No one wants their loved ones to suffer. I hope I’ve helped. Please take care.

Dr. Kristina Randle