Schizophrenic Brother Living with Elderly Parents

[PinkWaffer]

I’ll try and be brief-

My brother is severely mentally ill with learning difficulties and schizophrenia. He’s in his late 40’s and is living with our elderly parents. Their living situation is not sustainable due to my parents age and ill health.

Not to go into too much detail but my brother has recently been in trouble with the police several times due to threats to members of the public, damaging property and intimidation etc.

My parents are broken over the whole situation however when it comes to offers of hospitalisation they shut it down because my brother has refused to stay in hospital. The doctors and professionals strongly recommend he go into a mental health facility as he’s mentioned he is suicidal/is extremely paranoid.

Up until recently he was seeing no mental health professionals and wasn’t taking his medication as my parents left it up to him to take them himself.

My parents take the attitude that my brother has to be the one to decide he wants to move out when it comes to offers of supported living and seem unaware that their situation is not sustainable.

He is in a terrible state physically, has poor personal hygiene and for the last 20 years has not been claiming any benefits at all. My parents have been paying for everything and recently admitted that he has no money in his account.

I’ve tried many times to suggest various options of them all receiving support and that my brother cannot remain in their house for much longer.

Seeking advice please on a very difficult situation. I would happily take charge but my brother and Parents shut down my offers of help.

My fear is that this situation will end very badly.

I think you need to get social services involved for both your parents and your brother. He's mental unwell and if not taking his medication is a danger to himself and everyone else. Could you suggest he at least starts claiming benefits,? Won't actually help the current situation but would be a foot in, as the benefit office would need proof why he can't work and he'd hopefully go for a medical. Alternatively you can make social aware that your concerned for your parents and brother

I would ring Adult Social Care on the basis that both your parents and brother sound vulnerable and risk of harm. If your brother is in such a poor physical state you could say he is not in a position to recognise the need for hygiene and you're concerned about his physical and mental health.

It sounds such a difficult situation for you, but clearly your parents are now not able to be responsible for your brother.

Might be worth starting with a safeguarding referral to LA although, I am not sure it will amount to much. But, at least, they will give them/him a call. I would also be wondering why there is no CMHT involvement. Has he previously been sectioned?
If he doesn't want to go to a hospital and he is deemed to have capacity, there is nothing you can do. If you don't think he has capacity, speak to his GP and they can organise an assessment. Police can also organise an assessment if he is ever violent in the home or elsewhere and police has to be called out.

ETA: apologies, it sounds as though he is now under CMHT, in which case they will be the best people to contact about this.

It's almost impossible to get a bed in a hospital in the UK, even for the most severe forms of mental illness crisis. So if they're offering, then he must be in an extremely difficult state right now. Your parents possibly have a very old-fashioned view of mental hospitals and think they are protecting him. They need to understand that they are not protecting him, but are stopping him getting better. I'm sorry you're in this difficult position.

It’s a terrible position, I have tried explaining that mental health facilities are safe places and my brother would receive all the help and support he needs. They see it as his decision to make however he does not have the capacity to make that decision and cannot act in his best interests unfortunately.

By end badly do you mean he has threatened your parents or been aggressive towards them? If so, then make a safeguarding report to social services.

There really isn't much you can do unless he's sectioned. Your parents seem to be treating him as though he has full capacity when he has a serious mental health illness. He needs to take his medication.

Rethink would be a good organisation to contact. They can advise you on what you can do in the circumstances. You can also phone Age UK.

Definitely speaking to Adult Social Services

Can you offer to help him set up his benefits? Some of the forms etc might be too much for him alone.

And check your parents are claiming all they are entitled to as well

It’s been a very difficult situation for many years as they have refused my offers of help but thankfully I have now set up a universal credit account and put in a claim for him so it’s a start at least!

My Dad is an issue as he takes the attitude that my brother has to suggest these things himself and that we can’t “force” him into these things. Unfortunately that’s meant that he’s gone without any help or support/benefits for years. My brother is unfortunately in such a terrible state now, physically and mentally that he cannot make these decisions for himself anymore.

We can't assume person doesn't have capacity just because they are making unwise decisions. Whichever doctor saw him would have informally assessed capacity and would have recommended a formal capacity assessment which could lead to him being sectioned. If there was no such provision put in place, then we assume he does have capacity until proven otherwise. This is how the law works, I'm afraid and it is there to protect people like your brother from unlawful deprivation of liberty.

You can refer to social services. To have them accept him he needs ti have care and support needs that are not met. Given your parents keep him clothed, warm and fed the only side you really have is his inability to take care of personal hygiene.

Has he had a capacity assessment recently? Until you have it in writing that he doesn't have capacity to make decisions about his care, then he will be deemed to have capacity.

CMHT and social services can do a best interests intervention, ie act outside his wishes if it's in his best interests but it's complicated. Really he needs to go into hospital, I see that was offered. Was it a section 2 or section 3 that he was being offered a mental health hospital stay? A section 3 can be refused by your parents.

It is a difficult one with regards to capacity. He is lucid and is obviously aware of what’s going on, he is in charge of his finances however he has moderate to severe learning difficulties and that’s where the lines are blurred. I do understand that he can’t be forced into a mental health hospital however he is becoming a danger to himself and others. He does not take his warnings from the police seriously either unfortunately.

He does have capacity in the sense that he can hold a simple conversation, can take himself out alone and buy himself food etc. it’s a difficult one.

Capacity is time specific and task specific. It's never as clear cut as having or not having capacity indefinitely. For example, a person can have capacity to make financial decisions but not decisions about treatment. It is based on whether they are able to understand and retain information and consider risks and benefits of their decision. He can have capacity to make decisions about his treatment during lucid moments but not when in acute psychosis. Which is why it requires two professionals to do a capacity assessment and is not based on opinion of well-meaning relatives.
If you have concerns about his capacity, you need to contact his mental health team or his GP who can organise a formal assessment.

I'm sorry op 😔

Are you the only other child of your parents? I'd be taking charge immediately and accepting being the bad guy

Could you take some brief time out from work etc to focus on this situation

Make a list of all that needs to be done such as apply for benefits, call social services, put him on the housing register etc etc - if you decide you're the one handling this, your parents will soon accept it, I think

Easier said than done, I know
Xx