What do I do about my brother?

[ifoundasock]

I am 45; he is 47.

He has autism. He can’t work. Every time he starts a job there’s a honeymoon period for a couple of months, cracks appear and he ends up being dismissed or resigning before he’s dismissed. Added to which he’s then referred to his regulatory body as well (he is qualified as a nurse although has limited experience in actually nursing.)

He’s spent a lot of time at university retraining and doing various qualifications and sort of sees himself as deeply intelligent and way above any ‘menial’ jobs (I don’t think he’d manage them anyway.) He also isn’t IT literate in the slightest.

He is also addicted to various OTC meds, codeine mainly.

Increasingly the pressure has sort of built up financially and emotionally. I have two very young children and I just can’t afford to support him. I need a proper conversation with him about benefits but I don’t know how to address the fact the reality of his life and the way he wants his life to look are so vastly vastly different.

Scary how he is even allowed to become employed as a Nurse with addictions. Do these new employers ever question why he has had a series of jobs which only last short term? Surely it would ring alarm bells?
Clearly he is lacking self awareness if he can't see that this is not the profession for him. Also how is he a Nurse when he is IT literate ? In Nursing there is a lot of IT stuff to do. Has he been qualified for years?

Well, he doesn’t walk around with a sign on his head saying he’s addicted! Anyway, he isn’t working as a nurse; that’s kind of the point. clearly he’s lacking self awareness ya think!

Not supporting him financially is the first step and boundary you need to implement, if you don't do this then he will have no motivation to look at other forms of supplementary income like benefits.
I would make a call to adult social services to see what other steps such as various assessments are available to someone in his position so when you have this talk you are armed with the relevant information.

Your first post makes it sound like he is being employed repeatedly and then loses the jobs? How long is it since he has worked? If he goes down the route of claiming benefits then there may be disability work coaches that could direct him towards more suitable work. The government are currently putting a lot of money and resources into this.

Yes I wondered about the IT. I’ve been a qualified nurse for years and even then we had to be good with IT. Every qualification since has included the need for IT, for research and assignments. Is he having you on?

I think helping him with the addiction could be step one - only giving as much time as you can - ref to drug services and encourage GP. Then you contact adult social services. You can’t force someone to engage though, especially not if he has Asd. Not saying you cut him loose but equally the changes must come from him. There might be some coaching that would help him in terms of the job market but not if he is in active addiction.

How are you supporting him at the moment?

I think you need to chat to him that you are struggling and not able to help but there's help available. Can you work with him to complete the necessary paper work/chat with C.A.B. (if in UK) or other groups on what he's entitled to. Benefit claiming is minefield.

The benefits system do offer work coaches, and he can look at volunteer work to keep himself motivated and perhaps find an area,of work suited to him.

It's really hard for you both. I hope he's willing to try and help himself. You might need to leave gaps in between events for processing to get the best results

Are your parents around OP?

Just wondering why the burden is upon you alone x

Good advice upthread about talking to adult social services. In what way are you tied to him financially at the mo? Where is he living ?

If he doesn't live with you leave him to it. He's not your problem to fix. Make sure he knows you're not a hotel or a walking piggybank.

I think people have misunderstood a bit and I’m sorry if that’s not clear. He is my responsibility; he has no one else and morally you can’t leave a disabled vulnerable person to rot, if you would it might be best if you didn’t really comment further because we just won’t see eye to eye on this.

The issue I have is the discord between the reality of his situation and what he sort of thinks his situation is. Really, what he needs is to accept he can’t work, he’s going to be reliant on benefits and live a very limited life. Obviously that’s harsh but it’s the reality. But how to get that across to someone? Otherwise we end up in circles of ‘well when I’ve done this or that …’

He’s actually has a lot of help with the addiction. I don’t actually think the addiction is the main problem, it’s his autism.

I think honestly if he has previously been reported to NMC multiple times in the past then why on earth hasn't he been removed from the Nursing register? This would in itself prevent him form being employed again as a Nurse and would mean he could not even apply for those roles? It's almost like his GP or someone who knows about his addictions and autism needs to write that letter to the NMC stating that he is not fit to practice . This may help him to accept that he cannot be employed at a Nurse any more although there may be other work he can do.
Is he totally against applying for any benefits ? How does he currently live and pay rent etc? He needs to look at Universal credit and hand in fit notes from his GP and possibly PIP depending on how he manages everyday activities etc.

@Minty25 thats not the point of the thread. I don’t work for the NMC; I’m not a nurse, I can’t answer that. What I can say is that even if he isn’t sanctioned or struck off this time, even if he somehow manages to get another job, it’s only a matter of time before he loses it and the cycle starts again.

What I need is to somehow get him to understand that he won’t work as a nurse; he probably won’t work at all. That’s a tough thing to do when there’s such a big disparity in how he sees his life going and how it is / will go.

And that is why I said that if he was taken off the Nursing register that may help him to understand that it is just not an option any more to keep applying for Nursing jobs. It needs a health professional to write to the NMC regarding him not being fit to practice.

Shall we move on, as I feel you’re fixating on part of the thread that actually isn’t hugely relevant. He can’t just be taken off the nursing register. It doesn’t work like that. Yes, people can and are struck off but there is a process which is quite drawn out. He’s been through it numerous times before.

Ok I'm not going to comment again. Good luck with whatever you are trying to achieve. I do appreciate how difficult it must be.

it seems that there is just no support out there, there doesn’t seem to be any advice or guidance

would posting on the ND board help ?

I’m sorry you’re going through this. Must be such a worry to know what to do for the best.

Have you spoken to adult social care? Might be worth starting by engaging with them. They might have services or support for autistic adults that help you having those conversations.

Have a look for local autism charities as well. Again they might have an outreach service that can support you to structure the conversations so that they land properly.

It’s likely to be a slow conversations that tackles each issue in term to allow him time to come along with the realisation as well.

The problem is that even if adult social care agreed to provide any support (I’m not sure what this would look like to be honest) he’d be unlikely to accept it. It is hard; I need to really get him to accept he’s going to be reliant on benefits, lonely and struggling for the rest of his life and he won’t want to accept it. Who would?

Does he actually want to be helped by you?. You are a parent with two children and they are your primary responsibility, not your brother. You cannot help anyone who does not want to be helped and you do not want the role of enabler.

Not the same topic, but also an autistic family member. We’re currently doing an intervention to support an autistic family member. We’re the ones doing the appointments with the support services. They are teaching us how to approach him about the topic rather than working with them directly (if that makes sense)

Its helped up to breakdown the problem and approach it in a way that works for them.

You are trying to do something that's just not possible. Anyone capable of rational evaluation would have worked out by now that he's not able to deliver against those roles. If he can't see it from his own personal experience nothing you can say will get you there.

I'm afraid you're just going to have to come up with a different approach. Probably something like a) set your own boundaries (eg no financial support, not sacrificing your kids to give him emotional support) b) know where to signpost him when he runs out of money.

It's awful, and I really feel for you.

I don't think you can "get him" to understand. He will have to come to that realisation for himself. You are responsible TO him but, while he is autonomous and making all life decisions for himself, I don't think you can be responsible FOR him as you can't prevent him from making decisions that you think are very unwise.
You have to put boundaries in place to protect your own life and health while still giving him some support. Otherwise you will end up being dragged down yourself and with compassion fatigue.
Boundaries are things you decide about what you will or won't do, regardless of what your brother does.

So you might decide that you can't offer any more financial help other than offering him a meal twice a week ( for instance). You communicate and hold this boundary regardless of what your brother does, and this is the tricky bit. He may flounder, get into debt, try and manipulate etc but you need to hold firm. He probably won't be able to understand the reality of his situation until he faces the reality of it. If you give in and bail him out then you are actually enabling him to continue to live in his fantasy world.

Other boundaries might be for instance that you are willing to spend X hours a week helping to apply for benefits/going with him to Citizens Advice etc but you won't actually give him any more money. He may or may not choose to take you up on the offer but you have a clear boundary.

All of this means you ARE still supporting your brother, but in a way that is sustainable for you.

Holding boundaries is hard and you may feel really mean, even though it isn't a mean thing to do. Ultimately you need to do it. Do you have a carer's association in your area? I think you might benefit from meeting with a carers group who will understand more of what you are experiencing and if you can find any low cost counselling, then I think this would be good to help you process your own feelings of discomfort with holding boundaries.

I don’t think I enabled anything particularly. But if people want to see photos of the state of his house when he was left to it for a period of time I’ll post them. It was inhabitable; freezing cold, no hot water, filthy dirty, no bedding on the bed (just a mattress) - shit oozing out of the broken toilet; I could go on.

Meanwhile he was spending £300 on plants for the garden which didn’t get planted. It’s just about impossible to understand if you haven’t got someone in that position - how bad things can be before intervention happens.

Anyway I suppose the point is now I can’t support him financially. I have two young children. I need him to claim benefits which he can live off long term.

That's such an offensive post

@olderbutwiser thanks; the problem is that you can’t just see someone starve / be cold. Like I say anyone who says that they would - I just can’t agree with you.

And you’re right he won’t ‘see’ it. Sigh.

I’ve no problem holding boundaries and I’m not interested in counselling. What I need is a long term plan to support him into his fifties and sixties otherwise we just keep lurching from one thing to another and in six months XYZ will happen only of course it doesn’t!