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.

That's how I read your post. You were clear I thought.

It seems OP's brother thinks menial jobs are beneath him. He has delusions of grandeur. And yet, according to OP, he is incapable of holding down any kind of job. That's a tricky situation in terms of what benefits he could get as he is giving the impression he is capable, fooling employers (as well as those making an assessment of what he would be entitled to), when really some honesty of his capability is needed so he can get what he needs.

Sorry but you’re being naive. He’s not your responsibility. Simple. You can help and guide but he needs to sort himself out. He’s got to address his own issues, especially with drugs. Otherwise you’re flogging a dead horse.

I think you might find if helpful to ask your thread to be moved to one of the Sen boards - I think unless someone has tried to help a close family member with severe mental health problems they are unlikely to fully understand the challenges you face.

I am not a medical professional, but over the years I have developed an impression through experience, that some ND males struggle to accept their mistakes or ‘failings’ because they are trying to protect their ego / sense of self. I’m guessing it’s deep rooted in how society sees males as strong and they don’t want to accept their mistakes or ‘failings’ as that would make them feel weak and vulnerable and emasculate them.

So whenever you deal with him I would avoid things that might make him feel emasculated as that’s what I am guessing he is trying to avoid.

I think if someone has pip their council tax is reduced. I think you need to go in from the angle that him getting pip would help you and the kids as it means you would pay less tax. Of course this is all about him … but I would avoid saying that and make it about other things. Like say you’ve heard the government is changing to pip rules and he might as well get what he can before they do so apply quick etc. Free money or whatever.

Alot of neurodiversities also have comorbidities as I suspect he also has adhd hence not being able to look after himself / his house. Autism tends to like sameness / routines … adhd and poor exec functions makes it hard to achieve these things and there is a constant internal conflict.

The codeine is likely because he’s self medicating anxiety - really he needs to be on antidepressants and adhd meds but not sure how you would achieve that.

and well done you trying to help him. I bet it’s been really hard. If you ever get to the point now you have kids it’s too hard and you need the authorities to take over you really should not feel any guilt. He has severe mental health difficulties and they are what drives him. You are not dealing with someone who has the capacity for clear rational thought and action. It’s sad it really is - we can love someone but we can’t change their reality and give them the skills they need to function in the world. It has to come from them. He has to want change and want to engage
with medical professionals. And the only way I can see you getting him to do that, is if you force it on him through advocating to the right people he’s at risk of self harm, or you convince him he’s seeking the help for another reason other than he is not mentally well.

You can report him yourself though - if he’s struck off (with your input as well as everything else that you say has/is happening) he will have no choice to accept he can’t work as a nurse…….

That is quite a good summary although I don’t know that he fools employers. He’s had a lot of jobs but over a twenty year period not that many.

His first job was about eighteen months and he was suspended for some of that. He was newly qualified and he went down to Surrey where at the time nurses were like hens teeth.

Then he was unemployed for four years. He did an MSc for some of that and he was suspended from the nursing register but not permanently - I can’t remember the correct term.

Then he managed to get a job in a hospital but was dismissed after a few months. I think he was unemployed for a couple of years but then got another one. That was his longest stint - two and a half years - BUT he was actually suspended for over a year of that period! Then dismissed.

Thst took us to the end of 2019 and then Covid happened. In the summer of 2020 he worked as a nurse in a nursing home; obviously that was needed. If still ended badly!

But then he managed to get a job through an agency. I think there was probably less scrutiny and cynic more desperation because he worked for a year. It wasn’t without problems because I remember one hospital refused to have him back but he did OK, I think.

Then he did another MSc. And then got very unwell (this was when he nearly died!) and after that he worked for an agency again and this time it was a disaster and his contract was terminated after a few weeks. Then was out of work for a few months and got another job in a nursing home which lasted six months. And that brings us to present.

It isn’t a great history given he’s 47!

@ittakes2 he is on anti depressants. I don’t know about ADHD meds but he’s on quite a lot of prescribed medication, for depression and also for various other health problems.

If ‘the authorities’ would take him that would be good but they won’t!

I had a beyond frustrating conversation yesterday and this was now it went.

’do you have £5, just so I can buy food for tomorrow?’
’well yes OK but I can’t this month, I really need you to -‘
don’t worry about it’
‘no, I’m not worried, I’m telling you that I really don’t have any spare money so …’
’don't worry about it’

Every time I tried to explain he just kept saying don’t worry about it until I shouted I’M NOT WORRIED. Which I’m not. It sounds awful but in many ways I feel the best outcome for everyone would be if he passed away peacefully at home. But unless that happens he is … a presence; a responsibility , even though people say he isn’t, yes, he is.

Two things stand out to me.
The need for DH to be placed in an effective program for his addiction.
That is his biggest problem.
The need for DB to have a professional case worker.

Can you involve a case worker to offer him two options - detox program or going on benefits.

@user1492757084 he has been. It just doesn’t work. He’s not going to be able to move past it; he’s just too reliant on medication.

I dont think there's anything wrong with your brother saying "don't worry about it". It's his way of shutting down the conversation when you've turned him down regards the money

I'd make an appointment to see his GP

Make a written list of all the things you're concerned about now and for the future

I dont imagine that the GP will be able to discuss anything specific with you, but the GP has a duty of care to your brother and could (and should) refer your brother to SS as someone who needs support in the community. There are all sorts of options but one would be moving him to supported accommodation

Is your brother a possible suicide risk?

How would that have gone if you hadn’t started to explain or tell him what you wanted him to do? If you just said “no, sorry, I cannot give you any money now or in the future” and left it at that? Would that be less frustrating for you? I’m struck again by your desperation for him to understand - which he won’t, so you are doomed to be frustrated….

His ‘don’t worry about it’ is ‘stop talking. I don’t want to hear it.’

The point is that he shuts you down with ‘don’t worry about it don’t worry about it don’t worry about it’ then three days later asks for £10.

He has been like that since we were children. My parents would say no; he’d ask again. My mum used to call him Ariston after this advert if anyone remembers it …

I see

I'd see his GP and get that rolling

Is he very sensitive to any implied/perceived criticism (him reading a no/being turned down as criticism) or is he just being arrogant/dismissive?

So very frustrating for you OP, you have my sympathies.

I would guess someone has already suggested Citizens Advice Bureau for advice on what your brother might be entitled to. The best people to help would be those with similar issues who are living with the support of benefits. Perhaps seek out advice on forums for people with Autism and those that care about them. Wishing you well with finding support for your brother and also yourself, it is so very tough.

A bit of both. I think he genuinely thinks he can cope better than he can, for one. For another, he just doesn’t see the big picture and focuses on one thing intently at a time.

I know I’m not going to have one chat with him and all is resolved. I just mean I think I need to be more realistic and pragmatic. I’ve been ‘mm yeah maybe …’ about his plans because it seems so harsh to do otherwise but I think I need to be ‘ok well is that likely to happen … it isn’t … so …’

Would it help to put things in writing? A plan of action, setting things out realistically. What you are/aren’t prepared to do and the actions he must carry out for himself. Focusing, particularly, on the income angle.

There is no reason why someone with autism of the severity you describe cannot work, he considers himself intelligent, so why can't he hold down a job? I very much doubt he would be able to claim benefits without looking for work-so you definitely need a serious conversation with him.

If all else fails and his bills are not paid - he will have to sell his flat. He will then have money to live on too and will move into assisted living accommodation.

Hi @ifoundasock

Over the past, nearly 2 years now (?) it has come to light that I am not appropriate shall we say, to work in a 'normal' office environment which is something I've done all my life.

I was about to go into the full spiel right from the beginning (it's a lot) as ADHD makes me over share but I've stopped myself to let you know of a service that I got via the jobcentre. I'm doing a little dance 😁

I live in Greater London and I was put in touch with the Shaw Trust by my local jobcentre.
They focus on the things you actually want to do for work rather than just get any job like the jobcentre would prefer.
They would be able to tell your brother that he won't get nursing work.

I told the employment specialist that I never had any problems getting work.
He replied with, it's just keeping them right Chan?! Which is absolutely true.
For me, I was too much for an office due to my ADHD (undiagnosed until 2024).
I'm such a distraction for one thing.
Attention to detail was hit and miss.

Anyway.... There's a charity near me called Reliant Care (government funded via grants for the employee to be) and they help ND people who wouldn't get a job in the real world, learn and get a qualification to work there.
They have a coffee shop that is run by ND people, the kitchen out the back bakes goods for the coffee shop as well as food contracts with the council and other businesses so they learn about food/kitchen h&s. They have an office for digitalisation. They scan documents and save them to a hard drive. They shred the documents and take it to the recycling point.
It's a pretty wonderful facility and above the shop there's assisted living units.
I think something like this would be great for your brother.

Maybe he/you can speak to your local jobcentre and see if there's anything like this in your area.

Good luck mate. I feel for you

That’s amazing @MusicMakesItAllBetter , good for you!

He would never do that @MusicMakesItAllBetter , glad it’s worked for you though.

Where is he going to live then @tara66 ? Honestly this pushing of supported living is getting a bit frustrating. He would never be eligible for that; he isn’t even diagnosed with anything. He’d end up on the streets or more likely in my house which isn’t going to happen so if I have to pay his bills I will!

Would he be open to getting a diagnosis?

Instead of ‘ok well is that likely to happen … it isn’t … so …’

How about - OK, that's the long term plan, but in the short term I'll help you apply for PIP (or whatever) so you can eat/pay the electric bill etc.

Basically don't challenge his world view and set him on the defensive where he goes to 'don't worry about it', but try to get him to do the things you need him to do by framing them as steps on the way to the thing he thinks he's going to do. Even if you know the end goal is never going to happen. It sounds like the only way you'll get anywhere is if you can find a way to get him to do what needs to be done without him having to accept he's being unrealistic, because as soon as you try that he shuts down.

Theoretically but he’ll probably just say yeah yeah and won’t. And a diagnosis on its own doesn’t mean you can just get supported living; you have to have significant learning difficulties to qualify for that.

@GrannyAchingsShepherdsHut but we do have to plan for the rest of his life in a way. He can’t keep thinking he’s going to be fine; he isn’t.

OP where were his/your parents in this matter of having him diagnosed?
He did not suddenly become autistic at 40.
They had many years during his childhood and adolescence to have him diagnosed ? Are you sure this did not happen but you were never informed /,were too young at the time to understand? Would SS/NHS have records?