Obligation to struggling sibling?

[CaseyMiller]

Hello SL's,

I regret having my first post on this forum be so heavy but I'm just going to dive in.

Setting the foundation of the issue: Brother, in mid fifties has been a life long alcoholic and heavy smoker. Parent enabled brother to immerse himself in his addictions and basically live decades without responsibility. Parent lost the ability to enable brother several years ago. Brother, after job loss, found himself basically destitute with a severely stunted emotional/maturity level. To be clear he had no job, no phone, no transportation, no place to live, very little income. Unable to cope with brother living in a shelter, I started helping pay for his apartment hoping it would be temporary until he got back on his feet.

Fast forward two years, brother has done little to improve himself. I'm still paying most the rent. Just as I was about to pull the plug on my own enabling ways, brother is diagnosed with stage 4 prostrate cancer. Brother is ill and receiving government supported medical treatment. I am unable to asses a potential prognosis because of his emotional/mental issues. He will not let me accompany him to the doctor. I don't really think he understands the seriousness of the situation.

Brother probably qualifies for food stamps and, maybe, SS disability but so far has not applied. Now, I'm stuck paying rent for a seriously ill brother that will do nothing to improve his life without some serious prodding. Given his illness, I am very reluctant place more worry on him by pushing him to apply for assistance. At the same time, as bad as this sounds, I do not want to assume a possible long term financial & emotional burden with this.

I'm racked with worry for his health along with a good helping of guilt for not wanting to be enmeshed in possible needed support. I suppose I could take on a more active role of getting him some assistance but, in truth, I really don't want to take that on. Guilt!

There is no solution here and plenty of opportunity for finger pointing and second guessing. I was just wondering if others have faced this same, or similar, sibling issues and wouldn't mind sharing how they coped with it.


Side note: I used to post in the old SL forum under a different handle but basically quit posting when it migrated to this platform.

[Tradd]

After experience with an alcoholic father (who got dry after I left for college, but still had the same behavior patterns he did when drinking), I have no patience with people with drug/alcohol problems.

This is going to sound harsh, but here goes: cut the brother loose. He's used you for a long time already. I would give him the contact information so he could get assistance and that's that. Maybe him being in a shelter would give him the wake-up call he needed. You never know.

Can you afford the financial assistance you're giving him?

[CaseyMiller]

Thank you. I can afford the support however it is a tangible amount of money and will, if it drags on, impact retirement options and being able to abundantly provide for my own family.

The difficulty in cutting him off is that he is now ill from the cancer and the treatment. Problem is, based on my research, this could last years. Based on your experience with your father, you can probably guess what type of relationship I had with my brother just from a sibling perspective.

[Tradd]

Call me a cold b*tch, but he's already used you for long enough. That he's got cancer means jack to me. Maybe put in a bit of effort to get him on SS disability, as you hopefully won't have to be coughing up cash anymore. Your own family - spouse/children - come first. Since this is going to impact them sooner or later, bro has to go.

To give you an idea of my own situation, I moved six hours away almost 17 years ago. Last saw the parents 10 years ago. They don't like the traffic where I live so they've never come out here, aside from when they first helped me to move. Phone contact is non-existent. Occasional email or cards. That's it. The extended family was wondering some years back why they never saw me, and I found out when I visited a relative on my own six years ago (I was in town to visit friends) that my parents had lied to the entire family. I've made my own family with friends.

[Simplemind]

But there is a solution here... First let me say God bless you for trying. You gave, he took and it will continue. He can still take, but not from you. You can still watch over him, without footing the bill. Assemble all information on assistance that he qualifies for and then work with him to fill it out. Tell him that you care about him and want to ensure that you have helped him put things in place. You can see he needs help, he knows he needs help. He has to know that although you will help him get assistance you will not be writing checks anymore. Do it.

[ctg492]

al anon or other surpport groups can help you get through this.

[sweetana3]

Ditto Al Anon. It will help you find coping skills and then perhaps lead you to a balanced decision.

[Fawn]

From a nurse perspective, stage IV prostate cancer can go on for years (I have known several individuals that survived for 4-10+ years before succumbing to the disease.)

I hope that info helps you make the right choice.

[razz]

Sounds like you are trying to be helpful with a kind heart and money.

Would the health situation not trigger a consultation with a social worker referral from the attending MD? Hand over the situation to those professionals who know how to the health system works and get out of the way.

You didn't cause his problems, can't control them and cannot cure any of it. Ensure that the appropriate agencies have been contacted and let him find his feet.

No one says that it is easy but abusive behaviour that is enabled is still abusive behaviour. Stop tolerating it because you are not helping in any way at all.

[bunnys]

If he's stage 4 he is dying. I would normally say cut him off, he's a grown man but he's going to die and you're going to be left knowing that when he was dying (the one time people are deserving of help even if they've never helped themselves in the past) you cut him off.

I would INSIST you get supplemental help from the government to help you continue to carry him. I would INSIST he do whatever is necessary to apply for all the governmental aid he's eligible for so that you aren't financially ruined by this debacle. I would kick him in the ass all the way to the SSI office (or wherever it is he needs to go.) Then I'd sit beside him and make sure he fills out and submits all paperwork.

I'd also have a candid talk where I told him (he's probably in denial) that you will be managing his affairs until the end. I would insist he get some kind of document together that allows his physicians freedom to answer all your medical questions.

If he balks, I'd say "you're on your own" and cut him off. He won't balk. He doesn't want to be on the street at the end of his life.

I wouldn't worry if he drinks/drugs himself into oblivion in the meantime. This is the end. You aren't going to change him or save his life. It's over. This is about providing human comfort in the end.

Good luck.

[bunnys]

Fawn makes a good point. All the more reason to talk directly with his physicians. He may have 4-10+ years or he may have 4-10+ months.

I'm no oncologist but I thought stage 4 was metastasized--systemic.

[CaseyMiller]

I deeply appreciate everyone's input.

He has had symptoms for years but refused to go the doctor until they became very severe. He angrily rejected my request to accompany him to the doctor to find out the results of the tests. He is not mature/knowledgeable enough to know what questions to ask in those type discussions. All I know is that the cancer has spread (bones & lymph nodes) and appears to be stage 4. He does not understand the treatment he is being given but it sounds like chemo. I think he doesn't want to know how serious this is. Obviously if I went I would ask the doctors some difficult questions he may not want asked.

He will do nothing unless an ultimatum is given. Given his current condition, I'm extremely uncomfortable giving the types of ultimatums needed in this situations.

[pinkytoe]

Unless you are his legal guardian, it seems that some sort of social agency would be able to assist him with his needs. Although he isn't elderly, perhaps an elder care social agency could advise you on how to help him so that you don't burn out emotionally or financially. My future sil just went through the exact same scenario; however there was quite a bit more extended family to get involved with their 50ish uncle diagnosed with st 4 prostate cancer. He was diagosed in late November and passed away six weeks later; spent the last three in hospice. DD said he was quite remorseful about his behavior towards the end when he finally decided that he would not live much longer. I guess the catch-22 is that if you are not his guardian, doctors can't share health results anyway. I recall that situation when my brother was terminally ill; they would not share any treatment or prospect info with me even though I was his only family close by. I never knew what was going on or best way to help and brother was in no shape to explain. I would say you need professional social service advice however you can find it.

[Amaranth]

He might be eligible at this point to live in a hospice care facility.

[ToomuchStuff]

I don't have any dependent type (alcohol or drugs) in my immediate family, but have dealt with some. This is going to sound cold, but I don't know how else to ask. How do you know he has cancer, or what he has, if he wouldn't let you attend? What is to say he didn't leave the office and go get drunk somewhere?
If he qualifies for food stamps, and disability, then he probably also qualifies for section 8, etc. I would have set a date, up front, and not paid rent past that.

[CaseyMiller]

I don't have any dependent type (alcohol or drugs) in my immediate family, but have dealt with some. This is going to sound cold, but I don't know how else to ask. How do you know he has cancer, or what he has, if he wouldn't let you attend? What is to say he didn't leave the office and go get drunk somewhere?
If he qualifies for food stamps, and disability, then he probably also qualifies for section 8, etc. I would have set a date, up front, and not paid rent past that.

I'm 100% certain the illness is real. I've seen the progression of the illness; prescribed meds, appointment schedules etc...

Not having a prognosis or first hand knowledge of the cancer progression, I don't know if he would qualify for disability or not. I know they've been pretty strict lately. Section 8 priority is given to families. In fact, as a single, childless, male, the options for him receiving government assistance seems limited.

In hindsight, I wish I would have done a lot of things differently. Of course I gave this support during worst recession in decades.

[larknm]

My parents refused appropriate help in their last few years and each died in a nursing home without family around. Looking back, one was on L-dopa, which makes a person paranoid (he was already paranoid but that made it worse), and the other so mean (broke one of her sitter's back) lifelong friends wouldn't go near her when they finally saw how she was. Was it their choice to die alone? It's not cut and dried, but when we had tried to "help" it was never enough.

[Zoe Girl]

Sometimes in really crappy situations like these I just spend some time accepting that every option really does stink. Every option contains potentially things you can't quite live with, and yet can't change or affect. I am sure if you knew how to make these decisions it would be better however with having many unknowns it is difficult. Stop helping and give him an ultimatum, sucks. Keep helping and have it drag on, sucks. Do nothing different, still sucks.

All I can say is to take care of yourself in this process, watch for resentment and signs you are getting worn out, and then let go of what you can.

[Fawn]

Fawn makes a good point. All the more reason to talk directly with his physicians. He may have 4-10+ years or he may have 4-10+ months.

I'm no oncologist but I thought stage 4 was metastasized--systemic.

Stage IV is metastisized. Prostate commonly metastasizes to the lung and bone and brain. If it is merely in the bones, it can be very painful, but go on for years, ie. 4-15. Prostate cancer is one of the slowest growing, and because of this does not respond well to traditional chemotherapies, but does respond to hormone treatment.

[jennipurrr]

I have to heartily recommend AlAnon. Even if you are hesitant, go to a meeting and see. The support and peace you will receive there will help you immensely whatever you choose to do.

My MIL is an alcoholic and has a number of other health issues. We thought last year it might be the end as she was having liver failure from hepatitis C, but with chemo she has extended her life somewhat, probably about 5 years guesstimate. For me I have always wanted higher boundaries with her, but she is not my mother so it is much easier for me to do and stick to those things. Alanon was the first place DH felt that people understood what he was struggling with in having an alcoholic relative and in the struggle of setting limits with her while she was so sick (in our case emotionally, we are not financially responsible at this time for her).