My brother had his first stroke 8 yrs ago, second one last July and we believe he's had a third small one just before christmas last year. He isn't bathing, he is going to the bathroom on himself, sometimes it seems like he either doesn't know or doesn't care, we've discovered his utilities have been turned off, he's behind in his rent as well and has lost his job. His speech has come back, and he's walking well for the most part. (does lose balance from time to time) He is also diabetic, he was on shots but then was moved to taking pills. All he is taking as medication is baby asprin, nothing for the stroke, or diabetes.
What do we do? We've gotten him out of his home and into a family member's but it is not a forever solution. He isnt going to the doctor's as much as we think he should, we think there's more wrong than what he's telling us. How do we convince him to give up his place and get help, assisted living or something. What's the next step?
It's a huge task, but start collecting data: tasks he isn't able to do for himself, finding out truth of his financial situation, get a really good physical with a geriatric doctor or family doctor and referral to a neurologist. He may also need to see a psychiatrist since there may be depression component involved. Ask doctors about competency and let them know all you have discovered. You will need a doctor to declare him mentally incompetent to use the POAs.
There are many options for assistance: home health care aides in his home, assisted living, and full care residential facility. With somebody helping him manage his finances and daily home health care aides, he may be able to stay in his home - which will be the least expensive option.
Tell him he's behind on Rent and his Utilities are off and that you don't have the money to pay and staying with a family member was just short term.
Tell him you will Look for a couple nice places for him to stay and let him choose which one he likes.
If he doesn't want to do this, then the next time he has to go to a Hospital, let them know that they need to find a place to release him to because there isn't a place for him to return to and he can't live on his own because it isn't safe.
Of course the next
It's a matter of following the trail back to the last person or team that were actually doing anything useful for him, and picking up from that point.
If the stroke has affected his abilities as much as stroke often does, he probably isn't capable of co-ordinating and complying with his own treatment plan unassisted. So he will need assistance. What sort and how much and where and from whom, it will be easier to work out once he's more stable and back on track with treatment.
Go with him to see what his current health issues are.
If he is resistant to seeing the Doctor, consider a 'fiblet' to trick him there, like needing more prescriptions or a flu jab. Otherwise, wait for a hypo & call emergency services.
Once stable, it can be discussed if he has improved enough to be safe living alone again.
If so, I'd contact Area of Aging. I found this - for 60+ but also disabled adults under 60: http://www.milestonesaaa.org/
He will probably need a current medical exam to see what he qualifies for.
Currently it sounds like he needs supervision & cannot look after himself & therefore I think you will need to ask the Doctor about your brother's capacity. Doctor may be able to do this or may need to refer to Neurologist or other specialist. This may be confronting, & I'm very sorry, but it will be important. He may lack insight into his care needs (search Anosognosia on the forum). This is common with stroke, although they vary a lot - but like other brain injuries, the brain does not know it has been damaged.
If he does lack capacity, he will need a legal Guardian. Then the Guardian can arrange to move him into a supervised care setting. Probably need legal & social worker assistance to research options & help get this done.
I am so sorry you are going through this.
If his decline continues it may mean LTC with Medicaid paying the bill. Its nice that family wants to help but they have lives too. And in the long run that may not be the best solution. Sounds to me the strokes may have caused some damage and brother maybe in early stage of Dementia or even depression. And, if not taking his meds correctly could be a problem.