Hi and thank you for your service in the difficult, but important nursing profession.
I sent you a private message. It's at the top right corner of your screen. Check it out!
You are probably not going to like what I am about to say though.
I am not sure if you are asking for advice, but I'll go ahead and say that I know many nurses and that many of them have issues setting clear limits with their male children. Nurses I know, are stuck in abusive, dysfunctional communication patterns with their kids. I know quite a few nurses who are verbally abusive to their kids, or overcontrolling/domineerings (which constitutes emotional abuse because it does not allow the child to take initiative on his own and develop - they teach this in nursing school btw). The type of parent I see is tyrranical and at the same time lenient. Like the mom will fight the son about washing dishes, yell at him and so on, and he will misbehave back, but at the end of the day, the son does not was duishes, ends up crossing more boundaries and has not learned anything at all.
I see a pattern with nurses I know - often their daughter goes to college and gets a PhD, while their son ends up partying through all through his twenties. Somehow, the nurse's can't translate patient handling skills into parenting skills.
Of course, your son has legitimate psychiatric issues and you are doing your best. In fact, you being a nurse and pulling in a nice steady income and taking care of things at home earns you a monument of appreciation. But hopefully, if you read my post, it may break some of the thinking patterns that so many parents are stuck and maybe help you think in different ways.
Also it is very common for moms of kids with disabilities to fail to set limits for them. Remember though, that setting limits means that you don't yell and that you are nice, but firm, serious - you look the child straight in the eye and reason with them. You do not take no for an answer, but you never abuse them or make them feel small or powerless. In fact, setting limits is a time for you to help your kid develop his skills, feel better as a person, become empowered. Limits also make kids feel safe. Kids need structure. You can bargain with him how he will wash the dishes and when. Give him choices so he has some power to decide.
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Some of the threads I started are really long - yeay!