46 year old Bro in Law likely has Asperger's, now urgent

Post Reply New Topic

Hi!

After doing a lot of research online I discovered this forum. While I am still taking everything in and exploring the site, I have a situation I am a bit desperate with so I am looking for advice immediately.

I have long suspected my now 46 year old brother in law of having Asperger's. He exhibits a lot of the classic symptoms, has trouble with social skills, holding down a job, managing money, etc. He lives at home and is largely supported by his parents. My wife and i have tried to reach out to him and build some kind of relationship with him, albeit this has been a very slow process, with the eventual goal of getting him help and being ready to look after him when his parents are gone.

The situation has escalated rapidly within the last month however. My mother-in law was officially diagnosed with Alzheimer's and has diminished memory and mild dementia at this point. Her relationship with her son has always been dysfunctional to begin with, but now she has episodes in which she will accuse him of various things, and he will fight back with her. While the battles have not been physical in nature, apparently they have been so stressful my mother in law has been hospitalized twice in the last few weeks.

Firstly, we have to separate them. Any more incidents like those above are very likely to occur while they live under the same roof. With the Alzheimer's my mother in law is not always capable of controlling her emotions and outbursts. With the undiagnosed Asperger's my brother in law is incapable of having any empathy for his mother and is actively making her situation worse.

My wife and I are in the process of moving her in-laws in with us (her father is in declining physical health as well) and while this is going to be a huge task in it's own right, the idea of taking in the brother in law as well is basically too overwhelming for us as well.

We are fortunate in two regards. Firstly, the parents are set up well financially, so the question of the move, plus cost of care and treatments is not a concern at this time. Secondly, we are in area which has a lot of great resources and support for both Alzheimer's and Asperger's, and we have received much help and advice in these matters.

The only problem is the brother in law refuses to acknowledge there is any kind of problem with himself and won't look into any of the resources available to him. We finally approached him and suggested he may have Asperger's, carefully explained what it was and gave him many links as a start to do research for himself, as well as offered to guide him through programs which could help.

He naturally rejected all of this.

He is aware that his parents are moving and selling the house so he will have to move to (his is being very uncooperative in this and is actually hindering the process of the sale), I don't think he is aware that he will not be living with us.

There is an opportunity to set him up in his own place to live; either an apartment or even a condo down the road, NO ONE thinks this is a good idea unless he seeks some sort of treatment.

Time is important, because my mother in law's condition is worsening by the day and we need to get her out of her current environment (she is responding very positively to the care my wife and I are providing, but she is just far enough away that we need to get her closer).

We are at the gentle coaxing stage with my brother in law right now, urging him to seek help on his own and providing him with resources on the matter. He is being extremely stubborn however.

We have yet to move to the threat/promise of mentioning he is going to need to find a new living situation, and what he can get and the support he will receive will depend on his willingness to get help. (Is it even advisable to dangle such a carrot). Either way, he can't live us, quite frankly it's a bit too much for my wife and I to take.

We also have yet to do anything in a threatening manner. Not that we want things to come to that, but if he fights with my mother in law and she winds up in the ER again we will have to do something drastic.

This is a somewhat abbreviated version of the situation, but if anyone has any suggestions or help it would be greatly appreciated. I don't necessarily believe that getting him in a program or therapy will be a magic bullet to make him instantly better, but i am hoping for a start, as you can see I have a lot of things going on at the same time!

What does your father-in-law have to say about all of this? Has he been able to communicate the seriousness of this situation to his son?

Is there a way that you guys could swing this financially without selling the home, right now? If he were there on his own could -you- sign him up for services and would he comply if someone else set it up? Could he live there on his own safely?

Here is why I say this:

From his perspective: If he has AS he is probably a person who hates and is scared of change. He is probably a person who is not good at the executive skills/social skills required to sign up for whatever services are available. Given that he is undiagnosed, he is likely to be at minimum initially in denial and maybe longer. That is a long time to be undiagnosed and then suddenly be expected to accept a thing like this.

So from his standpoint, his home is being sold out from under him, he is scared, and so naturally will try to sabotage the sale. There is a ton of uncertainty with his living arrangements, and even if he were moving in with you, it would still be a big change. Change is scary. In actuality, no one can tell him where he is going to live. Uncertainty is scary.

My father in law is turning 80 this year, and although mentally sharp has been in a physical decline for awhile. (Part of the reason we're making the move is because he's had about five trips to the ER in the last two years himself) He is an immigrant from China and some old world views on mental health and isn't always the best communicator himself. He's long been aware that his son has issues, but he's not been sure of what or how to deal with it.

He has been very open to what my wife and I have been saying, and is offering his support to the best of his abilities, but his relationship with his son is that he is depending on my wife and I to make the communications and most of the leg work (for both his wife and son). He has been financially supporting his son all this time, and we could simply get his son an apartment, but his condition is severe enough that NO ONE thinks this will be a good idea without him getting some kind of treatment.

I should point out that the diagnosis of Alzheimer's on his wife has been tough enough on him (it was about six weeks ago!), plus years of living in a house when you have two people with definite but undiagnosed problems has definitely been rough. He's been extremely supportive and stepped up himself in a lot of ways, but given his condition we're trying to not overwhelm him.

There is no "treatment" for Asperger's though.

If your brother-in-law could be set up in an apartment, what kind of help would he need to be able to live independently? Would that be affordable or even acceptable to him, do you think?

Edited to add:

I'm conscious that my posts might seem abrupt, and just wanted to add that I have every sympathy with you and your wife, in what must be a very difficult and emotionally challenging and draining situation. Alzheimer's is particularly cruel.

I am not sure what you mean by treatment. Do you mean have someone teach him adaptive living skills, emotional regulation skills, provide therapy?

Remember that all that will take time, even if he is compliant. He may need services to handle adaptive skill type things like paying bills etc. (If your F-I-L is paying, he could have it set up as autodraft, initially)

I guess what I am asking in a round-about way is what specific skills is he missing that would preclude him from living on in the family home? (or an apartment, if that is not feasible) Those are the things that need to be initially done by someone else until he can do them himself. These skills make take a long time to acquire or may be beyond his capabilities, depending on his exact situation.

The homes have to be sold for this to move forward. We are in an area where real estate is extremely expensive (SF Bay Area) My mother in law has wanted to move for years in fact. The house is huge, but a bit isolated from services and easy access for people to visit, and the isolationism has been a source of stress for my mother in law especially.

I am aware that he is not going to like the change. The house is huge, and he has the run of nearly 2000 square feet to himself downstairs. That area is filled with toys (he probably has like 20 stuffed animals on his bed alone which has to take him a considerable amount of time to arrange every morning), and pictures of himself all over the place (oddly enough he has an aspiration to be a model, and the poses and subject might be a bit of unintended comedy if i didn't think it was a symptom of his problems).

Part of the problem as well is the level of co-dependency he's had with his mother. Aside from not having to worry financially, she will cook for him (he will sometimes make his own meal regardless) keep the house clean and even do his laundry. Whether they move or not, she is not capable of doing those things for him anymore. We would have preferred to have this transition be more gentle or gradual (sometime before his parents passed on ideally), but delaying this will definitely be detrimental to my mother in law's health.

I don't think it is fair to not give your brother in law the full story. It isn't a threat, it is the reality he will have to adjust to.

Sit him down and be matter of fact about it. Tell me that you want him to understand, agree to, and be a part of the changes that are coming. Tell him that you all love and care about him, but are also aware that he has never lived alone, and are worried how he will adapt, which is why you have been pressing the issue about help. Ask him what he wants and how he sees the situation evolving. Explain why your mother-in-law and father-in-law will be moving in with you and why that means the house needs to be sold.

Always treat him like a rational, intelligent adult who has a right to make choices and share his opinion. Gently remind him of situations he has struggled in when he argues that he can do all these things by himself.

And, if push comes to shove, let him fail at living on his own if that is what he needs to do.

I do wonder if you could carefully find him an apartment that he could safely live by himself in. Minimal or no kitchen, walking distance to restaurants he likes. Hire a maid service. Let him know that he can bring his laundry to your house once a week for help getting it done. Basically, reduce the opportunities for issues to arise.

Last edited by DW_a_mom on 11 Jun 2014, 11:07 am, edited 1 time in total.

If money is not an issue and it is primarily housekeeping that will be an issue, housekeeping services can be retained for him, if he is OK with someone he does not know doing those things for him.

it sounds like he has a ton of stuff, and that will be an issue with him also. Moving from a spacious house to an apartment will mean you will presumably be making him choose which of his things to get rid of. This, you may already know, will be a huge issue.

I agree, the idea of losing his things will be a giant issue. Any alternatives have to include some way for him to keep his things. Many people with ASD see their things are being similar to people, and truly cannot discard them. Even if that means carefully arranging them in a storage unit that he will be able to access on a regular basis, find a way to keep his things.

Be aware that the rental market in the Bay Area is awful right now. You may find that it costs more to find him an apartment than to allow him to stay in the home.

To be more specific about my Brother in law's condition, although he has not been diagnosed, a number of professionals I have discussed his situation with seem to believe that Asperger's is a likely diagnosis, with some other mental problems from being undiagnosed for so long being likely.

When I say classic Asperger's Syndrome, I suppose I mean the no eye contact, trouble reading social and emotional clues, inability to make new friends and hold down a regular job (he works food demos at places like costco and the like).

I can site other some more troubling incidents as well. Aside from fighting with his mother (fully aware she is Alzheimer's he makes a point of telling her off when she is having an episode), there was one incident when I had to take his father to the ER (pneumonia) and my brother in law was in the house but went about his own routine without even acknowledging his unconcious father in the room)

There is also a very real concern about his ability to take care of himself and make proper judgements. He has declared bankruptcy at least twice, once sending all of his money to a mail order bride in russia who never even came to this county. Even recently I discovered he purchased a computer from a friend that was about 15 years old, and he paid what would probably be over list price when it was new.


I don't want to come off as unsympathetic towards my brother in law. I really believe he can't help himself in a lot of cases and I've been working for years to build some kind of relationship with him. But right now, what he is doing is having a direct effect on the health of his parents. I am also aware that he won't be cured, and getting him treatment won't provide any quick fix, but i do think his case is severe enough that it is necessary, as it is necessary to move at an accelerated pace because of everything else going on.

I should point out that we have communicated this with him already, and pretty much used that exact wording. (He responds well to e-mail, talking to him in person is very difficult) Changes are coming, we are concerned for you and want you to have a good future, we want to support you, but we need to take care of your parents. Pretty much a flat out rejection at this point, but he is still communicating and hasn't shut us out, so I think there is hope. Like I said, his staying at the house will not be an option, and his living with us isn't really going to be an option either (to be frank, I don't think I could deal living with him even if I didn't have to take care of his parents on top of things). We're trying to empower him as much as we can in this situation, gave him a lot of research and even have multiple options for him.

His response is summarized that he doesn't have a problem; everyone around him including/especially his employers are flakes and idiots, and he hates his mother and thinks she should be put in a home. To be blunt his responses are making it more difficult to be sympathetic with him, as we're all under a tremendous amount of stress at the moment. He emphasizes his future is his concern, although the reality of it he doesn't have the tools to be independent at all without his parent's support, which he can't count on forever or even in the very short term.

I would have less of an issue letting him freak out or fail if I didn't think it would result in another ER visit for his mother.

I'm at loss as to when I offer the reward (if you at least comply with treatment you're more likely to get your own place) or even when to go on to to outright threat (he can't be aggravating his mother intentionally in her condition.)

What kind of treatment are you expecting him to comply with?

I am not sure how much "treatment" there is available for a 46 yr undiagnosed aspie. If you specifically spell out to him what he needs and why, he might understand unless he does not understand himself to be bad at those things.

There is no general AS "treatment" so I do not know what you mean, myself. Do you mean life-skills training or any of the other things I mentioned before? Life-skills training maybe could be sold to him b/c you could explain the natural consequences of not being able to take care of himself, properly. Other things, I don't know. I don't know that they have social skills group for his age, for example, and I doubt an adult would want to do that, anyway. From what I have heard once kids get to a certain age they balk at it, even. What specific "treatments" do you foresee him needing?

Edited for syntax.

I tend to think that if he hasn't learned these skills by now, or decided that he wants to learn them, you can't expect that he ever will. Which means that things move into protective mode, reaching a balance that both you and him can live with. Money for him could be placed by your in-laws into a trust, for example, that directly pays for rent, utilities, health insurance and housekeeping, while giving him a food allowance for eating out. Most definitely, given what you have said, I would make sure that he is NOT just handed his share of the inheritance someday.

So, I guess, I question what you expect from trying to force him to engage in services or treatment (although co-morbids like depression you would hope he would agree to treatment for).

I wish things had not progressed for him to this point and he had gotten appropriate help earlier, but I don't really see how you can go backwards. I've been on this forum long enough to feel many of the adults are pretty well set in who they are and how they think; sometimes things like cognitive behavior therapy help, and I've seen some of the adults choose that and be happy with the choice, but everything strikes me as a long shot with an adult over 30. You can't force someone to see what they are, simply, not capable of seeing, and that is why people with ASD can seem insanely stubborn. They don't mean to be stubborn, they just have no way to move inside their minds from position A to position B, and I don't know how you, given all that you have said, are going to be able to force it. Threats are useless when issued to someone who really has no path to achieving what is sought. I can't even begin to tell you how much work I've put into getting my son to understand certain things; probably hundreds of hours of gentle conversation. You don't have that time or the trusting relationship it takes for him to learn from you, so you really may have to accept that the vision you have for what he needs to do may not be workable. You have to find something he can absorb and accept, even if you don't consider it the ideal option.

There are some group homes in the Bay Area but I don't know how to access information on them; that is probably something you should look into.

I really would be inclined towards a small apartment with reasonable food options in walking distance, and funds held in trust to pay for it, if there is enough money for all that. You've made it sound like there is, so that is still where I think I'd go.

Last edited by DW_a_mom on 11 Jun 2014, 1:12 pm, edited 1 time in total.

You seem to have a lot of empathy for your mother-in-law and father-in-law, but none for their son. When I read between the lines of your posts, I sense a lot of disgust and impatience. I feel very sorry for him.

To be fair, I think we all have limits on how much patience and empathy we can dole out, and I would not expect anyone to be able to provide enough for three in-laws no longer able to care for themselves. It is enough that he seems to want to make sure the brother-in-law ends up in a positive situation.

I do, of course, also feel sorry for the brother-in-law, but I don't know how to do better by him, either, other than to provide information on how he will see things and what allowances the family should give in letting him have some things his way.