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(I apologize in advance for the length of this:)

As of the end of June 2014, my older step-brother moved from the Southwest US up to our home in Ohio. We've never been close, there's about ten years age difference between us (he's 63) and we're very different people.

He's lived on his own for 30+ years and has a mean streak. He is highly intelligent and highly self-centered.

He suffered moderate strokes in March and April of this year. He spent two months in a TX nursing home, and found the experience very unpleasant to say the least. He very much wanted to stay on his own but finally realized he just couldn't do it by himself any longer and finally accepted our offer for him to move in with my family. He walks with the aid of a walker (when needed), he's able to bathe himself, go the bathroom, feed himself, drive around town, self - medicate,etc.

Between his SS income and his receipt of a lump sum disability payout, he was able to cover the costs of the move which included us flying from Dayton to Dallas, meeting up with him and driving back in his car.

It was agreed that we would provide him a private room, cover all his food expenses, laundry, trash, utilities, help with transportation, etc. In return, he agreed to pay us $500/mo.

My wife is a RN and it was expressed by us that having a nurse around could be useful should questions arise about health issues, medications, etc. Due to a degenerative back condition, she no longer does floor nursing. I too have a similar back condition that requires medication so more physical tasks such as moving this person are beyond our capacity.

Our hope was that he could remain independent and perhaps improve in Ohio with less stress and more help available. Finding his own apartment here in town also seemed a possible path that would've given him even more independence.

He is a 1.5 pack a day smoker....we permit smoking only outside-to which he has complied.

Until recently we'd felt the transition had gone reasonably well. We've tried to be as attentive as we could be to his requests, food preferences, laundry needs, setting up his bedroom, getting his driver's license, etc. I've also made it a point to try and sit with him for 30-45 minutes a day to visit. In other words, I/we've tried to make him feel as welcome as we could. No other family member or friend offered him a housing alternative. Just us.

The bumps that came up were...

1) a complaint of being too cold: The thermostat is set between 69-70 degrees. IN the summer, it doesn't usually fall below 72. We've also blocked the air vent in his bedroom, provided him a good quality space heater, and made available additional blankets and sweaters. He thinks we're keeping it "cold" just to :control" the issue...

2) one morning, he nastily complained that he was unsatisfied with the food situation. He claimed he spoke to my father (his step-dad), our sister, our aunt and his attorney and said if he didn't start getting prepared meals-he was going to refuse to pay his rent. I reminded him that a) the vast majority of the items he'd communicated to me that he wanted we in fact in the house and that b) if he wanted something else-he needed to let us know and c) "prepared meals" were never a daily service. Wife works 7 days on, 7 days off with 12 hours days, and my schedule is highly erratic. d) When we do have prepared meals, he's always welcome to join us. (As of a week or so ago, he acknowledged this issue had been resolved satisfactorily...)

3) the use of his car: In the month leading up to our going to TX to bring him back, he often and regularly offered us the unconditional use of his car. Knowing one of our vehicles was in need of a fairly serious repair-he almost daily remarked, "Well, once I get up there-you'll have another car to use as you need to..." To be clear-we didn't ask for this---he offered...

Once in Ohio, he continued to make the same offer, so we took him up on it several times a week. We liberally replaced whatever fuel we used. After a few weeks (and after the food complaint) he stated he was feeling abused about us using his car as we had been. I was floored. When I reminded him of all the times he'd reminded me of the availability of the car, he stated, "that's what you say." I asked him firmly if was saying I'd lied about the matter and he wouldn't answer. I told him it was certainly his car-and he had a right to change his mind if he wished on how we used it, but that I found it offensive to suggest I'd made it up. He then said "only in the case of emergencies," which we immediately respected.

Things were pretty quiet for about a month...

About 2.5 weeks ago, while the 3 of us were eating dinner on a Friday, out of the blue he tells my wife if it would make it easier on her she could use his car for work all week. We were surprised and identified a single day when it really would be helpful. Unfortunately, the next Monday, he fell in his bedroom and sustained another....

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I agree that you are handling it well. How much did he expect for $500 a month. Even in TX that isn't a lot of money. I would have been grateful if someone had done for me what you did for him.

I am a little less kind than Jeanne. :) I would be very upset if he had talked about my spouse like that. Your loyalty is with her. If he finds fault with her, then he doesn't deserve to live with her. If he does regain enough ability to leave the NH, perhaps you could help him find a place to stay. There doesn't have to be hostility, but you don't have to live with him, either. $500 is not enough money to put up with someone making your home stressful.
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Bill, your post is articulate and well-organized. Thank you for providing so much detail.

I really don't know what you need suggestions or advice about. You are handling this well, in my opinion.

He's angry, he's depressed, he's afraid, and really, that does kind of give him license to say anything that pops into his head. Or at least it obligates you to crank up your compassion and make some allowances. If this were the first time you were having problems, I'd say let it pass, wait and see how he is if/when he completes rehab, and make decisions then.

But this really doesn't sound like it has been working out well. Is it adding stress to your marriage, or can you take it in stride?

In my opinion, once he refused you the use of his car, you should have just dropped it and never brought it up again. It is a control issue, and each time it comes up you fight that battle all over again. If he hadn't moved in, or if he didn't have a car, you and your wife would have figured out a way to handle it. Figuring it out without consulting him would have been the best move, I think.

But that brings up the lack of warmth in this relationship. He hides the car keys in his bedroom? Huh? He accuses you of making things up? He insists on services that were never promised him? This all just sounds stressful to me.

You've never been close. This has been an opportunity to grow closer, to get to know one another, to bridge the difference in age and personality. But it doesn't sound like that opportunity was fulfilled.

It appears that you have been able to address difficulties in this situation and get beyond them, one by one. How much effort does that take? Does it take an emotional toll on you? Is it interfering with your relationship with your wife? What does she think about the possibility of your step-brother returning? If anyone could make this work, you sound like the guy! But at what cost to you? Are you willing to pay that cost? That is for you and your wife to work out together.

Please keep us informed and this plays out. We learn from each other!
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You need to let him and the NH know that you and your wife are unable to care for him any longer due to your own physical health. He will not be returning to your home. How do you think either of you can handle him getting up and down the stairs? Or do you have a downstairs bedroom? I would start packing up his things and make arrangements for either a move back to Texas or assisted living near you, provided you wish to continue being a part of his life.

There must be a reason he had no options in Texas and decided to bring his meanness to prey on you; a step brother he had no real relationship with. Once the disrespect starts you are best to set boundaries to limit contact.
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I notice you mention other family members. I didn't notice you mention any other volunteers when it comes to supporting your step-brother. I wonder why that might be…

I agree with the consensus, and join in Jeanne's thanks for your detailed and moderately-voiced account. Really, I think you've done all you can, don't you? It's a pity your stepbrother hasn't taken this opportunity to become part of your family, but as they say you can lead a horse to water but you can't make him drink. This horse isn't thirsty. And he's not your responsibility, either.
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Getting a correct psychiatric/Neuro diagnosis also matters so that you and your wife understand that he's not lying, he's not remembering.
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Your brother-in-law could be suffering from some cognitive deficits from his strokes. Or he could just be a mean, self-centered SOB, who knows? Regardless, he's become a psychological and financial burden to your family despite your best efforts to integrate him into your loving home.

I think it's time to say, "This just isn't working." Let the hospital/rehab find him an appropriate place to live. Continue to offer emotional support but let him find his own alternative housing with the help of professionals. He's not the least bit appreciative of all you've done for him, from what you've said. You tried, it didn't work out so no harm, no foul, everyone moves on. You and your wife have your hands full with your own immediate family and he has other resources he can use to help him.

You and your wife are to be commended for stepping up and trying to help your brother-in-law. Too bad he couldn't make the best of it.
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You need to let the discharge planning office know that your family is unable to care for your brother's increased needs. There is no other explanation needed to them or to him. Don't let them or him try to manipulate you. Whether or not you or the staff see it yet, your brother has significant personality/mental health/dementia related issues that require professional intervention. Don't feel bad. You tried it. He has increased needs. End of conversation.
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Do NOT let him back in your home. There are numerous posts on this site about people not being able to evict someone from their home. Pack up his stuff today and move to garage or storage unit. Let the discharge planner that do to health problems, you will no longer be able to care for him. They will find other arrangements. Let him know in front of others such as the head nurse or discharge planner. Also let him know you have already packed up his belongings. Don't wait until he is ready to be discharged to spring it on him that he can't come back. He will need time to readjust to where he is going. You wouldn't want to know at the last minute about your own living arrangements. You gave it the old college try. It's no crime it didn't work out.
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Don't take him back to your house, not even for a little while, because a little while can turn into months.
Setting aside issues of the car, and insults about your wife's weight, you and your wife simply aren't in any physical condition to care for him.
You gave it your best shot, you tried and it didn't work out. These things happen. It really doesn't matter if he has neuro-psychiatric issues on top of his physical ailments that cause him to forget what he promised about the car, he's just too much work for your and your wife to cope with.
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Well, from your description of your brother I would have expected this outcome. People don't change. They grow meaner, crazier, stranger or whatever as they age or get sick. He is just showing you he has not changed. Please don't be surprised. Put him in a nursing home and let him complain all day to people who are used to hearing it.
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