I have an uncle who is...well...reality challenged.
Once upon a time, he was a college professor. He taught Anthropology and Archaeology, he traveled to Israel and Mexico and other places on his summers off to participate in digs, and he seemed a little like Indiana Jones to me.
Then my grandmother, his mom, started having "small strokes." Transient ischemic attacks is the medical term for them. Every time she'd have one, she'd lose more and more of her memory. It became clear that she could not care for herself anymore, and that he would have to become her caregiver.
Little by little, he pared down the number of courses he taught at a local community college, and eventually he stopped teaching altogether as my grandmother's hold on reality slipped away, and she needed more and more help with her activities of daily living. He did not know it then, but he was headed on a downward spiral himself.
More of the tale under the squiggle.
By the time my grandmother finally gave up the ghost, uncle Jerry's whole life revolved around caring for her. He wasn't teaching anymore, he wasn't doing much of anything other than being an unpaid caregiver. It was almost a relief for everyone when she finally died, and Jerry talked about getting back into the swing of teaching.
Only he didn't.
Depression is an insidious, sneaky foe: I have dealt with it myself. My depression came on concurrently with a bout I had with Chronic Fatigue Immune Dysfunction Syndrome, which I have been in remission from since 1995. Which came first, my immune system going berserk and getting stuck in "ON" mode, or the chemical imbalances that caused my mood to change? It's a chicken-and-egg thing. Depression tends to run in families, and I can see its marks on people on both sides of my family.
Jerry did not recognize the dark place he had arrived at as depression. He didn't want to go get help to work through the grief process, he didn't see anything wrong. Eventually he gave up on teaching. He let his drivers license lapse. The last straw was when he started getting mysterious four figure water bills...eventually it became obvious that a major pipe under the house he grew up in had broken, and the DWP cut his water and power off. The phone lapsed next. The house began to look like that of a classic "pack rat," with stuff piling up like sand dunes. Growing up, I spent a fair amount of time there, visiting with my paternal grandmother, grandfather and uncle. Now it was unrecognizable. During hot summers, Jerry would often sleep outdoors like a homeless person. While technically homed, he lived like a homeless person.
My husband and I would visit him from time to time, and we asked if we could help. He rationalized his situation. "People in most of the world live like I do. Why should I be so arrogant to think that I should live better than that?" For the next 14 years, we attempted to get help for him. But the fact is that an adult cannot be forced to get help, unless you go through a humiliating process where that adult is declared by a court of law to be incapable of handling their own affairs.
By the time he hit 65, he was finally getting health care at least. And his situation was getting the attention of the social workers in the network he got his Medicare Advantage plan from. However, their hands were tied. The assumption was, Jerry was a competent adult. He could not be forced to get help, even as a senior citizen.
Finally, after a lot of persuasion, Jerry having significant medical problems that required the insertion of a pacemaker and defibrillator in his chest, and the realization that perhaps he shouldn't be recovering from surgery under those conditions, he began coming around to the idea that he might be better served living in an Assisted Living facility. However, those facilities are crowded, demand is high, and the first place he was approved to live in was in an isolated, unfamiliar part of the Northeast San Fernando Valley. After one day at the facility, he never went back.
Part of what had to be done for Jerry was to deal with selling the house and putting the money into a trust to preserve it for his upkeep. There was no assistance available to him had the house stayed in his name. However, his leaving the first Assisted Living facility complicated things. The house had already been "trashed out," and assessment of the necessary repairs to make the house livable and those said repairs would mean he couldn't crash there. So until we (me and my family) found alternative living arrangements, he was not just living like a homeless person...he was out-and-out homeless. We attempted to offer him alternatives, but he refused to live in a motel. "Too expensive" he said, dismissing the offer.
The current situation is looking up, thankfully. I found another facility, this time in the neighborhood he was familiar with. I have my fingers crossed, and am hoping that what the director of the facility said was true: that he can move in this Monday. It only took me 14 years, the last few on my own without the emotional support of my late husband, but maybe Jerry will finally be in a safe place, and not live the life he's led. Maybe he'll also get some help for his emotional needs too, but I'm not holding my breath. As long as he doesn't think he needs help, he can't get help. He is an adult, and assumed to be competent to handle his own affairs. I can only hope, advise, and think good thoughts that one day he'll come around to understanding the need to reach out for psychological help.