Dilemma [View all]

I don't even know where to start with this, but hoping someone here might be able
to offer a voice of experience.

First, my hubby is a psychiatrist/psychoanalyst. Been in practice for about 45 years.
Old school, doesn't just hand out meds but engages people in talk therapy. Doesn't
practice traditional psychoanalysis, but uses psychoanalytic techniques in the approach
to treatment. Has always had a component to his practice of working with people
of limited means, whether at the VA or in community clinics.

I have a 60 year old cousin whom I always thought of as a little odd.
Had limited exposure to him growing up, and probably hadn't seen him half a dozen
times as an adult until first his mom died, 4 years ago, and then his dad, just
before last Christmas. They lived in Pasadena (the cousin lives in Seattle) and
we live in NC now after living many years in the L.A. area. Never considered
the cousin might have mental health issues, and my aunt and uncle (his parents)
would never talk about him much when we were visiting. After my aunt died,
I spent a couple of days around him, with my uncle, and became increasingly
concerned about his behavior. He ended up driving away, back to Seattle,
leaving his almost 90 year old dad alone to clean out the house they'd lived
in for 30 years before putting it up for sale. The cousin was not working (his field is construction)
and has no family. There really was no urgent reason for him to return to Seattle. My cousin did nothing to help
his dad identify whether he wanted to go to assisted living, or look at places.
I had a conversation with a close neighbor across the street from the uncle's
house--who had been like a daughter to them over the years--and she rather
matter of factly told me the cousin was "on the spectrum" and certainly had
Asperger's. Well, that blew me away. I had never considered it--but it fit
his behavior--and his parents had never said a word about it. Eventually,
with the help of the neighbor, my uncle sold his house and moved to assisted
living in Pasadena. About two years ago, after a couple of falls, an increase
in the monthly cost of the assisted living arrangement, and numerous calls
from Pasadena to Seattle about my uncle's deteriorating condition, my cousin
elected to move his dad up to Seattle with him. There was plenty of money
in the estate to arrange some other way for him to stay in Pasadena where
all his friends were. The neighbor tried to convince my cousin of that, but
he resisted and moved his dad to Seattle. My uncle reported to my husband
during one phone conversation during that period that my cousin had told his dad "I'm just
waiting for you to die".

OK. The celebration of life event for my uncle was held in Pasadena on the 15th
of March. My brother went to it, we did not. He reported that the cousin had
gained a lot of weight (he likes his beer) and was talking non-stop (which he's always
done). He showed up in an old van--modified with a battery to run a/c--in which
he had driven down from Seattle and was sleeping in it. The cousin is the sole
heir of his parents estate--and there should still be LOTS of money in it--enough
to buy a nice RV if his wish was to drive around the country. He mentioned he was
thinking of taking a road trip--to Colorado--to visit two of my brother's kids who live
there. Two days ago, my brother e-mails me that the cousin had showed up, unannounced
and uninvited, at one son's place of work--a car dealership--stinking and looking like
he was "homeless". He had first gone to the residence, let himself in the back door,
and it turns out the son's wife had been sleeping in a back bedroom (she works nights).
She's never met him. Can you imagine if she awakened to find this unknown, unkempt
guy in her house? The son was angry and speechless, and I gather told my cousin
to get lost and never come back.

From this description of events, putting together behaviors, my husband thinks that this cousin
could be undiagnosed bi-polar, and possibly evolved to schizophrenia. There is a high degree
of association of alcoholism with bi-polar diagnoses, too, according to my husband.

It appears that my cousin's condition--whatever it is--has deteriorated significantly from
the last time I saw him almost 4 years ago. He has no family left (only child) and just
my brother and me and our children. We've never had much connection with him.
My husband is optimistic that, if my cousin would get treatment, that it could have
a very beneficial effect on his life. People--and frankly, we're no different-- don't want to be around my cousin, because
he is so clueless in social situations. We suspect that he has gone his whole life without getting appropriate help,
and that my aunt and uncle not being willing to talk about him did not help that situation.

My question is, has anyone dealt successfully with this kind of situation--either been the person with the mental health
issues or the family trying to get someone to realize they need help?

I would appreciate any comments or suggestions.