Is there a way to determine if someone can live independently?

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Is there a way to determine if someone can live independently?

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My brother-in-law (36) has never lived on his own due to short-term memory loss. Is there a program that could evaluate his ability to live on his own? I'm essentially trying to either see if it's a future possibility or if I should plan for him to live with us when the time comes. My fiance is hesitant to allow him to do some things and I'd like to either ease his fears or confirm them. He has already said he doesn't want his brother living in a "group home" likely because of some stigma he feels they have.

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You've asked similar questions about your fiance's brother on this forum in the past and have gotten some good answers:

https://www.agingcare.com/questions/how-do-i-stay-sane-468499.htm

Even if he tested well to determine he could live independently, would your finance AGREE to letting him live independently? I think that's the question to ask yourself more than anything.

He can go to the doctor and be given a cognition exam, normally a MoCa test, to determine where he falls with his cognitive skills. That will let everyone know whether or not your future BIL is able to live independently or whether his short term memory loss is considered cognitive impairment/dementia and that he's in need of living with assistance. He'll be scored on a scale from 1-30; a score of 26 and higher is generally considered normal, 25 and less than 25 = mild cognitive impairment and so on down the scale to progressive dementia/Alzheimer's. You can Google the term for more in depth information.

Short term memory loss is a serious disability and normally prevents a person from living alone; they can forget to turn the stove off and burn the house down, or mix chemicals together to clean, not realizing the combination can asphyxiate them. While your fiance's brother may appear to be fine and capable, having a relationship & a job, he still may not be capable of living on his own. Only a qualified doctor can give you all that answer, once some cognitive testing is done.

Wishing you the best of luck finding a workable solution to this situation.

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Thank you for the advice. I didn't recall receiving specific information regarding a cognitive/abilities test. I realize that he has limitations with some things but I have difficulty with seeing him do so much on his own. It may be because my father died young and my mother hasn't had many, if any, issues with memory this far. I've not had any family members with dementia or memory issues other than my dad for a short time after his stroke. I'm trying to be more understanding with this situation and think of what I would want or do if it was my brother or sister. It's becoming easier but he still has some habits that are becoming an issue. My fiance is seeing things his brother does that aren't respectful or just flat rude. I suppose we'll just have to work with him on those things because neither was raised to be rude or selfish.

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Yes I understand 'stigma'.
Also fear of other housemates who may also have cognitive impairments &/or behaviour issues.

But living independently without the skills to can be a safety concern + a burden on those propping it up.

Does your BIL have a Case Manager? This person can start the process.

Having a Cognitive Exam is a good starting point. Then an OT can do a functional life skills assessment (ADLs & IADLs). This can show how his cognitive skills will translate into daily living skills. Will highlight the areas he is independent in, is semi-independant (needs supervision or assistance) or even dependant (someone else must do it).

Hopefully the Case Manager can refer to a social service, like a Social Worker or Disability Service to assist discussing the best housing fit. There maybe other options besides group homes, like independent living but with case management support & support workers for some tasks. Eg some people live alone but have cleaning services + a support worker to take them shopping as they need support for this task.

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Thank you! I think my fiance just thinks of "group home" as "no one cares about me". I've told him most are good places where he could learn more about being an adult. He does have a case worker who I believe helped him get the job he has. I'm beginning to see that his memory loss could end up causing more problems if he tried to live on his own. I may look more for ways to allow him to have a separate space whe still being close enough to be assisted when needed. My step-dad's son has a medical condition (purely physical but he's very ill) and they fixed up the upper portion of their garage for him and his family. It's like an apartment because the space is large. I always joke that my BIL is like Arthur on King of Queens :)

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I will PM you re a similar situation.

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Perhaps the answer would be an independent annex attached to your property.

My niece who is now 39 has short term disability, along with other problems, but she works full time in childcare and lives in her own house.
She has been set up so that she doesn't have to remember bills - all paid by DDR
and has a drawn up "routine" chart.

I think that short term memory disability on its own is not a reason to think he could not with adequate planning be accomplished, but it rather depends on what other issues he has.

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Thank you! I believe he would definitely need something set up to automatically pay his bills as he's never paid a bill in his life. He could be taught how to do so but likely would never remember to. Unfortunately, he's never been taught certain skills because his family has always assumed that he would need to live with someone else his whole life.

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Perhaps contact an assisted living facility - one that also has independent living housing associated with it. They will be able to tell you as they do this all the time. They tell residents/family when it’s time for the resident to move from independent to assisted.

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Assisted living is great. Some have different tiers of care—one resident may need oversight and regular meds, but another may need help additional help with bathing, etc. Some assisted living places have age cutoffs. My brother had a nice apartment with a small, basic kitchen and he had his own furnishings, nurses to deliver his meds and housekeeping to do his laundry, pick up his trash and vacuum his apartment. The assisted living nurse did an assessment to see if placement was appropriate and what tier or level of care did he require. As always, shop around and tour these places.

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Yes, a social worker can evaluate your loved one. I have found social workers to be of tremendous help. They can give you insight, direction, guidance and the confidence to follow through.

My mother is under the care of hospice. I have found the social worker to be all that I mentioned above.

I think a RN would be able to do this evaluation, also.

I encourage you to seek advice. I have it to “take a load” off of all the decisions, plus you are getting help from a trained professional.

Best wishes.

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Thank you! I believe he has a current social worker of some sort. He's in some type of work program that helps with transportation as well. I've mentioned talking to his brother's doctor to get her opinion as well. I realize short-term memory loss is very serious so I wouldn't want to put him in a situation where he wouldn't be successful. I also wouldn't want it to be a situation where he's living on his own but we're there every day helping him anyway.

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"He currently lives with a family friend...He has the ability to live on his own but would need help because his family has never taught him to be independent...He has a job and relationship, so he's capable of doing most things on his own...My fiance is one that doesn't want to "let go" and allow his brother to have his own life, so he assumes that he will live with us at some point...He is already here about 50% of the time. I treasure alone time and need a "reset". My fiance's schedule allows me this time but not when his brother is here."

What has changed??? Did he lose his job? Did he lose his relationship? Does the friend want him to move out?

You don't say where you live. Are you and your fiance prepared financially to be his brother's caregivers for decades and decades? Are there adult daycare programs where you live?

And what about your own need to "reset" and have alone time? Do you think that you will want to live with his brother for the rest of your life? Does it matter to your fiance what you want?

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He isn't working right now for some reason (my fiance said he's going to look into why he's not working but hasn't yet). He still has his girlfriend of many years. The woman he lives with appears to treat him as someone who isn't really there. Left to his own devices, he gained around 30 pounds in about 6 months and is morbidly obese. She doesn't seem to care much about his health - both physical and mental. There are adult programs near us and we would definitely have him in some type of program to teach him independence and some sort of work program. When he's here for 1-2 weeks at a time, I'm able to go to a different room and be by myself. My fiance also takes him out while he's here so that I can have some time for myself as well. I think if we had the right living situation where his brother was out of the house during the day, I can live with it. I've had less and less involvement with his brother's daily care over the last year.

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Fwiw ages ago when I was venting on determining if my nonagenarian mom (in another state) should continue to live in her home of 50+ years, a close friend who deals with emergency response programs, said to me….. “can she get out of her home 100% on her own and be 30’ outside of the home in under 5 minutes? If she can’t, then she needs to be in a place with enough staff for 24/7 oversight”.

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First of all, beware of this relationship. I understand where you are all coming from but if you take this burden on, it will be part of you forever while you are with this fiancé. Are you prepared to give up so much and not have a normal life? I would think long and hard about taking this on. If it ends up that he does come with you, then part of the agreement should be he has a caretaker to leave you free of the burden. If you and your fiancé can't settle this now, watch out down the road. Look into what situation you are in and are you willing to take the results of bad outcomes.

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Sometimes I break down and think of the exact things you're mentioning. It's hard to not just want a normal relationship where it's just my fiance/husband and I without any interference, but I knew this would be a possibility from the beginning of our relationship. I think the main thing we will need to do is get him into a program during the day that teaches him skills and a work program as well. He will need to buy certain things himself and not depend on us 100% financially at least. My fiance has come to see that his brother doesn't contribute, so he's reduced the amount of things he pays for right now. He even agreed that his brother should be paying for his own phone bill and certain other things whereas before, he would say his brother can't do it. I think it will take a professional to either tell me that he can't live on his own or to tell my fiance that he can live on his own. The spectrum is closing in a bit on me learning that his brother can't do as much as I think he can and my fiance realizing his brother can contribute more than he does.

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Get an assessment from a social worker specializing in disabilities. Let an expert give you and your fiancé a clearer picture of where your BIL stands now and what the future may hold. I think the stigma of a group home is an issue with your fiancé, and he’s thinking of his own needs, when a good group home could be more beneficial to his brother. An assessment could fill in a lot, including knowledge of the best places to consider. Nothing is a sure thing for the future, but keep in mind that bringing BIL into your home will be a bigger source of stress than you could ever imagine. If he gets worse, how will things go if you have kids? Practically everyone on this forum who has taken in a loved one who requires a lot of care has come to regret it. Then they struggle with what to do next—where to place them and feelings of guilt and sadness. This gets worse when there’s disagreement about keeping the person at home or putting them elsewhere. As a wife the bulk of the care will likely fall on you. It’s great that you and your fiancé are thinking about this now.

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Very well said. This will put a big burden on their relationship and may not last do to the stress that is guaranteed to come.

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I don't wish to be critical, or negative, but I see in this situation one comparable to others in which the female is asked to care for her BF's or husband's parents, sometimes before marriage, or sometimes after.

Something to remember is that if you agree and commit to your to-be BIL living with you, you go into a marriage under that assumption and condition. If you end up caring for him more than you planned, and you change your position, how would your then husband respond?

This seems to be the crux of these kinds of situations, i.e., that the woman is the caregiver, is expected to step up and compromise enough to care for the relative, and ends up ready to walk out from frustration of being the Cinderella in the family.

I don't wish to be harsh, but I cringe whenever I think of this kind of situation and how it could ruin a marriage.

I do understand your fiancé's position, though. I would research what's available and try to find out what specifically is available, including some kind of training that could help him live independently.

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Thank you for your input! I think my attitude has changed within the last few months because I'm seeing more that my fiance's brother is less able than I believed he was. Sometimes it seems he can remember things clearly, but then he'll do something like try to dry his clothing in the oven. We're teaching him some basic things but he will definitely need a program to teach him what we can't. I realize it's a great stress to any relationship but it's something I agreed to at the outset of the relationship. My fiance is stepped up a lot lately with his brother and does most of the caring for him, unless he's working. I do very little for his brother unless I choose to (like showing him how to cook his own dinner).

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He is not her husband. She is not his wife. Spouses have rights while fiances do not. Many women give up years of their lives on the promise of a wedding ring being put on their fingers and, for whatever reason, it doesn't happen. Why buy the cow when you get the milk for free comes to mind. Many men take advantage of women. Caregiving destroys marriages. There isn't even a marriage in this case.

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I've waited a very long time for marriage and children, so I feel you on this and I agree. I've done many things that are "wife status" but it's always appreciated by my fiance. We're getting married next year and planning to have a child if we're able to. Who knows? Maybe having a child will change his mind on trying to help his brother be more independent. His brother could also eventually get married and want a life of his own someday. He's been with his girlfriend for many years, but she lives in a group home and I'm not sure if they'd be able to live together at any point.

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I’ve worked with Developmentally Disabled Adults for 25 years. They can live wonderful full lives in the community. In nj they can pick how they receive their care. Supportive living through agencies supplies so many levels of care. Like living in apartments. Getting jobs, using transportation. Short term memory challenges is the least of the challenges I’ve worked with.
I suggest you contact your Board of Social Services and find out your options. Also contact the office on Aging and disabled services.
Find other families that meet and use them as your support and networking source.
By the way I managed a group home of 5 males that transitioned out of the antiquated institutional care level.
This home was in an upscale “regular” neighborhood. It was beautiful and our staff loved our guys like family. The residents families were always welcome and enjoyed their visits.
Help this young man live his own life. You will all be blessed.

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Thank you! When he does eventually move here, we've talked about getting him into a program that can teach him independent living skills and help him find a job, transportation, etc. Right now, he's working and they provide transportation for him. He's able to do the majority of things on his own, except manage his finances and has somewhat of a limited understanding of social norms/cues. He still acts as though the people around him are the adults and he's the child, so he doesn't contribute financially for things like food, bills, etc. I think if we can get him into the right program, maybe my fiance will see that he's able to do more than what he thinks he can. Even if he doesn't live on his own ever, I think he should still have more skills than he has now.

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Your fiance' should talk to your future BIL's doctor. The doctor can "write" a prescription for assessment of independent living - most likely as part of a rehab type setting. Group homes can be wonderful places that provide the structure and support that your future BIL's areas of need. If your future BIL "lives" with you, there needs to be a plan to transition him into another living situation when you both get older and may need you help.

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Thank you! I've mentioned to my fiance that he can ask his brother's doctor during his next visit how she feels about him living independently. I've been learning more about memory loss and how it may be more beneficial for him to live with us, but have activities he can do during the day. He's able to work as long as the work is repetitive, so he should be able to find a job here through a work program. We live in a different state, but my fiance and I have also discussed getting him into a program when he lives with us that will allow him to make friends, work, etc. Basically everything except live on his own. His memory loss may be more severe and problematic than I'm thinking and I'm learning that it may be best and less stressful to have him live with us instead of worrying that he's going to burn his home down.

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Emotionalwreck: Your BIL needs an evaluation by his town's social worker.

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Thank you! I believe he has a case worker and it would be interesting to see what they and his doctor believe he's able to do. I'm learning with time that it may be more stressful to have him living on his own vs just having him live with us.

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EW, OT's, social workers and nurses affiliated with rehabs and nursing homes do assessments which measure ADLs and IADLs (Activities of Daily Living and Instrumental Activities of Daily Living). Based on an assessment, a good evaluator can tell you what level of support your finace's brother needs.

Tha choice shouldn't be "live alone and we go crazy" or "live with us and we then have no privacy and spend our financial resources on disabled relative".

At least where I live, there are all sorts of suppotive group living situations for folks with mental, intellectual and physical disabilities.

From the sound of it, future BIL needs more oversight and instruction than he is currently receiving, and your fiance appears to be a bit unrealistic and lackadaisical about follow-up.

Is there a formal guardian? Is BIL receiving SSDI?

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Thank you! He is receiving SS benefits of some sort, I assume SSDI. Essentially, right now, he's receiving no real oversight because we believe his work program was suspended. It was initially suspended last year, then he went back to work, and now he's not working for some reason. We're just not sure if it's because of COVID or something else. There's no formal guardian, at least legally. I've told my fiance that he'll need to get some type of legal guardianship or at least POA if he lives with us. I believe that it would be much more livable if he was in some program while living with us. I think my fiance will need a professional to tell him where his brother is at as far as what he's able to do and what he needs help with. He tends to trust professionals more than things he reads online and if it's coming directly from someone who he trusts, he'll be more apt to follow what they recommend. He's coming to understand that it's more of a task than just being the hero who says "he's not a burden! He can live with me!" Luckily, his brother has insurance that covers 99% of his medical expenses. These expenses are related to his medical condition that caused his memory loss. He requires surgery every 5-10 years and the bills associated with that totaled a very insignificant amount (not paid by my fiance). The only issue that I have at this moment is that, when his brother is here, he's not able to go out and do anything because he doesn't know the area. If he actually lived here and had a local address, he would be in some program that would get him out of the house and make it way more doable for us. I think even if he didn't have any medical condition and just stayed with us temporarily, I would get irritated by having him around 100% of the time. My fiance realizes now that we all need alone time and time apart from each other.

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Why can't the brother go into the same group home as his girlfriend? Why take him from where he has been receiving services and medical care?

Drying clothes in an oven. If he lives with you, he will need constant supervision.

Unless your fiance gets guardianship over his brother, he should not be living with you.

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He has mentioned doing this before and my fiance shot it down immediately. His medical care is actually in our state, not the one he lives in. There has been at least one occasion when he was here that we had to take him for emergency surgery. My fiance will at least need POA over his brother if he lives with us. My fiance just needs to just speak with someone at a group home to realize his thoughts about them are wrong 99% of the time.

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Is there a way to determine if someone can live independently?

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