My brother ordered me out of his hospital room.

Two days ago a nearby hospital called me to ask if I knew someone who they were caring for. It was my brother. He cut off contact with me 10 years ago. I didn't even know if he was still alive. No one in my family knew what became of him. They said he was in ICU on a ventilator. They said they might need a relative to sign consents on his behalf.

Saturday he was too sedated to interact with me. Yesterday I went to the hospital again. He was awake and off the ventilator. He clearly recognized me and told me twice to "go away." So I did. He gets enraged if his wishes aren't respected. He gets arrested frequently for drunken bad behavior. He can be threatening and violent.

So the hospital called me again today, even though I'ld already told them that he does not want me involved. They said he is still not mentally competent to sign consent forms. They didn't need any signature right away. They said police wanted someone to sign consent for them to turn his two cats over to Animal Welfare Dept. In the past, I rescued a kitten of his that got left behind when he got arrested. I missed days of work caring for this kitten that had gotten quite sick. When it was clear that he'ld be locked up for months, I eventually was able to re-home the kitten. I placed it in an excellent home. When my brother got out of jail, he was mad that I "got rid" of his cat. So I told the hospital social worker that I would be afraid to sign anything on my brother's behalf. Down the line, he'll just be angry and critical of anything I do.

They moved my brother out of ICU. I expect he'll recover alright. My brother is unpredictable. I think it would be best if I did not get involved in his situation. He has been very emotionally disturbed for years. He builds up hate toward others at the drop of a hat.

If the hospital calls me again about providing any consent, I think I should encourage them to get a court-appointed treatment guardian. I don't see a better option. I've talked to my sisters. No one wants to get involved with my brother. We all tried over the years. He has a dependable income from Social Security that is enough to support him. But he goes in and out of homelessness related to his alcoholism and drug use. It's very sad. He won't really cooperate with getting rehab.

If anyone has any advice, please share it. I feel troubled, but I don't see what I can do differently.

@Rose76 you sound very helpful in your history of helping your brother. I agree that you need to protect yourself from the anger of your brother. Keep yourself safe is a good move. @CANDC

Hi Rose,

I'm not your brother or have your brother's problems, but I have cut off family. Speaking from that point of view, I would prefer a court appointed treatment guardian rather than a family member that I've purposely cut ties with. It's actually a little insane to me that you, having no relationship with him other than blood, could legally sign documents for him. I don't actually think you can sign documents for him. Typically the litmus is that it must be a "close" family member or authorized legal representative.

Next of kin laws scare me to death. That's why I have an advanced directive and selected people who can consent for me as well as what to do in a variety of situations.

Don't feel bad not getting involved. And don't let them bully you into getting involved into someone's life, especially someone who sounds like they have not treated you well.

If he doesn’t want relationship with you up to the point of not wanting you in the same room and cut ties long time ago, it wouldn’t be wise to sign any kind of papers. When and if the hospital calls again, emphasize that he doesn’t want you in his life so you can’t sign anything.

Families can be brutal and exhausting.

At first, my only concern was his welfare. But, after my visit yesterday, I think I need to have more concern about protecting me. I've always felt very sorry for him. He's milked that for help, in the past, which I didn't really mind. But he always found a reason to get mad at me. He gets mad at just about anyone he deals with. Then he cuts off ties. Now I know he really wants to stay estranged from me. Him being mad can escalate to rage pretty easily. He's never been violent with me. However he threatened me once. I certainly don't trust him. He has quite a tract record of threatening and being violent.

If you hear from the hospital again tell them you are unable to help. The hospital knows they can go to court emergently and have someone appointed to help him I need be.

Thanks a lot for your input. I appreciate getting a point of view from someone who might be the person needing a treatment guardian. I, also, thought it was a little odd that they wanted my involvement, after I told them how estranged my brother and I were. I googled the topic in my state. It seems they had an argument, in that my brother was highly sedated on a ventilator and, I guess, had not been too coherent prior to being intubated. Plus, it was he who named me as the emergency contact back 13 years ago, when he was in that hospital. Back then he was on friendly terms with me. So they were going by that.

I doubt he has anyone in his life to represent him. He mostly makes enemies wherever he goes. I am now convinced that he does not want me involved. I think the hospital may simply have not wanted to go through the trouble of petitioning a court, if they could find an easier way. Plus, it looked like he would recover and soon be able to voice his preferences. If they contact me again about any consents, I think I will say that they need to get a treatment guardian thru the court, or state, or wherever that is arranged.

I am surprised they even gave me so much info on his condition. It seemed to not accord with HIPPA regulations. They even said they think he needs to be on antipsychotic meds longterm to manage his behavior. (I guess he was yelling and being hostile. They've kept him in wrist restraints.)
They knew he had a psych history.
Someone from their psych team talked to me. I'm sure not getting involved in that. My brother used to say he didn't ever want to be the recipient of "forced doping."

At any rate, he seemed to be greatly improved yesterday. Yet, they called me again today to say he "lacks decisional capacity." That means he's not competent to give "informed consent." So, if that continues, then they may really need to get a treatment guardian - one who is non-family.

This thread is helping me to clarify my thinking. I think the hospital may have been looking for a short cut.

I think that is the bottom line. I think I got that across today. However, I'll see what tomorrow brings. Two different MSWs called me today. So, they don't seem to be fully hearing me. They thought I could at least sign for the cats. That could get my brother furious with me. They later contacted me to say a neighbor was caring for the cats.

He seemed very alert yesterday when he told me to go away. He has that right to cut off relations with any, or all, family. It seems to me that I would do best to take that seriously and respect his boundaries, which he has a right to set.

Yes, I believe that process can be expedited in an emergency situation. It seems like he's recovering and will be okay to get discharged in a few days.

They also told me that he has been in the hospital a few times in the recent past. They said he usually leaves the hospital "against medical advice." They said he did that in September. Now that I think this stuff through, it sounds like this hospital staff has had more of a relationship with him than I've had for a long time. And it does sound like they've gotten a sense of how he conducts himself and the state of his mind. I guess that's why the psych team got brought right in.

If you were his emergency contact, he probably also gave approval for you to be informed about his condition. Its a separate line on the form, but i dont see how you could reasonably get one without the other. "Make her my emergency contact but dont tell her anything"?

About 13 years ago, he was not mad at me. There were a few years that we were on good terms. It was during that time that he put me down as a contact. So they were going by that.

Probably since he did not expressly withdraw/negate assigning you as his emergency contact during any of his subsequent stays at the hospital, it accorded with HIPAA for the hospital to call you 13 years after you were originally designated by him.

Please protect your sanity and piece of mind. I am glad a neighbor is caring for the cats.

Please keep yourself safe, it does sound like its best if they get the courts involved

I think that is exactly what happened. He never changed what he told them 13 yrs ago.

I do need to protect myself. I, too, am glad someone's looking after the 2 cats. I felt kinda bad that he told me to go away. Actually, that may have spared me the many headaches that go along with being in touch with him. Being around him can get very stressful.

I think that would be the best way.

Rose, has the hospital staff relented?

Yes, I haven't heard from them since. I don't expect I'll hear anymore about him, or from him. He's probably discharged by now . . . back to his hotel room.

Briefly, I entertained the delusion that I'ld have a brother in my life again. That was foolish. Back when I used to see him regularly - years ago - he'ld always manage to eventually say something insulting, whenever I'ld be around him for any length of time. It was like he tested how much I'ld tolerate. He's not changed. He uses people. He spews a lot of hate.

I'm glad to know he's alive and knows how to get care when he needs it. That may be the last I'll see of him. I'm sorry it didn't go differently. Things are what they are.

Things are what they are. It is not that you did not try and try hard. He is indeed able to get the care he needs, which is good.

I tried. I would have done a lot more. He has the right to have me leave him alone, which I will do. Getting reinvolved with him would just eventually go sideways. Anyone who gets involved with him finds that out. It's just a bit unerving. For years I've surmised that he went back to a place far from here. Ten years ago, he said he was leaving for another state. Now I find out he's been living 2 miles from me. It's a little creepy.

Years ago, a lawyer assigned to my brother advised me that I was wasting my time. He said my brother was headed for death in a dark alley someday. Odd thing for an attorney to say about a client. Not an unreasonable forecast, though, given how he lives and how he acts.

How is your mental health holding up, rose?