My brother has AIDS but won't seek treatment. How can I intervene

Question

My brother was admitted to the hospital because of a mass on his leg which was deeply infected down to the bone. He had a portion of his thigh muscle removed. He was on intravenous antibiotics for a week straight. He's kept us (his family) in the dark regarding his health. He stays secluded a lot and I think he's known that he had AIDS for some time now. As his caregiver and big sister, I've always been able to be called upon by my siblings whenever they needed it. My brother told me he might have cancer, this was about 2 weeks ago, I had a difficult time trying to process this. I physically put him in the car the day I took him to the E.R. at the hospital. He didn't like it, but I wasn't about to watch him suffer. I had to get him some help. I'm glad I did. As I was the person who he wanted to be released to from the hospital, I received his prescriptions from the hospital staff and his belongings. I saw his discharge papers too. He's been diagnosed with AIDS...an STD, he has lost most of his body weight, he looks like he's wasting away before my eyes. He has no appetite, has headaches, vision loss, diarrhea, besides the bacterial & mouth fungal infections, I had an immediate gut instinct as his sister that he wasn't being honest with me. He still won't admit it & I don't know how to tell him I know, because his mental health isn't where it should be either. He has good moments & then he'll get either irritable, mad, yelling, then depressed and emotional... I am not going to sit and watch him die. I'm sure from everything I've researched that it's advanced stage. What can I do? Can I call social services? The doctors listed on his papers that he hasn't called? Please help! I have to be able to take him somewhere for treatment and to get on the required medications he needs. "Yes, I am my brother's keeper." Even if he's angry with me, I can deal with that, as long as he's alive.

Answer

Thanks for writing. I'm sorry for your difficult situation. There is an incredible amount of shame and fear that go with an HIV diagnosis. This can result in people pulling into themselves and refusing help, or even being willing to acknowledge the situation. Do not take this personally.

I would recommend sitting down and letting him know you will be there for him no matter what, that he can count on you for support and that nothing he can say will change the fact that you are his sister and that you love and support him. This will give him the opportunity to open up, although that may not occur right away. Be persistent. Let him know you can deal with whatever he has to say.

A number of laws protect the confidentiality of persons with HIV. I would speak with your local AIDS organizations about what you can do for him and what resources are available. He does need medications and he does need love and support.

Be persistent but be certain to find ways to take care of yourself. Caregivers are at high risk for burnout.

Wishing you and your brother all the best,

David