High Noon, with respect, you really knew the answer before you asked. It's just that the path forward is going to be unpleasant and is kind of hard to face, Guardianship now. You and your brother really should be the ones doing this. Get with a lawyer who does this and make it happen. Mom will be even more conflicted than you, so spare her some of the guilt. Get his doctor the full story so he understands. Maybe meds can help and maybe not. The idea of home health care is a good one and home care agencies have social workers who can help when the time comes for placement. That time has probably already arrived. Hug him if you want, but don't expect to " love him out of this". Oh yea, an ass kicking for him is really a stupid idea. He may be a SOB, but his mental decline is nobody's fault. It just is what it is. Sometimes #$@&** happens and somebody's gotta deal with it. This time that somebody is you. Best wishes in this difficult time.