Brother's Mental Illness Concerns

I am going to drop by his house tomorrow, however I do not intend to stay long, nor turn it into a heavy session of advisement / investigation / intervention. If the short-term bodes well, then I may look into things further via third party professionals as referenced above.

Not today afterall, my brother tells me he is "not feeling well" (whew...that's a relief for me). I took the "not feeling well" to mean his mental faculties are diminished today and/or his appearance was inadequate and/or he had a change of heart in wanting to see me in the physical sense for some other reason.

As an aside, the secondary purpose of this thread is to produce an easily accessible mini-log of brother-events, brother-viewpoints, brother-solutions and the like.

When you do finally get together, don't expect that he is going to be consistant. This sounds like the kind of problem that can vary enormously from day to day and even from hour to hour. About all you can do is follow along. If you try to demand explanations of something he says, it's entirely possible he won't have the slightest idea what you are talking about. Trying to follow up can be incredibly frustrating, and the attempt can get really stressful. Stress isn't good for you, and can be terrible for him.

Right you are roger! I am finding that in simple telephone conversations the equivalent of a mental reboot takes place between each call. For example on one of the recent times we talked, he said he is no longer working whereas before he said he was working.

Perhaps the most unnerving thing (in the short run so far) has been the virtual flood of voicemails in which some sort of urgency is either stated or inferred, only to find in follow-up conversation that he simply asks me about my day in redundant and trivial detail in combination with oftentimes reiterating items of (I would assume to him) interest.

As a strange aside, I have an associate who somewhat mirrors his persona, and I find that person can potentially trigger (kept to myself) reactions I've suppressed towards my brother in telephone conversations. These reactions being of the kind in which I think to myself: “what the hell was that all about vacuum brain?” and “holy crap, what a repetitious and annoying waste of time!”.

Been there; been through that.

This brings to mind one of Clarke's Laws: "any sufficiently advanced technology is indistinguishable from magic" which by point of amusing comparison could be edited to read "any sufficiently compromised intelligence is indistinguishable from annoyance".

You don't have to answer every barking dog.

A similar thing is going on with a good friend.

She often recognizes that something is going wrong with her thinking and has arranged to have herself tested re Alzheimer's. It is frightening what she gets up to sometimes. A few weeks ago she wanted to tell me something. Her cell phone had lost its charge, she couldn't remember how to start her computer, and she'd forgotten my phone number so she got in the car and drove here to tell Set to tell me when to meet me later in the day.

By the time I caught up with her, Set had written down the phone number, the cell was charged, she'd gotten the computer restarted and she was feeling quite frightened by what she'd done.

Last week we went to a concert where we ran into a current colleague of mine, C, that B used to work with. C suggested B join us for lunch one day. B said she didn't know where we worked. I pointed out that she meets me there a couple of times a month after work. An hour later it clicked in with her what she'd said. I hope she gets the testing done soon.

Sometimes prescription medication can interfere with normal functions. Sometimes the change is so gradual people forget the medication could be a factor.
I'm not at all suggesting she is abusing her meds, but my neighbors daughter almost had to be hospitalized when a new med reacted badly and she was so disoriented her parents hid the car keys. She kept waking up every few hours and attempted to drive to work, but she was very disoriented.
My own mother was diagnosed with Altzheimers when she was only 58. I don't know how old your friend is, but she certainly needs a good work up to figure out what's causing the problem.

I very much sympathize!

Your friend as my sympathies.
Memory deficits are terrifying.
I worked in a neuro ICU, a step down unit and also in an ER.
Obviously I don't have much information from your story, but it does trigger a few ingrained alarms in my little nursing brain.

I will be speaking from that perspective in the following:
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My first reaction to an altered mental status in a sober person is not "maybe Alzheimer's" it is "maybe stroke".
Early interventions to cardiovascular events are very beneficial.
Later interventions not so much.
The same is true for a host of other causes of altered mental status.
Altered mental status is a medical emergency.
Coming into and out of a confused state is not necessarily a sign that there is not a serious problem.
I hope she visits a doctor soon.
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If she does have the beginnings of Alzheimer's or another type of dementia, I am glad that she has supportive friends like you to support her.
In my experience the fear associated with cognitive deficits is one of the most difficult challenges to a patient.
It reminds me of a quote from Dune by Frank Herbert.
The litany against fear by the Bene Gesserit.