[Non autistic OP] Brother fell through the cracks, now what?
(Posting from a throwaway account for brother's privacy.)
I believe my 46 year old brother fell through the cracks of autism diagnosis and treatment. My parents are around 80 and there is no care plan in place. He lives with them and has no other meaningful relationships outside of them. He asks them how to do every basic thing all day like he's a child. There's no other family to help, and I can't move where he lives (~90 minutes away.) As things stand he would be completely alone when they're gone.
He is on disability and does not work or drive. He's reasonably smart and was able to complete a college degree with extreme involvement from my mom, but was never able to hold a job. I'm 6 years older, so well remember his childhood and how he never initiated social interactions or had friends outside of arranged playdates, always had flat affect and had terrible meltdowns when he couldn't get his way, as well as a lot of "lining things up" type hobbies.
My brother has never seen any specialist in neurodivergence for assessment or autism-specific therapy. When I ask my dad about diagnosis he just says "it's complex" or he'll say "OCD and maybe Aspergers." My parents enforced a "we don't talk about troubling things" atmosphere so I don't think my brother has any sense of his diagnosis or why things are so hard for him. They put him on "off-label" risperdone decades ago, which helped the meltdowns but he has terrible insulin resistance now and recently had to go to the hospital for blood sugar issues which was super traumatic for him.
I know we shouldn't diagnose others but my parents are refusing to get him assessed so I'm forced to go with my best judgement, which is that this looks like level 2 autism to me. I really want to get supports in place before my parents are no longer able to help, but my initial attempts to broach the subject were "you're crazy he has a degree so he can't be level 2", "there are no supports for people like him", and "you're too into the autism thing." My brother himself is extremely oppositional and volatile and my parents would kill me if I tried to speak to him directly about this, since it would blow back on them in the form of extreme behavioral issues that they would have to deal with. He only really trusts my dad, so I think if my dad encouraged him to get assessed he would.
Any advice is welcome! We're in the US if that makes a difference for advice. I really think he could have a much better life than this. Thank you for reading!