I'm glad you told your social worker about that housekeeper. Not everyone is cut out for jobs like that.

A med change, maybe an increase in the Doxepin could help with the depression, but I understand that you may not feel comfortable seeing your pdoc

Your nephew will get over the Zetia issue. IMHO it's such a minor issue I think he will let it go easily. I've gotten myself into worse trouble spouting my medical knowledge where I didn't know it would be relevant to someone in earshot and it wasn't well received. If the subject comes up again apologize for upsetting him, say that was never your intention, and move on.