My adult brother suffered a TBI eight months ago, including minor bi-frontal lobe bleeding and a subdural hematoma on one side. There was also evidence suggesting diffuse axonal injury. He spent nine days in ICU and lacked short term memory for two months.

Long story short, despite amazing progress in months of inpatient therapy, my brother appears to be in full denial of his cognitive and emotional deficits, which are quite significant. He has been living with our aging parents for two months and they are overwhelmed and "done" with him. He is just spinning his tires now and muddying everything, so to speak.

He refuses to take medications, even upon threat of being kicked out. His fuse is extremely short. He can't even remember to brush his teeth. If we gently remind him, he turns red, clenches his fists, and will storm away. Three minutes later, he acts as if nothing has happened. He is incredibly selfish and behaves like a teenager, convinced he is right and we're wrong about everything. All the fine and gentle features of his personality that evolved over the past 20 years seemed to have been sandblasted away.

I'm convinced his denial is psychological, a survival mechanism. After he failed to order something online for two days, asking my help, I confronted him strongly about why he was having trouble now, when he never asked me before his TBI. He got very upset and defensive, but I managed to get him to say this before he shut me down completely: "If I believe my brain is all messed up, then it's over. My life is over."

I was told recently by his outpatient therapists that I needed to let him go. They did. He was refusing to participate in the practical therapies that would helped him. He tells everyone they let him go because he was better, and says with a complete lack of irony that they would have kept him had his brain been messed up.

Can I do anything for him before we let him go live alone like he wants to on his SSDI income and food stamps? He won't live in a group home or half-way house, he says. He thinks he's going back to his hard work, which involved climbing ladders, yet he can barely walk upstairs carrying one bag of groceries now. He keeps saying his friends are saying they have tons of work for him, yet they deny saying this to him. He used to drink a lot too, and I can't rid my mind of him returning to that as soon as he starts hitting walls in the real world.

I want to be able to sit him down and force him to see his deficits, then be there for him when he breaks down. Can I force him to see his deficits? Can I show him his inpatient and outpatient discharge reports where they clearly say he has far to go? He recognizes he has trouble doing things now that used to be easy for him, but refuses to blame the brain injury. His brain is better now, he says, and we are being negative and not believing in him if we suggest otherwise. If we press, he shuts us down and storms away.

Do I have no choice but to let him go discover his deficits on his own, and risk a second TBI, or jail, or worse?