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Group Therapy is a relationship advice column that asks readers to contribute their wisdom. Each week, we offer up a problem for you to weigh in on, then publish the most lively responses, with a final word on the matter by our columnist, Claudia Dey.

A reader writes: My brother, 46, and I, 50, don't know what to do about our father. He has always been difficult and now he's impossible (he doesn't have dementia). His health took a sharp downturn around New Year's and he hasn't been out of the house since. He hasn't left the couch in about as long and refuses to go to the doctor. Our mother not only has to deal with filth he won't allow her to remove, but exhausts herself with broken plumbing and so on. My father may listen to my brother, but he has young kids and a busy job, so is stressed enough. My mother asked a social worker for help, but he said there's nothing anyone from the outside can do. Since she is at her wit's end and social agencies seem to respect the supremacy of a homeowner more than the health of the people living with them, is there anything we can do to help a stubborn, ailing old man?

Don't give up

Your father's condition may be rooted in his physical decline, but clearly there's a mental health issue here. Your mother needs help, too. If your father has a doctor, start by phoning and reporting your father's condition. If your parents share a doctor, let the physician know about the effect on your mother's health. Your mother may also benefit from seeing a counsellor, who can also be a contact point for getting social services help. If your father won't clean himself or leave the house, this is a crisis. Your brother needs to help the family deal with it. Together, you, your brother and your mother may be able to find a way to resolve this.

- Elise Moser, Montreal

You should be helping

Did your dad have a stroke? If he did, it might be affecting his decision-making. My second question is: Why aren't you helping your mum? If your dad refuses to allow her to take out the filth, she should just do it, as she lives there as well. As for not moving, there isn't too much you can do, except refuse to cater to him. If he wants to see you, he'll have to get off the sofa and go out. Remain firm, but help your mum as much as you can.

- Michelle Lynch, Toronto

Get help, pronto

There is probably a health problem. It could be depression or something as serious as a brain tumour. If your mother hasn't called his doctor and requested a house visit or an ambulance with police to get him to the hospital, that should be done immediately. Other issues can be addressed once your father's abnormal behaviour has been reviewed by medical personnel. You don't state how your mother is being prevented from removing filth or what that entails. If there is violence, then that should be grounds for social-worker intervention and/or police intervention. You, your brother or a plumber can deal with broken plumbing and other things that are exhausting her.

- Sharon Charboneau,

Sunshine Coast, B.C.

The Final Word

Dear Son of Impossible,

You are not alone. It can be a short distance between the barbed terrain of difficult and the impenetrable fortress called impossible. Many a senior has made the brief trip, leaving their adult children worried and desperate at the gate.

First, you are taking the appropriate steps and your instincts are a bull's eye. Months into the new year, you recognize that your father does not intend to move from his couch of convalescence. He is fixed in his filth, unaware and perhaps even unapologetic about its cumulative effect on your aging mother. It is time to heed the urgent words of Medical Personnel Charboneau: Call your father's doctor for a house visit. Failing that, to the hospital or bust.

Once you have a diagnosis, your strategy must result in care for both parents. As Help Your Mum Lynch and This is a Crisis Moser press: Attend to your mother's heightening stress. While your father is inarguably the primary patient, she must be as bright a blink on your radar. An elderly woman cannot be nursemaid, housekeeper and plumber. The role of wife - exhausted by the grief of her husband's drastic decline - is work enough.

I understand that your initial contact was a disappointment, but I urge you to revisit the possibility of support from Social Services. I do not know where you live, and as such cannot speak specifically to your area. That said, I will present my findings as encouragement - and on the jackpot chance that you may just be a neighbour. My Toronto city councillor provided me with names of some organizations specializing in seniors' care: Community Care Access Centres, Senior Link, Circle of Care and Advocacy Centre for the Elderly.

Once you have done your research and determined what is tenable and what you are able to afford, call a summit with your brother and, when you are both ready, your mother. Decide on a course of action. The gates to your father may never open. But this does not mean that your mother must be trapped behind them, too.

Next week's question

Click here to contribute your widsom - or submit your own dilemma. (We will not publish your name if you submit a personal dilemma for the print column.)

Claudia Dey's plays, Beaver, The Gwendolyn Poems and Trout Stanley, have been staged across Canada. Her first novel, Stunt, was published by Coach House Books. Her website is ClaudiaDey.com

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