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A reader writes: My roommate has autism, and while I find many of his qualities charming, his refusal to participate in basic acts of personal hygiene (bathing, laundry) and household chores (garbage, dishes) is filling my life with frustration and bad smells. Attempts to access public-health resources have been mostly fruitless, and private treatment is financially out of reach. I can't ask him to move out, because instability in his living situation always triggers an acute crisis. What can I do to make this situation bearable?

Social rules matter

Temple Grandin, doyenne among autistics, credits her mother with making sure she followed basic social rules. I wasn't diagnosed until my late 40s. The reason I was able to (uncomfortably) co-exist for so long? Family and others insisting that I behave. Without knowing more about the two of you, I'd say you are not doing him any favours in letting him use autism as an excuse.

– Mat Ratchford, Toronto

Pick your priority

Hygiene and messiness are not necessarily attributes of autism but when they occur with it they require a special approach. You have a breadbox of things you'd like your roomie to change. Assuming your roommate has high-functioning autism, you need to start with the one most important to you – bathing or garbage? Most autistic people at this level will respond to a schedule that has been mutually developed. Once you've successfully managed one of these issues, the others will probably be easier.

– Dale Dewar, M.D., Wynyard, Sask.

Harden your heart

You are obviously deeply conflicted about the idea of showing your roommate the door. But what you don't tell us is whether this is from guilt or a true emotional bond. From your letter it's clear that you have to live with it or he has to go, because he won't change. Unless there are deep ties between you, harden your heart and help him find another place.

– Dave Moores, Oakville, Ont.

The final word

Roommates are never a walk in the park – but with the garbage and lax approach to hygiene, your particular situation sounds like a stroll through Hobotown. However, your autistic roommate does come with one considerable perk. That is, an enhanced ability to appreciate straight talk.

I once shared a flat with a guy who used to smack his lips with relish as he strolled downstairs in a bathrobe that, length-wise, would've made Katy Perry look askance. He'd settle himself into an armchair, crossing and uncrossing his legs, while lip-smackingly sharing his thoughts on all the ways "the feminists" were ruining things for Today's Woman.

Why, you might ask, did I never fling my coffee aside and say to this fellow: "You know what's really tough on Today's Woman? Large, lip-smacking cake-holes that refuse to stay shut. Same goes for bathrobes." I will tell you why. Because the one time I made even the slightest indication of a preference for closed bathrobes/cake-holes, my roommate looked like he was going to cry.

Generally speaking, many autistic people aren't interested in pussyfooting – they want to know two things: 1) What do you want me to do? and 2) Why should I? Make a logical, compelling case for a change in your roommate's habits, and how it will benefit him in the long run. Assure him you're not going anywhere, but be as blunt as you need to be. Your roommate will appreciate having a friend who knows and likes him well enough to give it to him straight.

Lynn Coady is the author of The Antagonist , nominated for the 2011 Scotiabank Giller Prize.

NEXT WEEK'S QUESTION

A reader writes: Last year, my son married his long-time live-in love and they went to her hometown in Russia for their honeymoon. As I had admired fur hats that her father brought back, I asked if they could bring one back for me. They seemed enthusiastic, but I heard nothing from them after their return until I e-mailed, and she told me they'd been busy. I have had issues with this young woman in the past, and I don't think she's always kind to my son. Now she's not showing up at family functions. Any ideas about how I might handle this?

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E-mail us at grouptherapy@globeandmail.com. All questions are published anonymously, but we'll include your name and hometown if we use your response (it will be edited).