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Go see a Certified Elder Care Attorney for advice.
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The laws to pursue guardianship through the courts may be different by state, that's why you need to go see a certified elder law attorney in your brother's state. FYI going after guardianship can be very expensive ($10K) and time-consuming and requires court dates.

The last resort is actually having your brother's county pursue guardianship. He should be reported as a vulnerable adult with no PoA. When he eventually meets the county's requirements for requiring a guardian (when it "gets bad enough") they will intervene. Depending in the specifics of his situation, they will place him somewhere where he will be protected, fed, housed and receive any medical care he requires. No one will be privy to any of his financial or medical management or included in any of those decisions -- only the court-appointed guardian. You will be free to visit him and carry on your relationship with him, you just won't have any say in where he resides, his financial affairs or his medical decisions.

Some states/counties will provide an emergency guardianship order if his situation is currently really bad, so you can call social services for his county and ask them.
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Guardianship is expensive if contested. You can, however, often, if you are FAMILY in an emergent situation, be assigned "emergency temporary guardianship" for a senior in need who is incompetent and unable to act safely in his or her own behalf. This is often done through a social worker, while the patient is hospitalized,and often by phone call. After a specified time this would have to be made permanent before the court.
Again, if you are family and are trying to act for an INCOMPETENT and DIAGNOSED as incompetent senior, you may seek conservatorship or guardianship. Be certain first you want this. It comes with LEGAL fiduciary responsibility under the law, and ignorance of not knowing how to keep meticulous records will be no excuse under the law. Also know this is a legal action before the courts and the person you are attempting to get guardianship for will be represented in court. If this person doesn't WANT your guardianship they may fight it and they will have to be demented indeed for you to win. The State is loathe to take an individual's rights.
If you win the figth the estate may pay court costs; if you lose you may have to pay and yes, 10,000 minimum is what you are looking at.
More information about your own case may get a better answer here. But this is where to start.See an Elder Law Attorney will all the facts in your own case along with any MD letters of incompetency for your senior to act for him/herself.
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