ArcaMax

My sister suffers from Bipolar II disorder, has battled crack addiction and lives with her sometime boyfriend, a waiter who drinks alcohol to excess every day he isn't at work.

My sister entertains herself with a few household pets and her phone. She smokes cigarettes, a little weed, and drinks alcohol fairly habitually.

I have encouraged her on the phone to get exercise and just live, but all I got back was the brush-off.

We are the only two people left in our family. What can I do to help her?

-- Caring Sister

Dear Sister: I think encouraging a former crack addict who has breast cancer, Parkinson's and bipolar disorder to "get exercise and just live" -- is not particularly helpful.

Your sister may not be able to exercise. She may not want to exercise.

What she is doing right now -- hanging out with her pets, smoking weed, drinking -- this is the living she is doing.

It sounds as if you don't live nearby. Given the severity and complexity of her health problems, I think you should stop telling her how to live, accept her in an "as is" state, and simply be with her and communicate with her on her terms. This is not giving up on her. It is accepting her.

You might both feel liberated.

Dear Amy: Thank you for your compassionate advice to "Needs an Intervention," whose daughter seemed to have a hoarding disorder.

This is so tricky, as you noted. Extensive, hands-on therapy is called for.

Thank you especially for noting your concern for the welfare of the animal this daughter had in the home.

-- Been There

Dear Been There: As I said in my answer, the human can choose to try to change her living situation. An animal has no such option.

(You can email Amy Dickinson at askamy@amydickinson.com or send a letter to Ask Amy, P.O. Box 194, Freeville, NY 13068. You can also follow her on Twitter @askingamy or Facebook.)