Disabled adult son who is unbearable to live with

I’ve posted in another sub but we’re at our breaking point. I don’t know what options we have left for our adult son (18).

This has been a years-long battle, and it’s hard to explain without writing a novel. To keep it as short as possible:

Our son has a physical disability and is 100% reliant on a wheelchair. He has no diagnosed cognitive impairments (IQ 119) and is considered intelligent and capable. But he is manipulative, defiant, possibly dangerous towards others and refuses to take care of his hygiene.

He is fully capable of toileting but will instead urinate and defecate on himself, his bed, his wheelchair, and even the floor. We’ve had to completely renovate his room due to damage from feces. He now has a chronic wound on his back (from poor hygiene and pressure sores) requiring a wound vac for almost a year. We drive him multiple times a week for care because home health is “unavailable.” Realistically, I think his behavior has made finding help nearly impossible as no one wants to deal with him. Aside from being difficult his stench is unbearable.

This isn’t new. We’ve involved every resource imaginable over the years—DSC, social workers, therapists, multiple programs. He even spent time in the Department of Corrections but was released early because of these same issues. A forensic psychological evaluation he had stated:

“The most dangerous part is he has exhausted all resources available to him and none have proven effective.”

He’s also been on safety plans because he is not safe around minors or vulnerable people. Personality-wise, he’s manipulative, defiant, and hostile. Today, he left the house again after an argument over inappropriate electronics use (a recurring issue that has led to legal trouble). He says he’ll refuse to come home. He has nowhere else to go and no one else will take him in. He’s basically saying that he’ll live on the street. He left without his wound vac (it fell off due to poor hygiene) and his sister went frantically looking for him worried he’s going to go septic but he just doesn’t care. She did end up finding him but he’s stating that he would rather be on the street than “deal with our rules”. The other part of that is despite his manipulation and arrogance, he is so naive that I know that he will never make it on the streets, and that’s if his wound doesn’t kill him first.

We’ve tried setting him up for independent housing, but I know deep down he isn’t capable of living alone safely. It feels like I’d just be passing the problem to someone else. At the same time, I can’t keep sacrificing my family’s well-being. Outside of him, our household (me, my husband, and our other adult child) is close and loving, but his presence has been nothing but toxic and chaos for years. The smell alone is unbearable. The emotional toll is worse.

I’m riddled with guilt for feeling this way about my own child, but we’ve been told over and over that we’ve done everything right, it’s just hard to feel that way.

We’re in Indiana, and from what I understand there’s no adult protective services here. We’ve been advised to get an updated diagnosis, but nothing seems to fit. Instead we’re told by every professional we speak to that he is a unique case. His therapist at one point said that he would have been willing to give him a diagnosis of Anti Social Personality Disorder but that doesn’t seem to fit either. His therapist was also of the mindset that at 18 if his problems continue, we should not have any guilt washing our hands of him but again it’s a hard thing to try and convince yourself about your own child, especially knowing what I do about his tendencies towards others.

What I want is an option that removes him from our home without abandoning him to the streets or harming anyone. Has anyone been through something remotely similar or found resources that worked?

I feel like we have tried everything imaginable and when people hear our story for the first time, they always go through the same list of things or recommendations. I honestly feel like there isn’t anything left at this point but if anyone has ANY advice, I’m open to any suggestions or thoughts anyone may have.