I am so sorry to hear about your nephew. One of my kids was hit by a car at 13 and although he recovered somewhat he did receive a brain injury and it impacted him in so many ways. It's wonderful that your brother and his wife have been willing and able to care for their son. I imagine finding caregivers has been challenging. I've seen that with the various resources my son has needed. The caregivers who have the right combination of empathy, patience, knowledge etc can be hard to find.