Hope this doesn't count as white knighting-- although many people on here have tried to drop hints for Lou.
Once the COVID thing is no longer, there are likely programs for Medicaid recipients to retrain to enter the workforce. Lou would probably be good at something computer related as that seems to be his biggest interest. Hell, there are even tons of scholarships and programs for coding boot camps for TRANS people. He could call up some trans alliance organization to hook him up, I'm sure.
As for right now, whatever Medicaid plan he has, he could probably access discounted "virtual therapy" appointments. He could probably contact the social worker at the hospital who helped him if he needs direction as to where he could go, or call/ go on the website of his Medicaid insurance plan (in PA you have to chose a particular kind of plan that can differ depending on where you live in the state, what your needs are, etc).
Maybe instead of trolling twitter he should speak to a therapist... god knows they're all into the "gender affirmation" thing right now, so I doubt he'll have to deal with "transphobia". Clearly the dudette needs some human contact that can provide guidance, and Lou has difficulty managing emotions, difficulty taking care of himself, has limited capacity for self reflection. Obviously has some kind of personality disorder and electronics/shopping/food addiction, and those issues aren't easily dealt with via psych meds alone.
Imagine if Lou got a job and managed to rent even an efficiency apartment somewhere-- just being away from the mother alone might increase Lou's mental health dramatically. While I know Momma Gagliardi suffers while dealing with Lou, I'm sure their constant contact with each other is probably creating more mental anguish and stress for the two of them than they realize. There seems to be some kind of enabling/enmeshment/infantilizing going on and Lou has likely convinced himself on some level that he is either too incapable of becoming anything better, or that he needs to "need" his mother in order to keep her happy, This might sound fucked up, but I've seen a strikingly similar pattern in some families. His only positive interactions with her, for all we know, might involve the times when she is taking care of him via cooking his meals, etc..
Smothering controlling mother raises child to be a dependent helpless infant. Mother has personality disorder, and she NEEDS the child to NEED her, all the while she complains about being drained. If the child reaches a developmental milestone, mother gets depressed/angry/resentful and knee jerk tries to push the child back into an earlier developmental stage. This is where the Munchie by Proxy thing often occurs in some families, or when a kid's real disability is blown out of proportion so the mother has more of a "reason" to keep them in a childlike state, or to forbid them from reaching developmental milestones. Then, in adulthood, the child and mother constantly butts heads, mother undermines/guilts adult child from leaving home and/or adult child refuses to leave home because they have no means to support themselves due to mother's lifelong undermining. Note the brother with extreme drug addiction-- addiction is often a side effect of having a parent like this.
I keep asking myself, for example, why Lou's mother or stepfather didn't browbeat his ass to the hospital as soon as she could smell his nasty infection. Not blaming them particularly for his condition, but I find it odd no one intervened sooner. God knows that must have reeked. Most "normal" families would press their family member to get their ass to the hospital ASAP for something like that. Did they want him to become a complete invalid on some level?
Lou really needs to get himself together. He WILL end up being tied to his mother, of whom he declares "wants him dead" for the rest of her life, if he doesn't improve his physical health ASAP. Dialysis for diabetics with kidney issues, for example, requires tons of visits back and forth to the dialysis center. If Lou loses his foot, there goes any chance of him ever being able to drive himself! Relying on public transportation is super unreliable, even if it's offered at a discount through Medicaid. He'll be stuck with her "taking care" of him forever if he's not careful. Once she dies, which might not be for long, he WILL end up in some nasty flea infested PA nursing home facility.
