I am very sorry about your nephew and hope that he makes a good recovery.
I don't have any more advice for you than I have already given: get your finances in order (not as "punishment" but because you need to look after you), look to his actions and not his words and focus on YOU.
You may not be vocalizing your expectations but he has known you for 20 years - he can read you. I agree with KP, he knows exactly how much to say to keep you where you are without actually following through with anything.
