Robert Prezel greets you with a bone-crushing handshake and won't let go. For good measure, he'll twist his elbow slightly, working a few of your tendons into the pain mix.

	Steve Mellon, Post-Gazette Caretaker Chris Ingham, right, goes over the shopping list while siblings Robert, center, with knit cap, Jack and Lisa Prezel wait at a Giant Eagle store on Pittsburgh's South Side. Click photo for larger image.

Then, just as the throbbing radiates past your wrist, he lets go and walks away with a laugh. Your hand will hurt for an hour.

In the kitchen, his younger brother Jack Prezel, 51, paces back and forth in his Pirates jersey, muttering so softly that you can't make out what he's saying. Dennis Prezel, who just turned 50, will be along in a little bit. Lisa Prezel, at 42 the youngest and the only woman in the family, is at work, cleaning toilets in the Strip District.

This is the Prezel family, formerly of Plum, now living with 24-hour caregivers in a South Side townhouse under the supervision of Achieva, one of the area's major service providers for the mentally disabled. The Prezels are healthy and happy and, to the extent they're capable, they are productive members of their community.

It's quite a turnaround from April 2001, when Nancy J. Murray, then with ARC Allegheny, met the Prezels after fielding a phone call that four retarded adult siblings were living by themselves.

By the time Ms. Murray walked up the family's broken front steps in Plum, the Prezels had been on their own for more than a year, since their mother, Eleanor Prezel, went into a nursing home in February 2000 and died. Two uncles would stop by once or twice a week to help them get groceries, but the house had fallen into disrepair.

"That was the worst situation I've walked into in 30 years," Ms. Murray said. "There were feces on the wall. Everything was stained with feces and urine. Nobody had bathed in that house for a month."

As she stepped inside, she spotted Robert Prezel moving in her direction with a knife in his hand.

Ms. Murray quickly calmed everyone, assuring them she was there to help. But she is still shaken by what she saw that day.

"The thing that scared me the most was wondering how they had not set the place on fire," she said. "All of the electrical cords were all over the place. It was a death trap."

She first coaxed Lisa Prezel outside and into an awaiting car, then the brothers followed.

"If any of them had said, 'I don't want to leave,' I could not have forced them," said Ms. Murray, who is now the Pittsburgh-based area director for program operations for the state's Office of Mental Retardation.

	Steve Mellon, Post-Gazette From left, siblings Robert, Dennis and Jack Prezel sit down to Thanksgiving dinner at their townhouse. Click photo for larger image.

Because Pennsylvania has no adult protective services law for adults under 60, "If they'd said 'no' and slammed the door in my face, I'd have been up a creek."

Their problems weren't over, though.

The Prezels, not surprisingly, immediately moved to the top of the emergency placement waiting list, a list that now has nearly 3,000 names statewide, but procedure dictated they accept the first available slots.

"The county's offer was, 'We can house these people, but they will not be together,' " said Reid Wolfe, a vice president at Achieva.

Achieva officials decided the four had to stay together, and set in motion steps which landed them in their current home on the South Side.

Because Achieva had taken over their care, though, the Prezels were no longer considered an emergency case requiring county aid. So, for more than four years, Achieva, using privately raised donation money, and federal Medicare have each paid half of the nearly $500 a day needed to keep them together in a safe, clean environment.

"That was one of Mom's biggest things. She wanted them to stay together," said Richard Prezel, 53, of Show Low, Ariz., the fifth Prezel sibling and only one without mental deficiencies.

Richard Prezel said he grew up not realizing that his family was much different from anyone else's. Robert Prezel, he said, went to a regular school until second grade, when he contracted rheumatic fever and suffered irreparable brain damage. Jack Prezel is autistic, Richard Prezel said, and Dennis Prezel shows characteristics of Down syndrome.

Lisa Prezel is the only one of the four capable of holding an actual job, he said, and "wherever she's worked, they've loved her."

When everyone was young, the family managed well. "Most of the neighbors had been there for 20 years, and they were accepting of" his brothers and sister, Richard Prezel said. "As those neighbors got older and died off, it was a little bit different. [The new neighbors] didn't understand the situation. They would just kind of keep their distance."

Neighbors Sue and Mike Kozub said they bought their house in 1993 from a family who worried about raising a child near the Prezels, some of whom would wander through yards, or leave their shoes on a neighbor's windowsill.

"It was pretty bad over there," Mrs. Kozub said. She said she was called into the house once, when Mrs. Prezel needed help getting up, but "the stench in the house was so bad, I almost threw up.

"I don't know how they cooked. I don't know how they survived."

About four months after Ms. Murray's first visit, Achieva had moved the Prezels into the pleasant, contemporary two-story townhouse they live in today, a few blocks from The Cheesecake Factory.

"There couldn't be a better situation for them," said Richard Prezel, who thought at one point he'd have to move his brothers and sister to Arizona. "They've got good caregivers. They do a lot of things together, and they've all got jobs. If I'd brought them all out here, I couldn't have done that for them."

They keep a tight routine, with the three brothers going to workshops during the day, and Lisa Prezel, who Ms. Murray said did the cooking and kept everyone clothed when they lived in Plum, works at night. That leaves her mornings free to take fitness classes or go out for coffee with her caretaker, Bonnie Long. Chris Ingham, a former chef, cooks their dinners and stays with them in the evenings.

To a visitor, it might appear that the four travel in separate orbits within the same household, but that's not so, Ms. Long said. If one of the brothers is late coming home, the others know and will be checking at the window until he arrives.

"They are all kind of looking out for each other. They want to see they are being taken care of if something is wrong."

Jack Prezel, who rarely spoke when he came under Achieva's care, will now greet people he knows and welcome them into the house. Dennis Prezel wears a perpetual smile and proudly shows off his book collection.

Lisa Prezel is the most conversational. She says she likes shopping at the nearby Goodwill store, and she enjoys buying Tim McGraw and Faith Hill CDs when she gets a paycheck. Unlike the others, she has taken trips to the beach and she flew to Arizona by herself to visit her brother for Thanksgiving last year.

She misses the house in Plum sometimes, she said. "But I'd rather stay here with Bonnie." The others don't mention Plum, or their parents. Robert Prezel, 56, is still prone to blurting out, "I'll break your neck," or, "I'll bust your face," when he's in a situation that makes him nervous. Mostly, though, he just paces.

Ultimately, the Prezels' extreme situation might have helped them. It became something of a mission for all involved to make sure the four were together and taken care of. But, Mr. Wolfe said, "you just can't continue to use private dollars" to rescue everyone from the waiting list.

Three weeks ago, the Prezels celebrated Dennis Prezel's 50^th birthday with a cake and gifts at home. There was a time when few people with disabilities as severe as the Prezels' lived to see age 50. After getting physicals in October, though, the Prezel siblings are in their best health in years, doctors say.

"They're all doing really well," Ms. Long laughed. "They'll probably outlive me."