Dean has alway been like this, since the day he was born. When Sam was 4 and Dean was 8, their mother died of an Pneumonia. Their Dad was distraught, and became distant from Sam and Dean. It was up to Sam to help defend Dean at school from bullies, and helped him with his Daily routine at school, since he wasn't in regular classes. Sam also had to look out for Dean at home, by helping him do almost everything. Dean had no use of his right arm, and always kept his wrist bent and arm tucked up at his chest. He also also had a limp on his left leg. Dean was diagnosed with Autism, ADD, and a Verbal Learning disorder when he was 6. This makes it very hard for him to understand anything or communicate.
Sam got up at 6:30 as usual. He knew that Dean would most likely be awake and stirring. Sam has been watching out for Dean his whole life, and now that both their parents have died, Sam took Dean to college with him, instead of leaving him in South Dakota with Bobby. Their dad was an alcoholic, and he passed away from a failed liver about 3 years ago. Sam goes to college at Stanford, and Stanford is paying for Sam's off campus apartment, because Dean couldn't live in the dorm with Sam.
Sam got out of bed and walked across the room to Dean's bed. Sam reached the side of Dean's bed, and peered into his brothers open eyes. Dean had a blank expression on his face, and just laid there until Sam could get him out of bed. "Morning Dean!" Sam happily chirped. Sam reached for the corner of the blanket, and pulled it off of his brother gently. Sam saw his brothers right arm tucked against his chest as it always is. Sam put his hands under Dean's shoulders, and lifted his back up, so he was in a sitting position. Then, Sam gently guided Deans legs off the bed till they hit the floor. Dean's muscles were always very stiff in the morning, and because of his limp, Sam has to practically carry Dean out of bed. Sam put his hands under Dean's armpits, and hoists him out of bed, immediately putting one hand around Dean's waist, and wrapping Dean's good arm around his shoulders. Practically all of Dean's weight, which isn't much, is on leaning on Sam. Sam says, "Ok bud, let's get you to the bathroom."
Dean wears a diaper, because it makes bathroom trips much less of a hassle. Sam holds Deans weight while he limps slowly to the bathroom. Sam opens the door and sits Dean down on the toilet seat. Sam pulls a towel out of the closet, along with a new diaper, diaper cream, and baby powder. Sam helps dean up from the toilet seat, and guides him slowly to the ground, until he is lying on his back. Even though Sam has been changing Deans diaper 4+ times a day for 20+ years, Dean always hates it. When Sam tries to pull down Dean's pants today, Dean tried hitting Sam's hands away. "Come on bud, it's too early." Sam said understandingly. Dean stopped trying to move Sam's hands away, but started crying.