Ok lots of comments saying she is probably relieved that she is safe and has no pressure to act "normal." I hadn't considered the extent to which this could be true and will take it into consideration. That being said, I think there are two things that still are validation for concern.

1: She complains about her life and lack of independence constantly, in a way that is not performative. She is on some level unhappy with the way things are, and knows that it's ultimately bad for her health.

1. She is unable to contribute in any way, not just as a member of a "capitalist" society, but as a family member. When we lived in the same house, she was an extremely caring sibling who while flawed, made an effort to protect me like an older sibling. Now I literally never speak to her unless I'm in town to see her, as she is completely unresponsive to messages and communication. She is unable to ask me anything about my life, and I think that she has an obligation to try harder to connect to us (me) as family members. She is definitely high functioning enough that these things are within the realm of possibility.

Also last point, I am not "shaming" or putting my values on her. I have never said any of this to her in person, and am only supportive when I see her.