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rainydays

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Reply with quote  #1 
My daughter had purging type anorexia in 7th grade. Hers was a difficult case which sent us through IPU, ERC and is now in recovery with monthly visits to a DBT therapist. The trouble is that she has a 16 yo friend who was having family difficulties and we let her move in last year on an as needed basis. She reported that her stepfather made her uncomfortable and was abusive to her mother. We told her if she felt unsafe and needed a place to stay she could stay at our house. That became full time. In that time her anxiety and eating disorder grew.

She reached out to me three weeks ago that her eating disorder was bad and she needed help. I contacted the parents. She did an intake at the ERC, where they recommended inpatient for three days and iop after. Her mother, and my daughter talked her out of going.

She's on clonazepam and an ssri for anxiety/depression, with no therapist to help with her eating. She does check in with Seattle Children's adolescent medicine.

We talked to the girls last night, told her that she'd have to go home to be with her family so they could help her. She was horrified.

I feel irresponsible letting the eating disorder grow out of control in my home and feel powerless to help her. I feed her. Set guidelines. Provide family meals and structure but have no authority.

Anyone else have experience with this sort of situation?
Torie

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Reply with quote  #2 
Quote:
Originally Posted by rainydays
She did an intake at the ERC, where they recommended inpatient for three days and iop after. Her mother, and my daughter talked her out of going.


Why?  What do you think of that plan?

Please don't blame yourself.  Doesn't do one whit of good.

If you want to try re-feeding in your home, it sounds like you have a built-in incentive plan:  If she can finish her meal, you are happy to have her stay.  If she can't finish the meal, you will need to take her - and the meal - to her mom in the hopes that her mom will be able to help her finish.

So sorry ED has visited your household again.  Ugh. Please keep us posted.  xx

-Torie



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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
mjkz

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Reply with quote  #3 
Why would your daughter talk her out of going?

Personally I'd be only supporting the plan at ERC and if she didn't do that, she would need to return home.  You can't be responsible for this kid and if something happens to her under your care, you could be held responsible.  You also have no authority to get her treatment if something happens to her and you could find yourself in a really bad legal situation.  I admire your willingness to help but you did the right thing getting her evaluated.  I don't know what your daughter and her mother were thinking but this is a situation that could turn really bad really quickly for you and your family.  Wish I could offer more but this is probably not going to end well for anyone if she doesn't get treatment.
rainydays

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Reply with quote  #4 
Thank you Torie, unfortunately, sending her back would be, by her account, sending her to an abusive home.

I don't think this plan will work, I'm not sure what to do. I'm not sure how hard to push for the ERC or something different.

My daughter didn't like going to the ERC. I'm not sure what the deal is with the mom, why she doesn't want her to get treatment. This kid has been out of lunch money for awhile. It honestly makes me cry because she's an earnest, hard-working kid.
rainydays

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Reply with quote  #5 
Mkjz,
I see what you're saying about being on a bad legal situation. The girl was in a bad way a couple of weeks ago. Sleeping all the time. Not going to school. She dragged herself out of bed to go see her boyfriend and rear ended someone. She totalled her car. The other folks were ok. I've taken driving privileges away until weight restoration for my daughter. I didn't feel like I had the authority with A. When I told the parents that she shouldn't be driving until weight restored, by text, I got an angry message from my daughter to butt out of their family decisions.

It's a rock and a hard place.
Torie

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Reply with quote  #6 
Rainydays, I'm trying to figure out what your options are.  Here's what I see:

1. ERC
2. Send her home
3. Contact protective services and report the abusive home
4. Let her starve at your house

What am I missing?

From what I know, in your shoes, the only one I would rule out is Option #4. xx

-Torie

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rainydays

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Reply with quote  #7 
Torie,

I love how you put that. It becomes very clear when stated that way. She is making a big effort, with my daughters help, to eat 4000 calories a day. There's no meal plan.

Number 4 is not an option.

Brooke
Torie

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Reply with quote  #8 
You are such a kind and giving person to try to help this girl.  In a way, I think it might help that you are not her mom as maybe she will try harder for you, and not lash out as freely.  Sure hope so.

BTW, we never used a meal plan either.  I wonder if it might work to require her to match whatever your d eats, and then additionally have 2 Boosts (or equivalent, or whatever would be enough) each day.  We did something like that for a time, and it worked out surprisingly well.

Thinking of you. xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
toothfairy

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Reply with quote  #9 
Hi there,
I saw this hours ago & have been thinking about it ever since.
I think the situation is very complicated & serious & needs to be handled as such.

First, I looked back on your old post,& saw that your own Daughter was very ill,just last October with her eating disorder. It was said that she needed at least 15 lbs more to get to WR.(Could well even need a lot more).

The friend moved in, there was still active ED in your home,& you have other kids too.
The friend complained of abuse at her home,,& is a minor,, this is really a very messy complicated situation that should have been brought to the attention of child protection/ social services.

She was allowed stay with you and her anxiety & eating disorder increased.
She was already under a physician for her mental health issues.

She has also now been involved in a RTA where she totalled her car. Lucky nobody was killed or injured.

She did an intake interview at ERC & a plan was made. Your ED daughter in recovery or not, should have absolutely ZERO say in the treatment of this vunerable teenager.

Ultimately at this point, the authorities need to be informed , & she should be handed over to her mother & social services -child protection..
Best of luck whatever you decide..

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Son,DX with AN, (purging type) age 13 in October 2015 ,  (4 months immediate inpatient) , Then FBT at home since.and making progress every day. He is now in good recovery, and Living life to the full like a normal teen. We are not completely out of the woods yet, but we can see the light at the end of the tunnel, thanks to ATDT. Hoping to get him into full recovery and remission one day at a time.
mjkz

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Reply with quote  #10 
Quote:
When I told the parents that she shouldn't be driving until weight restored, by text, I got an angry message from my daughter to butt out of their family decisions.

It's a rock and a hard place.


From my point of view, the problem is not between you and A but you and your daughter around A.  It might be time for a sit down and set the ground rules around where things need to go.  It is not appropriate for your daughter to be texting you about something that is between A, her family, and you.  To me, that whole interaction just makes it even more clear how muddy the boundaries are and how any authority you might have in the situation is getting nullified by your daughter.

I think all the first 3 on Torie's list are things you need to do.  The mother may not know how bad things are given that her daughter is living with you and may have no experience with eating disorder so she may not understand how serious the situation is.  I wouldn't be giving my kid money for anything if she chose to move in with her best friend either.  In some ways, your home has become a place to run away from her issues with her family so it is really hard to fault her family for not reacting properly. They have no control over what happens at your place and couldn't force her into treatment if they wanted too as long as she has your place to live at.  The situation reminds of me of the one OneToughMama was in with her daughter when friend's family sheltered her.  You don't know that there is any abuse going on at home, just her word on that.  Her eating disorder is out of control and you can't do much about that.  Any authority you might have over this kid is undermined by your daughter.  You really are in a no win situation.  Sorry if this is blunt and to the point but this kid's life is at stake.  Even without the eating disorder, she needs help and you are not in a position to give her what she truly needs. 

I admire your spunk and willingness to go to all lengths to help this kid.  I just think it is a no win situation for all involved the way things are.
rainydays

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Reply with quote  #11 
She went with her dad today to Seattlle Chilldren's Hospital and will hopefully get some guidance. The dad, who is somewhat estranged from her and is moving out of the country as we speak thought she should get treatment but is not the primary caregiver in their relationship. We are, with no authority.

mjkz

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Reply with quote  #12 

I hope things get sorted there with her father.  I think your heart is in the right place and I admire you trying to take this on.  My niece is going down the rabbit hole and I was going to have her move in with me but my daughter can't do it.  She has a trauma background and seeing my niece going through refeeding when she was with us a week early last month just brought back too many memories.  I am very grateful she was able to tell me that she couldn't deal with it at this point.  I really had to think about it and I had parental permission, legal papers, etc.  I wouldn't even attempt it without all the legalities in place so I could get her treated if something went wrong, permission of her parents, etc. 

rainydays

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Reply with quote  #13 
Seattle Children's hospital recommends treatment at the ERC. I'm not sure how everything will work out, but hopefully she'll get in soon.

The legal framework and who's driving to Bellevue everyday is going to be tricky.
mjkz

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Reply with quote  #14 
Quote:
The legal framework and who's driving to Bellevue everyday is going to be tricky.


Is she going to go?  Will you let her stay if she doesn't go?  I really hope she does decide to go.  Maybe the team at ERC can help you sort out the best solution to where she lives after treatment. 
rainydays

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Reply with quote  #15 
Her mom said ERC and SCH are coordinating care and there will be availability early next week. Meanwhile, she's coming here and stating that she's trying to get a dietitian and just do it herself at our house and is worried she won't be able to eat at ERC. I reassured her that they are very good at helping people to eat and not to worry.
Torie

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Reply with quote  #16 
Quote:
Originally Posted by rainydays
... is worried she won't be able to eat at ERC.


Sounds like a statement by someone seriously in need of outside help.  Also sounds like a ploy by ED, who is doubtless terrified of being required to eat the needed amount.

I really, really hope she goes. xx

-Torie



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rainydays

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Reply with quote  #17 
I do too. I know she needs help in so many ways.
sk8r31

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Reply with quote  #18 
It sounds like a good plan for ERC, & great that SCH is helping to coordinate care.  Is this outpatient, with the young woman staying at your place overnight & attending ERC during the day?

Still lots of work to house a teen who is seriously ill.  I admire you for taking this on when you are still helping your own d towards recovery.

Please do make self-care a priority.  Keeping yourself in the best physical/mental shape possible can help you to manage this challenging situation.

Sending strength & support,
sk8r31

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rainydays

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Reply with quote  #19 
I am really questioning my whole idea of giving A a place to live in the first place. That was poorly planned out. It's hard to not feel resentful towards the parents and it made the situation so complex And allowed her to get so sick.

With FBT treatment at ERC, won't they suggest that mom or dad be more involved?

Thank you for the self care reminder. That tends to fall to the side when so much is going on.
deenl

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Reply with quote  #20 
Hi rainy days.

I would fully expect that the professionals require her parents to step up. It would also be very helpful for social services to determine whether and how bad any emotional /physical abuse is.

Another issue to consider is the impact on your daughters health. Your primary responsibility is to her.

It is indeed a very messy situation and I see and admire how you are doing your utmost to thread a fine line. It may be a good time to plan for scenario a, b and c and decide clearly where your boundaries are.

Warm wishes
D

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2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
sk8r31

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Reply with quote  #21 
I second deenl's suggestions on boundary-setting and making plans A, B & C.  

Your primary concern is always your own d's health, & you & your h need to consider how much you are able & willing to help your d's friend, without jeopardizing your own family.

Sending warm support,
sk8r31



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It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
mjkz

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Reply with quote  #22 
Quote:
I am really questioning my whole idea of giving A a place to live in the first place. That was poorly planned out. It's hard to not feel resentful towards the parents and it made the situation so complex And allowed her to get so sick.


What could the parents do though??  At 16 she would be given some say in where she wanted to live.  Anything the parents did legally would have gotten you and your family in trouble.  The mother could have reported her as a run away and then you and your family would have been in trouble legally for sheltering a run away.  It doesn't sound like you know for sure that there was abuse and if there was, the first place you should have gone was protective services.

Your decision to give her a place to live made the situation complex and it was in your home with you as her caregiver that allowed her to get so sick.  It is really hard to fault the family when you left them few options.

I have no doubt you made the decision with your heart rather than your head (as we all do in situations like this).  You thought you were doing what was best for her.  At this point though I think you have to let her know that living with you is not an option and she needs to not only go to treatment but then home again to live.  As long as she thinks she can live with you, she is not going to see that treatment is where she needs to be.  The fact that she is trying to get a dietitian and do it at your house rather than going to ERC is alarming.  Level with her and let her know she needs to move back with her family and go to treatment.  As hard as it is, you need to look out after your own family's welfare.  If she ends up killing someone in a driving accident as sick as she is, you are her legal caregiver and are liable.  If something happens to her, her family could hold you responsible as her legal caregiver.


OneToughMomma

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Reply with quote  #23 
Dear Rainydays,

I have no doubt that you find yourself in this situation out of a desire to help, and that's admirable.  I'd like to relate to you some of our story, so maybe you can see another point of view.

My d was under FBT when she ran away to another family.  She (her ED) told lies and exaggerated the situation at home.  The family took her in and stalled her recovery.  We had no say in anything she did.  The mother said we should pay for her medical expenses, and they would 'support' her in her treatment.  At that point, H and I decided to cut her off entirely, giving the other family total financial responsibility for her medical care and general expenses.  we disconnected her phone. We were looking at cutting off our school fee payments.  We informed d's team that if she were to lose weight or fail to appear at an appointment we hoped they would take her under an Involuntary Treatment Order (basically have her committed). This is something we had fought against tooth and nail in the initial stages of her treatment.  It was the most horrific time of my life, having another woman take my child and say she knew better how to care for her.  I actually thought I would have a mental breakdown.  

Of course the situation in which you find yourself is different from ours,  but it is important, I think, to remember a few things:

  • ED lies with every breath,  
  • a patient will do everything they can to avoid effective treatment,
  • the best chance of recovery is scientifically proven to rest in treatment involving the parents,
  • your own family is the most important thing 
Take care of yourself,

xoOTM

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D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
rainydays

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Reply with quote  #24 
Thank you One Tough Mama. I don't want to be that mom, that's for sure. I don't want anyone to have a mental breakdown. That sounds like it was really hard. I want to untangle this knot were wrapped in and not lose my sanity or anyone else's.

How is your d now, how are You? Did things smooth out with the other family? Or was that a trainwteck?

rainydays

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Reply with quote  #25 
Mkjz ,

When I wad approached by my d and A, they asked for help for the mom. Could I help find a safe place bc she was leaving the step dad and he was scary. I said no, but I could give them nfo to pass along to the mom. I wasn't going to talk to her out of the blue about her husband. I asked if A felt aafe and she said no. I then told her if she needed a safe place to stay the night she could. Her folks would drop her off three days in a row. They wouldnt check in with me. Mom or dad would just drop her out on tbe street and leave. No "Hi, how ya doin, I know it's a school night, is it ok if she stays over?"

Then 6 months into this weird living situation, A says her room has been packed up and little step brother has moved into her room.

I tried reaching out to the mom for help with getting my d to eat school lunch. Being a teen is hard was all i got, not " oh yeah, my daughter also struggles to eat, let's talk."

I feel horrible she crashed her car and don't want anymore dangerous things like that to happen or for her to be hurting her body with malnutrition.. She's very clumsy right now, spilling and dropping things.

You're right about her needing to go home. My d is going to rail against this.

Thank you for helping us untangle our knot.
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