F.E.A.S.T's Around The Dinner Table forum

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

Join these conversations already in progress:
• Road To Recovery - Stories of Hope
• Events for Parents and Caregivers Around the World
• Free F.E.A.S.T Conference Videos

Visit the F.E.A.S.T website for information and support.

If you need help using the forum please reach out to one of the moderators (listed below), or email us at bronwen@feast-ed.org.

panda
We've been home about a month after 11 weeks at ERC in Denver, They discharged our D saying that she wasn't motivated to recover and they couldn't help her. Our D is over 18. We were clear that to live in our house she needs to follow the meal plan. She has a new treatment team, including Therese Waterhous as her dietitian. 

Our D tried to stop eating a week or so ago, telling us that she was simply done. We told her that if she didn't eat, we'd take her to the local psych ward. (She had also cut herself with a razor blade badly enough to need 7 staples, so it seemed possible at the time that a psych ward might take her.) She didn't want to go to the psych ward, so she continued eating. 

Tonight she texted us while out on a walk that she knew we couldn't take her to the psych ward because she was over 18, it's now been 5 days since she last cut, and she's not a clear and present danger. Therefore she plans to refuse to eat. 

We can't say eat or there's the door. She's has serious depression, is delusional.... she's fully weight-restored and has been for 9 months (I mean fully--she truly doesn't need to gain any more weight--Therese is monitoring her weight)...if we kick her out, I truly feel that her potential to recover will disappear in a matter of a few weeks, that her life will be over...

How do we get her back into treatment when she's over 18? It took all we had to get to ERC. We looked into getting a medical guardianship, but found that it wouldn't be of any use in compelling her to enter treatment--no place in the U.S. would take her unless she entered voluntarily. 

What in God's name do we do? I know that I can't live with her restricting...I will lose my mind.

Her therapist suggested Rogers Memorial Hospital in Wisconsin, because our D's illness is so entrenched and she also has borderline traits along with severe depression. Has anyone had any experience with Rogers? With getting an over 18 year old to return to treatment when they absolutely don't want to get well? 
 



panda
Quote
GiveMeStrength_US
I am truly confused.  We, too, were at ERC (in 2011) in the adolescent unit, but I find it surprising that a patient would be discharged for lack of motivation to recover when NONE of them are motivated to recover when they are sick enough to be IP to begin with.  What does that even mean?

We also looked into medical guardianship - I may be wrong, but I actually think our Dr at ERC was the one who mentioned the concept to us in the first place, so I'm also surprised that ERC (or other places) would not take a patient, only if it's voluntary.  I only did my research on what it would take to get medical guardianship for my D in my State (every State is different) and I knew I had the support of my D's medical ED doctor and psychiatrist (which my D knew too) if we had to go to court, but she continued to comply with treatment post-18 (despite threats to the contrary leading up to her birthday).  I knew that meant I could make all medical decisions for her, but I didn't ever ask any treatment centers whether that meant I could commit her.

But I do know that the ER is a place where both you and your child lose control if you bring her in - despite her arguing with you that she's not a clear and present danger and hasn't cut herself, etc., if you ever really feel she is unstable or unsafe, you can and should bring her in.  What may happen from there is anyone's guess - they have to do a psych eval and that could lead to a hold in the hospital, etc., BUT then you have to worry about her eating and refusing to eat there, so maybe do your research if there are an hospitals sensitive to ED AND psych issues (I'm just talking off the top of my head as a plan B type thing if you are in a crisis).

We had a situation where we had to take D to an ER twice - once was a psych issue (cutting) so we made sure it was a hospital that dealt with EDs and the other time was for an ED issue (refusal to eat) so we took her to where our ED doctor practices so they could tube her if necessary under our Dr's care/orders.

So you can say, despite the fact that she's over 18, you can take her to the ER for a psych evaluation or to be tubed (do you have an ED Dr or can Therese Waterhouse help you pave the way for that to become a reality) if you feel she is a danger to herself or if she refuses to eat.  You also have to use EVERY bit of leverage you have - money, car keys, etc.  You don't say "here's the door" if she won't eat - you say LSUYE and do whatever you can to make sure life, for her, does stop.  I have been there, fighting with a YA, so trust me, it isn't easy, but they are not as grown up as their ages indicate.  They need you to fight for them underneath all the ED crap.
Mom to D 21 in November, behaviors started at 15, hospitalized at 16, IP at 17, FBT at almost 18. Finished second year in college; now abroad in treatment program to deal with co-morbids.
Quote
heartbrokenmom
Oh Panda, I sooo feel for you.  I, too, have an adult d (23) and have been at this issue a long time.

We have recently returned from ERC, too (third time).  ERC is the only place that we've been that hasn't discharged her for being too much of a risk for them.  I'm assuming that since your d is weight restored they just don't have the motivation to keep her there.  And you are right about the fact that facilities won't take a patient against their will;  I have looked into this numerous times and facilities just aren't set up to deal with patients who are uncooperative/unmotivated.

I have medical conservatorship of my daughter.  It has been somewhat of a double-edge sword.  She's often angry that I have it, but then grateful also.  The conservatorship really doesn't give you the power to force her to go to a facility but does grant you permission to get information from her care providers that you might not be able to get without it (HIPAA laws).

There is a facility in Utah (Center for Change?) that we almost went to a few months ago that deals with eating disorders and serious co-morbid issues.  Unfortunately, we couldn't get to that facility before my d had a major event.  But, they sounded like they could handle the issues.  They are not a locked facility, but I think are somewhat secure.

At this point, my d's main issues are not eating disorder related.  She seems to have control over that at this point.  However, the depression and anxiety have skyrocketed now and my d is in a locked facility.  We feel devastated but it is now beyond our power.  Really stinks.


Heartbroken Mom
Quote
Red
I am talking as a parent of a younger teen, but in case it helps... we quite often got this kind of a text from d, but on our/her return, we'd carry on all pleasant and lovely, plate the food in the normal manner, and she'd eat. Used to puzzle the heck out of me. Occasionally, she'd lead with 'didn't you get my text?!' & I'd reply 'let's talk about it after dinner' or somesuch. It seemed to bewilder her that we didn't retreat into panic mode.
The future is not set; there is no fate but that which we make for ourselves.

"Not my daughter, you bitch." Mrs. Weasley
Quote
YogurtParfait_US
"Let's talk about it after dinner"--I love that!
"Hope is a wonderful thing ... but hope by itself is not enough. Hope is the reason to take action, to make a plan and then to change the plan when it isn’t working - over and over and over again if necessary." Hannah Joseph (Let's Feast Friday Reflection, "Just Keep Going," Friday, March 3rd, 2015)
Quote
panda
What does LSUYE stand for?  

Taking our D to the psych ward for not eating wouldn't be helpful. Unless she's a 'clear and present danger to herself or others' they can't help. 

D hurt herself while out (accidentally, but I feel it wouldn't have happened if her mind hadn't been in such torment). Once she was back home from Urgent Care, she ate. 

ERC discharged her because they said her being there was a waste of time. I wish they had sent us on to a different facility, rather than simply sent us back home. 

Has anyone had any experience with Utah's Center for Change, or Roger's Memorial? 

The anxiety and depression scare me at least as much as the ED. So much sadness....  
 
panda
Quote
Red
Life Stops Until You Eat
The future is not set; there is no fate but that which we make for ourselves.

"Not my daughter, you bitch." Mrs. Weasley
Quote
YogurtParfait_US
Here are two threads about LSUYE:


The search returned 1 topic 
 
 Topics   Posts  
 Topic SubjectAuthorForumViewsRepliesLast Post 
  How to do LSUYE when he never wants to do anything anywayTrueNorthMomAround the Dinner Table Forum96814June 25
by YogurtParfait_US
 
 
  
 
        
  LSUYE is tricky when there is no 'L' to 'S' 
1 2
anotherbite_CAN2,85162Nov 30
by MariaEC
 
        
 
Checked Topics:  -- Select -- Delete  
 
 
  
 New Topic 
"Hope is a wonderful thing ... but hope by itself is not enough. Hope is the reason to take action, to make a plan and then to change the plan when it isn’t working - over and over and over again if necessary." Hannah Joseph (Let's Feast Friday Reflection, "Just Keep Going," Friday, March 3rd, 2015)
Quote
panda
It's 2 days later and tonight D refused food and walked out of the house. She called to say that she's staying the night at a friend's house, and may be planning to return home tomorrow. What happens when she comes home, I have no idea. But we've crossed a really scary line--she's refused food and gotten away with it because she's over 18 and the only option we have is to kick her out of the house, which would be seriously cruel, since she's delusional. I tried the LSUYE and she just didn't care.

She needs a higher level of care and we don't know how to get her to go, or where to go. Heartbroken Mom, what locked facility is your D in? How did you get her to go?

For now, D can use the threat of not eating whenever she feels like it. We have an appointment with a family therapist next week--I'm not sure I can hold it together until then...  


panda
Quote
Foodsupport_AUS
Quote:
 But we've crossed a really scary line--she's refused food and gotten away with it because she's over 18 and the only option we have is to kick her out of the house, which would be seriously cruel, since she's delusional.


On your first post of this thread you mention that you had an agreement with your D that she needed to follow the meal plan to live at your house. I understand your D is still ill with her eating disorder and you would love to push her into treatment. At this point with her weight restored I can see how you feel your hands are tied. I think that since you have made it clear there is a house rule of no ED, you need to decide if this can be enforced. Do you have the means to get her following the rules she agreed to. Your ultimatum on coming home from ERC means nothing if it is not enforced. I agree this is a very scary line to cross. I am not sure if there are parents here who have crossed it and if so whether they had a successful re-engagement with their child. Is there any other bargaining power you have with your D that you could use to keep her eating as she needs to other than asking her to leave? If she did leave does she have any hope of caring for herself? Can you use any of this to get her to do what she needs to?
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
Quote
SnP
Hi Panda,

I feel very much for you and understand what a scary position you are in at the moment.... doesn't lend itself to being able to sleep at night!

regarding- "the only option is to kick her out"...

I did use this line- no ED in this house, and I arranged a back up with a homeless shelter! 
One day during a 'you can't make me do anything' moment of taunting from D, I responded with - 'yes I can, ED is not welcome here' and locked her out- yes it was dusk, she had no phone, and had very few clothes on. She took off. 
I spent an exeptionally anxious 4 hours phoning friends. Eventually, late in the night, I received a call from D, at a friends, asking to return home.
My message was delivered and received. Traction was gained.

I was very confident in my relationship with D and her dependence on me at that point to have taken this step, and at that stage she was not self harming.

I hope you have been able to secure some more helpful back up from her treatment team. Medicolegally any treatment team that deems they are unable to help should be at least be recommending or referring to another centre.

Sending you hope
Quote
heartbrokenmom
Panda--

I'm so sorry you are having such a rough time of it.  I completely and 100% understand your reluctance to tell your daughter to eat or leave, as she's too unstable emotionally and could find herself in a horrible situation if you did that.  We have faced that many many times and I just couldn't bring myself to send her packing--so to speak--as I knew that the result could be devastating.

My daughter was taken again to a locked psychiatric facility in the San Diego area after another suicide attempt last Monday.  She was just transferred today to a residential psych unit north of here.  There are places, such as the one my d is in now, that treats dual diagnostically (both ED and psych issues).  However, it is important that you understand that right now my d's psych issues trump the ED issues.  Since our last stint at ERC, she seems to be fully committed to eating (we'll see how long this lasts).  But the psych issues are a whole other thing....

The most important thing you can do right now, as I see it, is to get her into an ED-knowledgeable therapist.  Once the therapist can gain your daughter's trust, they will be able to convince her how much she needs help.  Unfortunately, as moms we are often targeted by our daughters as the enemy and they won't listen to any reason from us.

My next advice is a bit harder to swallow.  I simply had to let my daughter's physical health deteriorate at times to where she became so sick from restricting/binging that emergency hospital visits ensued.  Sounds horrible but I couldn't force her to eat (she's an adult).  It was my experience at hospitals that the doctors were horrified enough by her health that they often gave her no option but to go straight to treatment.  Learn the signs of health deterioration....dizziness upon standing and passing out was a big one for us.  Also, any self harm is a trip to the hospital (which we've had done by calling the police more than a couple of times).

I also obtained medical conservatorship for her within the first year or so of her anorexia/bulimia.  It was costly and she hates that I have it, but it does serve as some kind of motivation for her. 

I also insisted that she sit at the dining room table with us every day to eat meals.  I plated for her, she often didn't eat, but we sat there and made small talk and tried to keep the meal time pleasant.

This is a long hard battle.  But wars are won one battle at a time.  I chose to take the "love her to death" stance, even resorting to trying to guilt her and bribe her into treatment at times.  My d doesn't do well with anger from me, as she's very guilt-ridden already.  I let her know that no matter how sick she became, I would never give up on her.  Sounds righteous, I know, but it wasn't always that pretty.  If scolding/punishing her would have helped, I would have done that too!  I've had family and friends ask me if I ever just want to slap the bejesus outta her, and I always respond that I would have been happy to have done that if it would have worked.  Follow your gut and your heart---as a mom, you know when she's so sick that intervention is necessary.  Speak factually to her doctors and therapists--they seem to respond better when I'm very fact-based.  I kept a log of her medical complications and offered it to them.

God, please know I'm thinking of you.
Heartbroken Mom
Quote
panda
Thank you so, so much, for writing. 

D came home after being out overnight--we knew she was at a friend's and not eating. She has since returned to eating, saying that she plans to get a job and move out the second that she can afford to, so that she can restrict in peace. I have a really hard time listening to her talk about how she's 'looking at an apartment' and wants me to visit her when she has her own apartment. I just don't respond, but inside I'm very scared that what if she does get a job, because the equation when/if she has money of her own will be very different from now. Her sole interest in getting a job is to have enough money to move out. My spouse feels that there's no way we could get her back to treatment anyway. Her therapist is undecided on what should be done--she apparently suggested to D that D see her twice a week, and D refused. The therapist, who does seem knowledgeable about ED, hasn't been able to convince D to accept that D needs help. D has her plan--move out and return to starving--and that's that.  

I feel crippled with fear about my D's future.  
panda
Quote
Iris_US
I know you are terrified, and believe me I've been there, but I'm hearing something different in what your daughter is saying. What I'm hearing is "I want to eat, but ED won't let me, so I will convince ED that I need to eat just until I get a job and get my own place". My d has often said things along this line. I see it as hopeful...
Quote
SnP
Panda,
We hear the same chatter in our house.... going to get a job, leave home ASAP, lose weight, don't want to recover .... it's all ED speak
Our D has had opportunity in the past 2 months to do this....but she hasn't! Take heart....they are very stereotypic in their behaviours.
The fear for the future of our AN children is sometimes crippling.... I try to stay in the present, but the brain's bias for fear is hard to distract sometimes
Thinking of you.
Quote
heartbrokenmom
Oh, Panda, I hear you on the ED psycho babble.  If I've heard it once I've heard it a thousand times.  "I'm gunna get a job and move out" is a famous one.  On one hand her ED is desperate to get away from your home (which is where it's hard to restrict) and on the other hand ED is manipulating you by threatening you with things other than her ED.  That way, you could possibly give in to her restricting because you're afraid of her leaving home.

First and foremost, know this is her ED talking.  Many, if not most of us here, have heard it many times.  Very very frightening for parents indeed.  I have found that acting supportive of her desire to be independent usually shuts things down pretty quickly.  I respond with things like "wow, that's a big step, but I'm sure you can do it".  Once the argument from you is not obvious to your d, the subject usually just fades out.  But, it comes back again and again and again. 

Try to keep conversations brief when you hear the ED threats.  Occasionally, you'll have moments when you're talking to your actual daughter.  I usually know when I'm talking to a girl not being led by her ED because that's when she's honest about behaviors and is usually teary-eyed and guilt-ridden.  Just don't get caught up in the ED babble.  The ED voice is there to frustrate, anger and worry you, so that you will be less concerned with her eating than you are with the other threats.

Thinking of you...
Heartbroken Mom
Quote
mojo431
panda wrote:
What does LSUYE stand for?  

Taking our D to the psych ward for not eating wouldn't be helpful. Unless she's a 'clear and present danger to herself or others' they can't help. 

D hurt herself while out (accidentally, but I feel it wouldn't have happened if her mind hadn't been in such torment). Once she was back home from Urgent Care, she ate. 

ERC discharged her because they said her being there was a waste of time. I wish they had sent us on to a different facility, rather than simply sent us back home. 

Has anyone had any experience with Utah's Center for Change, or Roger's Memorial? 

The anxiety and depression scare me at least as much as the ED. So much sadness....  

 
Hi Panda.  I am so sorry to hear about your situation with your daughter.  I don't have a similar experience but our daughter (17 at the time)  did inpatient at Rogers Memorial in West Allis, WI last year.  She was in the pediatric & adolescent unit and we were very happy with the care and treatment she received.  I hope you can find someone who might have information about the adult unit.  I will tell you that when I spoke to a friend who works in mental health with adults in our city, about Rogers he said it was great and that they often referred patients (with illness other than ED) there.  I hope that helps a little.  Hang in there.

mojo
mojo
19 y.o. daughter dx 9/2013.  Weight restored 5/14 and doing well.
Quote
Calli
Hi Panda, my daughter was at Rogers Memorial four times this past year, twice in Oconomowoc - once in the adolescent unit and one time in the adult unit. The other two times she was in day treatment in Madison. I felt that the adult unit in Oconomowoc was far better than the adolescent unit but I was not happy that they kept her there for about 10 days, not enough time to have any real effect. They only keep patients until they feel they have been stabilized - very short term.
Since then she had an almost successful suicide attemp and we could have sent her yet again to Rogers but decided that since they were unable to help her the last four times we would pay out of pocket and send her out of state.

This is my first time writing on any forum, and I registered months ago, so I may get my name wrong, but I think I signed in as Calli
Anne riceman
Quote
tryingmom
Hi Panda,
Have you tried Hopkins?  Dr. Angela Guarda?  They have a locked unit that is both mood disorders and EDs.  Sadly, the two diagnoses are under two different medical services, the antiquated teaching hospital organizational structure, so it is hard to get all the problems addressed.  I have very mixed feelings about their program, but it might fit your circumstances.
Best wishes,
Tryingmom
Quote
Colleen
Hi Calli, welcome to the forum, and I'm glad you had the courage to post!  I'm so sorry things are hard for your girl right now.  I hope you will feel free to start your own thread.  We would love to help and support you in any way we can.

I hate ED.
Colleen in the great Pacific Northwest, USA

"What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease."
Alexander Pope, 1688-1744
Quote

        

WTadmin