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

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JDH
D was discharged Friday after returning to inpatient for 2 weeks...  
Weekend went very good at home.. 
Since Day Treatment didn’t go so good last time, we are going to try staying at home and just meet with the hospital once a week., 

D really wants to return to school...
Is it a good idea to start going back to school right away, or should she be waiting a few more weeks?
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scaredmom

Hi JDH, 
I would ask a few question about hers and your readiness for her to go back:
1) Does she eat everything you give her?
2) Will she eat at school unsupervised? Can the school provide supervision, by that I mean, adequate supervision for her meals? 
3) Does she throw food away or purge- that may go unnoticed at school?
4) Does she have exercise compulsions or standing issues - she may need to be pulled from all  physical activity at school- no gym no recess etc. Will the school support that she will not participate in health or gym classes? And she may need to have alternative projects to do while the others are physically active? If she walks alone to school, are you sure she will not throw food on the way to school. Are you able to drive her or have her driven to school and picked up? 
5) If she does not eat at school, do you have plans to keep her home or supervise her yourself at school?
6) Have you discussed her issues with the school? 
7) How are you feeling about her going back to school? Do you feel she can handle it and that you can handle it if things go pear shaped?

You can always try to let her go, and then see what happens. If the weight goes down,you will need to regroup and may need to increase supervision at school or keep her home. 
I like to use lists and figure out the best and worst outcomes of a particular decision I am working on... and then see how it goes. Remember though, "feedback not failure" we learn by trial and error.

It is not an easy decision and you know her and her situation best.
XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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JDH
Since discharge on Friday she has eaten all meals & snacks

I would be picking her up and supervising snacks and lunch as the 
school principle thinks by telling her to eat that she’ll just eat.. 

I am nervous about her returning to school cause if it goes as good as Day Treatment, she’ll be begging to go back to the hospital again.

Such a hard decision to make.. and with ED I’m not sure what the right decision is... 

I told our D we would see how this week at home goes and her appointment at the hospital on Thursday.. and if all goes well we could look into going back next week
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scaredmom

I think what I am hearing from you is that you want to keep her home at this time. 

  What you have decided about going to the next appointment first then you can see how you feel, is a good strategy. 

I actually think, when it is time, you will know. I really do. If you are concerned right now,then it is not good to let her go. She has only been home the weekend and so much can change day to day.  You may wish to keep her home a few weeks, get a good rhythm going first, weight gain, improvement in state first before adding in school. 
Try to keep her well socialised as to not get lonely. But if you need to keep her home awhile, so be it. My D was out for 3.5 weeks. 
It all worked out. 

XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Mamaroo
Hi JDH

If your d wants to return to school it could be used as a motivator to get her to eat. I think it is a good idea to supervise all meals and snacks, we did it until she was close to her WR target. You can also ask that she be excused from PE or get a medical certificate from your treatment team to exclude her from all physical activities (some schools have running activities in the morning). See how this week goes. You can always let her go to school for half a day and work your way up from that. School is not such a high priority during refeeding, in my opinion, but like the others said, it is a good distraction (and you get a break as well 😉)
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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tina72
We did it that way:
After IP she was at home for 2 or 3 weeks to get her used to the new rules and meal time schedule at home. When she was eating without problems we started with half days at school. 2nd breakfast was supervised in school and we took her home for lunch and no afternoon lessons and no tests. After 2 more weeks we started with full schedule but no PE and no tests and still took her home for lunch (in fact we did that for the rest of the 1,5 years at school). After 2 months in school the teachers decided to let her write the tests with the others but asked her after correcting it wether it should be counted for the result or not (it was without any problems).

If she wants to go to school it can be a good incentive ("you can go to school after you have eaten this breakfast" etc.).
Keep feeding. There is light at the end of the tunnel.
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mommiful
My D's high school offered a bridge program, which might be a useful model of transitioning back to school.

She had been IP for about 3 weeks and we kept her home another week. She had been able to keep up with some of her schoolwork from the hospital, but there was still a big pile waiting for her. The bridge program allowed her to come in to school for whatever hours we thought would be good on any given day, and she didn't have to reintegrate back into the classroom right away. She went to a little room off the library, usually with a few other kids returning from extended absences . The staff of the bridge program (adjustment counsellor plus teachers rotating through) coordinated with the classroom teachers to help her get caught up, and she could choose to start attending her classes on a case-by-case basis. Generally, once she was caught up in a subject, she started attending that class. If there was something going on in a class that the teacher didn't want her to miss, or if she just wanted to drop in briefly, she could come for just a single lesson. It took her about 3 weeks to get caught up. They really did a nice job supporting her academically as she got caught up.

Eating at school was another story. My D started out going in for just a couple of hours a day, so she didn't need to eat at school. After a week or two, she started eating lunch at the bridge program. I made arrangements for the staff to email me when she had eaten and list the items they saw her eat. She was also sending me pictures of her meal (what I had packed). Unfortunately, this did not prove to be enough supervision. She later told me that she had been able to get rid of parts of the meals without the staff noticing. She ended up coming back home. I think it's very hard for people who don't have experience with eating disorders to do adequate meal supervision, at least if you child has a history of hiding food. We did have better luck in middle school with the school nurse, who turned out to be well versed in mental illness, very supportive, and willing to learn.

Returning to school after a long absence in middle school (earlier episode) was really important for us. School provided badly-needed structure. Before that, we had really struggled to keep eating happening on anything resembling a reasonable schedule. It also really helped combat the self-isolation and it gave her something else to think about aside from food. 
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