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

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pricie
My D has been in residential care for 5 weeks with 10 days at home over Christmas as the unit closed over this time.
Due to her not being compliant, relying on fortisip too much (choosing fortisip when she can’t eat the meal) losing weight, seemingly being disrespectful and not engaging well in group therapy, she has been sent home for a week to consider if she wants to go back to the unit and comply with treatment.
Has anyone heard of this?
The very nature of anorexia makes these kids do all of the above or am I missing something here? Your advice and thoughts greatly appreciated as usual.
If you are going through hell, keep going. 
           Winston Churchill
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CED123
from my very limited experience I would say this (your D's reaction - not being discharged) is par for the course and the unit needs to keep trying. Patients have been discharged from our unit for non-compliance but usually after months (eg 9+). I would say you have completely described my D's experience and her unit see it as normal (although D is not disrespectful and is talking to one of the therapists).
Currently no light; only tunnel 🙁
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ValentinaGermania
Is that a specialised ED unit? Then they should be prepared for resistance and no complain. They should not expect any engagement, that is part of the disease.
No kid should lose weight in residential. That sounds not professional.
Keep feeding. There is light at the end of the tunnel.
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formygirl
Unfortunately, I do have a similar experience. My daughter was stepped down from residential to PHP (due to insurance, she was not ready). When she was unable to gain weight for a week (she had agreed to gaining 1-2 lbs./week after she continued to lose weight) she was discharged for non-compliance. It is infuriating. She needs help more than ever..
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ValentinaGermania
That is really not professional at all, formygirl, and you should stand up against that if possible.
My d was first refed in a hospital here and they did blame her for no compliance and punished her for not "getting it" and for no weight gain.
When I asked for more information I found out that they gave her only 1500 calories and really expected weight gain with that. When I took her home we needed 3500 to see weight gain.

There is no therapy for AN that goes without weight gain. This is the first and most important step. If you see no weight gain, you or the team need to change something. More supervision, more food.
Keep feeding. There is light at the end of the tunnel.
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pricie

Yes this is a specialised eating disorder unit. I feel my D was given so many mixed messages. The communication needs to be simple and clear. It appears she was expect3d to be eating 100% of the food put in front of her after 2 weeks in the unit! Because she was still relying on fortisip (4 times in the past week) this was considered non compliant. If she refused a meal and fortisip, she had to sign a non compliance form. She did this several times during the first few weeks, but hadn’t done this in this last week. Surely that is positive? Too many non compliance forms is considered to be bad and can also lead to being discharged!

At home we have been doing FBT, however, I have not managed to get enough weight gain to see an improvement in thinking. I did get food into her, just not enough.  I wasn’t at unit during mealtimes, however, there didn’t appear to be enough encouragement with food. It was easier to either give fortisip or let my D sign non compliance forms.  

Like most of our daughters, she is a high achiever, articulate, spirited and has an opinion. I feel she was being honest during group therapy, but this was considered being disrespectful. She was also very anxious at times. She has RAN for goodness sake!  The unit is 2 1/2 hours drive from where we live. Treatment for ED is very hit and miss in NZ. It seems this is the case in most countries.  I have been staying nearby for the 5 weeks.  I was really hopeful residential care might ‘water down’ her thinking with some weight gain, but it all got too hard for them

If you are going through hell, keep going. 
           Winston Churchill
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ValentinaGermania
Talk to the chief consultant there. Is she gaining there?
Keep feeding. There is light at the end of the tunnel.
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