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

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Oct18
My D has been inpatient for over 8 months and has a BMI now of 14 and has a discharge date set for 6 weeks time. She will be returning to live with me (she is over 18) and I will be responsible for her and her recovery as the hospital won’t accept her on to day care as she still refuses to eat some foods, ie cheese and meat. They said they won’t support such a restrictive diet, so I have no choice but to take over feeding her myself.  

I have had conversations and meetings with the Dr and others at the hospital and if I am honest I think they are discharging her because she is too “difficult “ for them. I queried 4 weeks ago why there was no regular increases in her food anymore and the response was that they weren’t going to push for it anymore as my D found it distressing ! Not sure how I am expected to manage it at home if they can’t. 

I queried why discharging at such a low weight and was told that the admission had gone on too long and there was no point in keeping her in but that they expect her to relapse and be readmitted in the near future and then she “may be better able to accept recovery then”. 

I am a bit speechless, I feel let down and if I am honest quite frightened about the whole situation....   Has anyone experienced this and how did it work? I am determined she won’t go backwards, but I think it’s going to be very hard
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yellowcaty
Hi Oct18

I just wanted to send you a big hug. We are 10 months in IP so I feel your pain.When my D was in the first unit we had lots of conversations about discharge even though everyone knew she wasn’t ready. We then had the move to the adult unit even though she is only 17. As it turns out this was the best move for her. She has begun to engage and I think this is partly due to her realising that it will take her a lot longer to get out if not and the fact that she had a new start.

We we had family therapy last week and I mentioned to the therapist about how they had talked about discharge at the last unit. She said that sometimes it is the last resort in the hope that they will then engage, so I think it must be something that happens a lot.

Is there anyway she could be transferred to another unit? I think my D had just got stuck and this did help her. Xxxxx
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melstevUK
Hi Oct 18,

In no way is this acceptable.  Is it a specialised ed unit?  Only a bmi of 14 after 8 months is absolutely shocking.  I think you need to email the CEO of the NHS Trust and make a formal complaint and identify another unit where you would like her to be placed.  
Do not take her home with anything less than a bmi of 16.  This is a dismal failure and you need to highlight this.  There is no way that she should have been considered too difficult.  In any worthwhile ed unit the staff would have found a way round it - even if it meant using the MHA,  And their comments indicates that they are hopelessly out of date in their attitude.  They need a kick up the backside and I am more than happy to be the one that does that on your behalf.

Happy for you to email me separately if you want to continue the conversation and think of other ways forward.  
Believe you can and you're halfway there.
Theodore Roosevelt.
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Mamaroo
This is a very difficult situation and reminds me a little bit of Eva Musby's journey with her daughter. Here is a summary of her journey, it is from her website:  https://anorexiafamily.com/anorexia-family/

"She was described by staff as stuck, and by her ninth month she’d narrowed her range of food and was again losing small amounts of weight. We were keen to get her back home, and she was discharged in the eleventh month. There were hopeful days, but soon she was missing out on snacks, then on entire meals. We’d come under the care of the outpatient mental health services, where therapists gave us weekly family sessions (a space to talk, review and plan), and gave my daughter individual psychotherapy. It was fruitless. Her weight kept dropping, her mood was low, and we feared she’d spend her adolescence in and out of hospital unless we found a better way to support her.

At last several things clicked into place. A specialist eating-disorders service came on board. They were receiving ongoing training from the US in a well-validated treatment method called Family-Based Treatment (FBT). Our therapist followed the principles of this method, though in our case she did not go through all the standard steps. She gave us weekly family sessions and she and I also had regular phone sessions. My husband and I began to understand what we should be doing, why, and how. When she visited our home for a few meals and coached us, we at last began to behave like the competent parents that all along, clinicians had assured us we were." 

If you want to read more, go to her website and look for chapter 1 of her book.

All training and experienced Eva gained, she shares in her book, which I highly recommend if you haven't bought it yet: "Anorexia and other Eating Disorders: how to help your child eat well and be well: Practical solutions, compassionate communication tools and emotional support for parents of children and teenagers"

 

D became obsessed with exercise at age 9. 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. She is back to her old happy self and can eat anything put in front of her.
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Kali

Dear Oct18,

I'm sorry you are going through this...
It sounds like a very unsafe plan for your daughter and it is shocking that the unit she was in was not able to get her to a weight above a bmi of 14 in 8 months and that they would risk her life in this way by recommending that she come home while so unstable. Do get in touch with MelstevUK, as she is familiar with the system and has good, levelheaded ideas about how to advocate for better treatment. As your daughter is over 18, if she is very resistant you may find yourself in a difficult situation at home, and if so, it might be preferable for her to be in inpatient care. A move to a different unit might be something to try if you can get that arranged. 

warmly,

Kali


 

Food=Love
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tina72
What would happen if you simply refuse to take her home in that bad physical state? She could collapse at home and then?
Keep feeding. There is light at the end of the tunnel.
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scaredmom
Please contact melstevUK.  I would also strongly suggest you document your experience to date. That will come in handy if there is a debate. Dates, times people, locations etc...
Hope it goes well.
please keep us notified. 
Be strong and don’t accept anything but the best of care!
XXX
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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tina72
I would also try to contact Eva Musby. She has good connections and may be able to help.

This might help you:
https://www.gponline.com/anorexia-nervosa/article/883275
"A BMI below 14, or precipitous weight loss (>1kg/week), is dangerous. Mortality is increased by purging or substance abuse. Such patients should be urgently discussed with specialists."
Keep feeding. There is light at the end of the tunnel.
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