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

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Hi all,
Daughter is now 3mts inpatient ,gaining weight and at stage 3 in a Cbte course.She was allowed home last Friday to Saturday evening which didnt go very well with her refusing to complete any of her meal plan.She was made to make up what was missed with ensure when she got back to the unit which see didnt expect and found very distressing.This week she has decided that she wants to be discharged saying she doesn't need to be there and finds it triggering.Met her Dr yesterday who tells us he is unable to make her stay.How can a 14yr old with an eating disorder decide what's best for her?Can we refuse to let her home ?Won't this turned into a cycle of weight loss then inpatient?
Any thoughts?
Hi Oxfordad,
sorry to hear it is so difficult at the moment.
I don´t know the legal situation in UK. Is she WR? Has there been any transition at home besides last Friday?
I would insist to not take her home without a proper transition plan. Transition at home and keeping up the meals eaten is hard and you need a team for back up if she does not eat at home. This must have consequences.

"Won't this turned into a cycle of weight loss then inpatient?"
That is what happens very often when there is no good transition plan and when the parents do not keep the rules about eating from IP.

I think it is ED that wants to be discharged because they made her make up what was missed with ensure and ED thinks it is easier to restrict at home than in IP.

Keep feeding. There is light at the end of the tunnel.

Hi Oxfordad
Sorry your d's home visit didn't go well. I am surprised the hospital sound so helpless in the face of your ds insistence on coming home (to escape eating it seems) and I would be very clear to the hospital that you are not in a position to have her discharged to your care and that you refuse. What you need is help from them to have your d eat when home. This may include them helping you refeed your d in hospital to learn skills in this area if necessary as well as  having much shorter future stays at home to begin with (straight back to the hospital if she doesn't eat if possible - this would send your d a very strong message) moving to longer stays as she proves she can eat. You can explore with the doctors about sectioning for her own safety if your d insists on coming home (even if there are not enough grounds presently) but it shows the hospital you are serious about her not being safe at home. 

My d was in IP 4 months under section  - not the same as your d; mine was was never a voluntary patient and so never had the option just to come home. I hope some other parents might pop along here with their experiences of IP kids in voluntarily in the UK and how they managed transitions with hospital help.

My understanding is kids refusing to eat at home whereas they did in the hospital is fairly common - hence shouldn't be a new situation for the hospital. It is just a situation they need to help you manage and is a crucial part of their job. I remember a kid at my ds hospital who often had not great home visits ie ate well in hospital and not so well at home. Her potential discharge date kept being put back as a result. She's now at home doing great (my d is still in touch with her) and so the fact that your d is struggling now doesn't mean she won't get there. However, the hospital need to step up and help you manage her to a point where she can be safely discharged.

Best wishes, 

Hi there
I’m in uk too with a 14 year old whose IP since sept
Have they not mentioned the mental health act? And detaining her?
My daughter is under no illusion she has to stay whether voluntary or not and that takes the pressure off us
Have you had that conversation with the unit!?
Has to be agreed by the psychiatrist but I would think that’s your next step

'She was allowed home last Friday to Saturday evening which didnt go very well with her refusing to complete any of her meal plan.'

How far are you from the unit? My d's unit used to tell me to bring d straight back if she refused to eat - I was three hour's drive so it was unrealistic but I would have taken her back straight away the next day if necessary.

If this is feasible - ensure someone at the unit, d's key worker preferably, puts this plan in place.  Then when d refuses to eat - tell her to get back into the car and drive her straight back.  Don't weaken or compromise.  She has to be shown that she eats at home as she does in IP, otherwise when she eventually comes home everything will fall apart straight away.

I am also surprised that there is no talk of the MHA being used to keep her in IP when she is clearly still so unwell.  It is worth discussing this with the psychiatrist.

Believe you can and you're halfway there.
Theodore Roosevelt.
A lot of kids here have started to eat on the way to hospital or in their car park...[biggrin]
Keep feeding. There is light at the end of the tunnel.