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.

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battlingdaily
My 13 year old son is scheduled to be discharged from a residential facility on 7/8.  The staff at this facility has begun coaching us on our role in the transition, but can anyone offer some advice on how to effectively manage this transition?  Are there resources/guides out there that we can refer to?  My wife and and I are excited that he'll be coming come but scared to death at the same time!  Thank you!
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Enn

Welcome battlingdaily,
I am glad that you have posted and hope that you find the resources you need to help your son.
We all wish to help!  
Please read around the forum  as there is a lot of information

When coming home, it would be best to keep as many rules/routines as they have in residential. We did not have residential but had IP and we had to keep home similar to IP. 

When they do get home, I found that ED tried to be the same as prior to hospitalization. My D behaves well for others in authority, ie the doctor, teachers etc. But at home it was quite different. Having the same routine for meals, and snacks and activities and bedtime, was helpful for me. It gave me structure so that I just had to do it. You mention that the staff are coaching you on what your roles will be. I think that is a good start. I would also ask them what problems to watch out for at home. I alway wanted and plan in case odd things happened. Then instead of being blind sided, I was empowered to act if needed. 

It is exciting and frightening at the same time for sure! I get that! 
Please ask any questions you have. We tend to work well with questions. We do share our experiences and the experiences here are so wide and creative. I am sure there will be some great ideas for you to try.
Wishing you all the best,


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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blondie
Get rid of everything you can that is associated with their ED and the period before they got admitted - for example any clothing that will no longer fit them,  if they used to a particular mug/bowl/plate then remove them and don't allow them to use inappropriate cutlery e.g. teaspoons when they should be using a normal spoon, small plates when they should be using a dinner plate and make sure the scales (kitchen and bathroom) are out of their reach and don't allow them to eat separately from other people/at different times - try to stick to the timing of meals/snacks that was followed in IP as much as you can


Ensure you are very clear from the beginning about the rules - and make sure you follow through on punishments if they break them - especially at the beginning when they may try and "test the boundaries" and see what they can get away with

Don't let them get involved in the preparation / choosing of or shopping for food  

The treatment team will hopefully have lots of other tips but hope these might help!
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Foodsupport_AUS
Welcome to the forum. Transitions are often really difficult with ED, and this one is very critical. As has already been said start as you mean to go on, and make things clear before discharge. So keeping what has been working in inpatient going after discharge, getting rid of what was not working prior to admission is all part of the planning. Expect an increase in ED behaviours. It is common for there to be meal and food refusals after discharge. Have a plan as to how this will be approached - be that supplement, returning to hospital for NG feed, waiting it out. It is really important to show ED how strong you are and that you will not back down. 
Despite that, sometimes ED gives them a really hard time. Sometimes the step down is too great and being prepared to move back to a higher level of care if things are not going well is important. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
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ValentinaGermania
Fill your freezer with ready made meals so you do not need to cook every day and can replace thrown food easily.
Have someone around for a break at least once a week for 1 hour.
Organize help with household, garden, driving someone to xy. Are there siblings?
Organize 24/7 supervision and slow return to school.
Prepare the house so it is safe and he cannot run off (locked windows in first floor etc). Like you would prepare it for a toddler.
Have a lot of distraction around (new games, videos, books...).
Keep feeding. There is light at the end of the tunnel.
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battlingdaily
This is all great advice!  Thank you all very much!  I'll likely be back with more questions...
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ValentinaGermania
Whenever you need/want. We are here 24/7. 🙂
Keep feeding. There is light at the end of the tunnel.
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Gofixgo
Our D just came home from residential and started PHP the same day.  It’s been almost 2 weeks with some ups and downs. She has not fought PHP but has been isolating, won’t talk to any old friends and won’t leave the house except for PHP.  As far as prepping your home, I agree that you should remove small clothes, scales and his mirrors if possible.  I also removed some of the frozen meals that she used to cling to before going to residential.   I would highly highly recommend having a family session or two before your S leaves residential to walk through a safety contract including new house rules (no closed doors, no devices after 10pm, all meals at the table etc). I would also plan family outings for Sundays as they don’t have any treatment on those days.   We did not have this and I believe it would have been a smoother transition home if we had.  Also, we went from res to PHP within the same company, so a I assumed there would be a transition between teams and plenty of communication. I was wrong.  It’s like we started completely over.  In our experience, the team at residential does not communicate with you after discharge.  I am so happy my D is home and hope that we can help her readjust. I was very nervous too, but now that I’m with her, I can witness the progress and the remaining issues first hand.  It helps us feel more connected to her and helps us understand her. 
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ValentinaGermania
"She has not fought PHP but has been isolating, won’t talk to any old friends and won’t leave the house except for PHP."

Think about arranging play dates (no matter how old they are; mine was 17). She might not send the old friends away if they just pop in "by incident".
We had to force our d a bit back to life and to leave the house. I asked her for "help" at some stores (no food) and forced her to leave the house at least once a day.
Keep feeding. There is light at the end of the tunnel.
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Stulken
I am so glad I stumbled across this thread.  My daughter has a ways to go in residential (at least 4 more weeks left, almost 4 weeks in) and bringing her home for passes to share meals is stressful!  ED tries to get away with stuff.  We are on the FBT track so I spend several meals with her weekly- and I am now seeing the value in this, as the dietitians are there to support and coach (not only her, but me too.)  

Best wishes to you and your family on the return home!
"There is no magic cure, no making it all go away forever.  There are only small steps upward, an easier day, an unexpected laugh, a mirror that doesn't matter anymore."
---Laurie Halse Anderson
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