difficult child 2 in psychiatric hospital and they are talking out of home placement

[seriously]

difficult child 2 was 5150'd Saturday night. He was finally seen this morning at the new psychiatric hospital but was uncooperative and didn't answer most of the psychiatrists questions.

His medical student called me and got hx and then he called me this afternoon. Apparently she talked to difficult child 2 this afternoon and he was much more cooperative with her.

He is going to switch him from Geodon to Seroquel and maybe add Trileptal. He said he hadn't decided for sure - wants to see how the Seroquel helps.

I told the psychiatrist that I thought difficult child 2 is incredibly anxious all the time. Also that he needs help with getting to sleep.

psychiatrist said difficult child 2 is being manipulative and trying to do splitting with him and medical student. I said yes, we had a lot of that going on at home. He said he was glad we understood about the splitting.

We talked about difficult child 2's rigid thinking and inability to take another person's point of view.

psychiatrist said you understand these are not things we can really help him with in short term treatment. He asked if we had thought about residential treatment placement.

Yes. I understand that these cannot be addressed in the acute setting. And we have no resources for residential treatment. Our health insurance specifically excludes it and we don't have the financial resources to pay for it. I told him we had an open CPS case and the social worker had talked to me about getting a group home placement through probation.

The psychiatrist said he had some experience with that and it was very unlikely to happen. There just wasn't any funding for it anymore.

So he asked me what are the goals for this hospitalization and I said I think we need to try to get his sleep regulated better if at all possible. And address the anxiety.

He said if difficult child 2 doesn't become more cooperative he's not sure what they will be able to do. He said it depends on how stubborn difficult child 2 is going to be.

difficult child 2 has called twice to say he isn't eating because the food is terrible. With great gusto he said he "hadn't eaten in TWO days!" and we should bring him food when we come to visit - or we could even drop some off if we can't come during visiting hours.

I told him the food isn't all that bad - I know I was just there for 3 weeks. He said they weren't letting him go to the cafeteria so he only got what they brought him. I decided not to tell him that what they bring him is pretty much what he would get in the cafeteria too.

So when the nurse called to confirm our agreement to continue the inpatient stay on a voluntary basis and the new medications I asked her if he had been eating. She said she wasn't sure and she would check on it. I asked if he was being allowed to go to meals and she said no - he's not working with the doctor so he has to stay on the unit.

I told her that he was a picky eater but had been known to survive well on PBJ's. She said they can do PBJ's and thanked me for letting her know about it.

I haven't heard from the wrap around program today. We have a meeting already on the books with the family therapist tomorrow evening so that's probably when we'll talk about the current situation.

The CPS social worker visited difficult child 2's twin sister at school today. The social worker didn't know that difficult child 2 was in the hospital (I left her a message this morning but it hadn't caught up to her yet.) daughter said she told the social worker that she had called 911 when she heard her brother threaten to beat my face in with his fists.

daughter said she told the social worker that she was afraid her brother would hurt her.

The social worker told her that maybe her brother would have to go to a group home because she's afraid of him.

At this point it feels like we are on a slope ending in out of home placement but there are lots of obstacles in the way. And I keep thinking if we could just find the right combo of medications and behavioral supports/interventions he could stay at home.

I don't know how it's all going to turn out but I am scared. Trying to stay in the moment and avoid negative thinking.

 

[TerryJ2]

That doctor certainly covered a lot of ground and you two communicated really well.
I am so sorry that difficult child is being so stubborn. I can only hope he gets worn down when he realizes that you are not going to budge, bring him food, or cater to his whims. He is there to get better and get some sleep, not sail away to a spa.
I wish I had some words of widsom in regard to placement, insurance or financing, but others here will jump in and help, I'm sure.
Many hugs.

 

[MuM_of_OCD_kiddo]

Work towards outplacement and do not feel bad or guilty!

He needs this as much as the rest of your family needs a few weeks or months or peace and quiet at home, and it will give you all a breather to catch up on "normal". You have not been able to reach him at home - as a matter of fact - as per your own statements things have been escalating lately to the worse - taunting, harassment, threatening physical violence and more.

He really needs to see how things are elsewhere and have something else to think about. I think at that age - even without all of the various difficult child health issues and limitations, most kids are very self centered and wrapped up in themselves and their own needs and wants, and have no idea [never mind TV and all that] of what real life somewhere else is like. Let him experience first hand what his life will look like if he is not working and contributing to getting better. Sometimes a wake-up call and a healthy dose of reality can bring a change and may be the turning point to the way of getting better. Do not shot yourself in the foot by feeling guilty about not having him home - push for outplacement. Do not sabotage his chance of growth by babying him and giving in to his childish demands [unless of course you love the drama and stress he creates in your home?]. He doesn't like the food, oh well - tough isn't it? He is not going to starve to death, trust me. Even picky eaters know when to more or less gracefully give in and eat, even if they don't like it. You just undercut the doctor there - he is restricted to the cafeteria because he is not cooperating and you are telling the nurse he likes PBJs - what were you thinking? I hope she just humored you - your difficult child needs to learn that the real world doesn't give a flip about his wants, tempertantrums and issues - I think getting that part is a big eye opener to how good they have it at home. Sure helped my own kiddo and got him thinking.

In most cases outplacement is for a limited time anyways, go for it if you can get it - he will be back sooner than you are ready for him ...

 

[seriously]

Good points. Hadn't thought of telling the nurse about PBJ's as undercutting. He has lots of sensory issues including an acute sense of smell and taste and a hearing loss that makes noisy places stressful. Going to the cafeteria won't be the pleasant experience he thinks it will be and there are pretty much no more choices there than on the unit. When he's been hospitalized before for 5 days or more he really didn't eat anything but yogurt and bread - neither of which is available at this hospital's cafeteria. He lost about 10 pounds that time. But you're right of course - catering to him on the unit doesn't keep pressure on him to cooperate. I think I'll call them this morning and tell them to skip the PBJ's and the reason why.

I am actually desperate to have him out of our home, even for a few weeks. But it will likely be financially devastating to us to make that happen as the local agencies really have no $$ for out of home placement and families like ours are saddled with child support payments or reimbursement of most of the costs even if it means we have to pay off the costs in installments. If we had that $$ we would be placing him ourselves in a Residential Treatment Center (RTC).

That's why I need to just stay in the moment and not assume the worst case scenario of placement by court order with us paying the bill. Somehow it will all work out.

 

[DDD]

Sending supportive thoughts and hugs your way. Sure hope things work out as you hope them to. DDD

 

[gcvmom]

One. Day. At. A. Time.

Take care of yourself while he's there. You're going to need your strength if he comes home.

(((((Hugs)))))

 

[DammitJanet]

Im seriously praying they can get him somewhere. He is the same age that we were able to get Cory in his state hospital and then into their psychiatric residential treatment facility. I would have never found that facility if he hadnt gone in through the state hospital because it was attached to the state hospital. It only accepted patients with psychiatric disorders. He went into the state hospital at 15 but turned 16 about a week or so after entering the prtf. All told he was there about 7 or 8 months and it didnt solve everything but it did help stop the downward spiral.

 

[DaisyFace]

Ugh!

First big ((((hugs)))) !

Second, yes - it's easy for the CPS social worker to say that he'll probably be placed....SHE'S not the one who is going to have to pay for it!

Are there any friends or relatives who would take him for a bit? Maybe give him a different perspective and show him that the grass is not greener at somebody else's house....

 

[seriously]

No. Already explored that avenue with the one brother-in-law. difficult child 2 would be alone 12+ hours a day while he's at work. NOT a good choice.

 

[susiestar]

First, you are handling this really well. Be sure to use the time he is out of the home to do some special things with your daughter. I also urge you to call the sw's BOSS and have her rip the sw a new one. NO child, regardless of if they are 15 or 5 mos, should EVER be told that she is the reason that her bro may not come home. Your lovely SW just dumped this load of guilt on your daughter - that because she doesn't feel safe then husband might not get to come home. This is a LIE - difficult child may not come home because he cannot be safe or non-violent around others, because he is is ill, or because he maes bad choices that hurt others. There is a HUGE difference between what the SW said to daughter and what the truth it. Both have similar outcomes, difficult child not coming home (IF the sw places him), but the way the sw said it puts guilt on easy child AND drives a giant wedge between the twins. Forever more difficult child will be able to say that his twin did him wrong and got him kicked out of the house.

easy child needs a therapist to help with this stuff and you have to keep talking to her about how it is NOT her fault no matter what.

As for the sandwiches, I would push them to wait, but at some point they have to get food into him. Yes, it should not be an easy accommodation, but you have to realize that many of the food issues are not just being picky. They are true problems, and not defiance. For years Wiz could not eat tomatoes in most forms. He liked pizza, but with all the other stuff the sauce wasn't that noticeable to his mind. A bite of spaghetti with sauce, or of lasagna, or anything with ketchup would make him gag or vomit. the smell of tomato sauce, did the same. My husband thought it was defiance for a long time, but I wouldn't allow him to punish Wiz. I have some major sensory issues with foods and have the same reaction to some of them. Liver, in any form, gags me. Mushrooms are hideous because the texture is nasty whether they are cooked or raw and their smell is worse.

So the pbj sandwiches COULD be splitting, but they also could be a very real issue. I owuld let the nurse know about the sensory issues with food and let them sort it out. I rarely felt that food was a battle I wanted to fight as long as they were eating fairly healthily.

I think out of home may be the best choice. You and easy child do not deserve to be the victims of domestic violence - and that is what difficult child is dishing out. You CAN get free help from the local DV center, as can easy child and even, when ready to see/admit his part, difficult child. PLEASE seek this out. Doesn't matter if it isn't an adult being the abuser - itis still abuse and domestic violence. the dv center may even be able to help get a placement and/or find ways to keep you from having to pay a fortune. Usually they have lawyers who will help pro bono and then the atty can at least try to reduce the amt it costs your family because you were the abused even if it was your child who hurt you - so making you pay huge fees would be abusing you again (or so it might be able to be argued).

 

[Liahona]

How is he in school? Is he having the same behaviors in school or is it all at home?

I had the thought if you couldn't get him in an Residential Treatment Center (RTC) to find out exactly which behaviors he does that are not acceptable/abusive, write them down, and you and everyone else in the house go over them first, then go over them with difficult child. Call the police every time he starts escalating. Not to create a paper trail but for the police to escort everyone else to the DV shelter. Or, to take him to phos depending on how escalated he is. It'll send a clear message of you want our company you must behave and we will be safe. You wouldn't be gone for hours so it would be better than brother in law. I don't know what he would do alone in the house. You might want to find a different storage place for anything you care about until he gets under control. Just a thought it might not work for your family.

I agree that sw should not have put this on easy child's shoulders. Its difficult children choices/ disabilities.