To just let my daughter go into hospital?

[Toastandstrawberryjam]

My 13 year old was diagnosed 2 months ago with anorexia. Since then she has gotten so much worse and life is now unrecognisable.

Current medical research now shows care at home has better results than hospital treatment. Supervised meals, continual care. And I have tried. Each meal takes at least at hour, if she will eat it. Then half hour to watch her after.

She's violent and aggressive with me and my other DC. They never get a moment of my time. Last night she finally calmed down and went to bed at 11.45.

She's tried to climb out of windows, threatens suicide, has punched me and tried to stab her dad. She is too ill for school so I have given up work, we can't go anywhere. I was trying to build my own business which was finally going somewhere.

She has refused her snack this morning and went to punch me when I tried to persuade her, calling me all kinds of names. I'm terrified because if she loses more weight she will definitely have to go into hospital, which would be awful for her.

I love her so very much, but I love my other DC too. Who are trying to be so brave. We have medical help and therapy, but she just gets worse every day and I'm so tired. I have to check on her at night and my youngest keeps waking scared that her sister might die. I just need a break, just a few days where I can sleep and eat and just talk to people rather than trying to cope.

It makes me a shit mum I know but I just don't know if it would be best to just let her go into hospital. If you could all tell me what a terrible thing that would be it might make me pull my socks up a bit.

I think admitting you cannot deal with what ever aspect of parenting that is happening at the time and outsourcing to someone who can makes you a truely exceptional thoughtful caring and loving mother so quite far from being a shit one.

Shit ones hang on in there because they are not able to recognise their own limitations and cause a shit load more damage in the long run

I know a child that was a year older when she was placed in a specialist unit. She's now a successful, healthy woman who has a 2 year old DS. It was a very rough road for her and her family but getting help that worked for her was what made the difference and it seems that things aren't working for her or you at the moment.

Meh indeed. I did point out if she had meningitis I wouldn't keep her at home and give her calpol.

Think he sees it as a "failure" as he's read all the books and reports and knows what he has to do. But I am really struggling.

Also, anorexia is an illness. No one would expect a parent to cure another life threatening illness single handed. This is no different. It's not a parenting issue, it's a medical issue.

You know what'd be a crap mum? one who puts their own feelings about how good a parent they are above the obvious clinical need for their child to be in an appropriate environment and treated for a very serious illness. I had a best friend with anorexia who I met in treatment, who died. I know of others who died while I was in hospital. The brakes won't work at this stage, from what I hear from what you have said - the best would be facilitating a long term chronic consumption by the illness while preventing absolute crashes. This is every bit as dangerous as acutely crashing down. She will NOT want to go and will resist everything because she wants to keep hold of her anorexia. There are usually other things like depression and quite massive anxiety going on. I'm not sure hearing voices is that typical tbh - I think if she is then she may be also experiencing delirium, may be dehydrated, electrolytes off kilter etc in which case it's a clinical emergency and will be very scary for her as well as you. She needs therapies to address the causes and underlying issues as well as support while restoring her to a normal BMI range and just as much support thereafter.
I realise it's easier for someone else to be the one who makes the decision - and she will act like she hates you for forcing her into treatment. It won't be an easy ride. But this is her entirely taken over by her illness. Once she starts to come out the other side it will be so worth all the emotional pain in sending her. I really wish you the best - she's very very lucky to have you. Please ignore STBXH- dangerous and unhelpful in this matter.

She has a therapist/dietician/psychiatrist. Weekly weigh in. Twice weekly blood tests. She refuses liquid often so is often slightly dehydrated. We do have all the medical care in place. Her bmi was 13.5 but I think she will have dropped weight again.

Also, I can't see what her BMI is at the moment - but IF the imminent admission to hospital caused a drive in her to stay at home to the point she herself took charge of her recovery efforts, started eating and drinking properly (really, this would quite possibly be only to ensure she still has control and the anorexia remains - she can still exercise, restrict, whatever, so long as she is at home - but anyway..) so if that happened please be aware that this is VERY dangerous if she has been restricting her intake so much - she could well get refeeding syndrome. Either she stays at home and her BMI is in a manageable zone and her behaviour is okay, she eats, she agrees to the conditions, has regular outpatient care and returns to school asap - or she's admitted to hospital, and then when she comes home you support her in managing that. Recovery from anorexia is the last thing she'll actually want - anorexia makes sure of that. But somewhere in there your DD is screaming to be let out and it's certainly important to try and stop it fully in its tracks now.

You would only be a crap mum if, in the face of evidence, you didn't take the action that your head (even if contrary to your heart) said you needed to take in order for your DD to become well again.

It will hurt, yes, but a change of environment may be what she needs to start recovering.

And ignore the STBXH.

Toast I wish I'd had a mum like you!
I know your concern is driven by what's best for your DD. I strongly think she 'd be better off in a treatment centre. 13.5 is very low. 16/17 maybe is more manageable at home, going to school, slowly getting there. But she needs admission quite urgently especially if refusing liquids and everything.
I think when I was admitted other than to the treatment centre it was medical reasons (i.e. something happened outside of anyone's control - although the talks and the threats were there of hospital before) - but surely it's best to avoid an ambulance, a coma, a fall, collapsing, heart problems - I think this is something you could maybe talk to her psychiatrist about and say if admission is required, then you'd appreciate and believe she would benefit from thinking it was the decision of others and not just her mother. I also think for recovery, she may be more resistant if she knew it was a family member. If psych can take the decision on, as it were, I think it would be best for both of you.

I think you have to ignore your husband. He isn't doing the bloody work is he, just telling you to try harder. A few hours here and there isn't the same as what you do. Plus if he has issues with food himself (not that I remember the other threads), he's unlikely to want to recognise that hospitalisation can be needed for food issues.

OP - You are a brilliant mother and reading through this post I think you are right that hospital is a better place for your DD.

Anorexia is a disease and needs to be treated like one. Go back and speak to her care team and see if there is a local support group for families. I would even ask on here about private treatment options vs. NHS because this area is so badly underfunded within the NHS.

I am no medical professional and neither are you. Let the professionals help your DD so you can be her mother. After all everyone needs their mother. If you STBEH wants to be helpful he can take the other DC while you take your DD into hospital and get her settled. Right now I would be telling him that this is beyond both of your capabilities and you fear she will die if you don't get the proper help now. A BMI of 13.5 is awfully low.

I think she would be better off in hospital. A friend who went through the same only began to get better when she became an inpatient. She had a very overbearing father, and I'm sure being away from the family dynamic was part of what helped her as well.

Speaking of which, I know you say "He is helping a lot but if he sits with her for a few hours her behaviour is worse for the next day or so" - do you mean he is actually helping? As in, making things better? Or do you just mean he spends time with her regardless of result? Because having read your previous threads, and what your DD has said about him, I strongly doubt that spending time with this man will do her any good whatsoever.

She is in the grip of a mental illness and doing and saying things that she would not otherwise. She is not really in control of herself. One thing to consider is that you (and the medical professionals) also owe it to her to prevent her losing all dignity via warped behaviour while in the clutches of this illness. I hope that makes sense. While her illness will resist all progress right now, she's not going to thank anyone for letting her behave appallingly and embarrass herself (though of course she shouldn't feel embarrassed, she's not in control) again and again over a long period of time. If she is out of control and getting worse then hospital might well be the best place for her.

Listen, I have a DS who has severe disabilities. Meal times are like you described, I can't sleep, have to be on him all the time in case he does something that will put himself in danger without knowing....

But because DS is disabled, he gets specialist schooling and I get respite 3 hours a week. Without those I think I'd run myself into the ground, and I just have DS.

You have other children, no respite, no help. You just might not be equipped to get her through the most difficult bit, not because you're shit, because you're on your own and you're a human.

If the hospital can get her through the worst (hopefully) then you can pick it up again. You're doing your best. You're not dumping her anywhere, you are finding her the best care. It's completely unselfish to let go a bit in this situation

I work in child and adolescent mental health so have a fair bit of experience with ED.

Your DD is in the grip of something that she cannot control. Her Eating Disorder is manipulating her into behaving in ways that she can neither understand not control. It will protect itself at all costs and you, as a loving capable parent, are a threat to it. That's why so much of her anger and hurt and confusion is directed at you and others who want to help her. That's also why she is not in a position to make decisions for herself until she has regained some control over her illness. If you, as the parent, feel admission is necessary then that's what needs to happen. If things do not improve the decision may well be taken out of your hands so I would argue that it's best to act now.

There is nothing wrong with approaching your DD's care coordinator and explaining that you feel that the situation at home has become unmanageable, that DD is refusing food and fluids, her risk behaviour is escalatingand that you are concerned about the long term impact that witnessing DD's distress is having on your younger children. Your ex husband is, of course, entitled to express his opinion but his lower level of involvement means he does not have the same insight as you into DD's condition and as the primary care-giver you have the final say.

For the benefit of those questioning whether OP's daughter hearing voices means there is 'something else' going on, OP is 100% correct that the experience of voice-hearing is very common in Anorexia, especially in adolescents.

Hi, I didn't want to just read and run, but having read this thread I don't think I've seen one response that says you're a shit Mum and should continue to struggle at home.

Your daughter needs outside help, like every one here has said. And you and your other dc's need a rest from it all. You are not abandoning her, you are just moving the care to another place for a while.

It's a horrible illness and you are doing absolutely the right thing. Sometimes we have to do the hardest of things with our children in order to do the right thing.
Can you think of a phrase that you can keep repeating to her about the decision? Something like: 'I know this isn't what you want but you are so ill that you need to be in hospital where they can keep you safe and help you get better. Once you are better, then you will come home where you belong'
It won't stop her battling you about this but it gives you a mantra to hold on to when she's raging at you.
You are so far from a shit Mum

Well the only really recovered (as much as you ever can be) Anorexic I know, was in a residential unit for a long time (6 months or so) and had several hospital admissions. She is now doing great but would say that she would never have recovered without those admissions.
If it is the right place - then it could be the saving of your daughter.

But it will also be very hard for you as a family - I would say that no family secrets will be kept hidden. That is probably what your daughter needs.

Even if she tells you you are rubbish, just tell her that you will do whatever it takes to help her get better - even if she doesn't want it now.

I agree I was in a residential unit for nearly a year. I also agree will be very hard for family. Without meaning to compare, there's a good chance if addressed properly right now this will go away as best as it can - catch it now and treat it now properly and hopefully you are doing the very best thing to prevent this from being untreatable or even fatal later; and there's a chance she won't need all that long in inpatient treatment at all - a couple of months perhaps is realistic - and would then, once through the worst part, do better at home with outpatient support.
phrases to comfort her may make her more angry. I think you could find something like 'your doctors say it's the right thing to go to hospital because it is a serious illness' that could work, and agree to reiterate you're only doing this because you want her to beat anorexia and you love her/miss her at home - but yes it will not go down well... good luck

I've just been looking at a pro-ana forum and the mindset is quite simply frightening. You can't possibly hope to overcome that alone.

Hope you can get her admitted soon, sounds like you all need that to happen to move one from where you are. Very best wishes for positive progress.

I did want to comment, really for others up-thread, that for a 13 year old a BMI of 16-17 may actually be normal, normal BMI increases gradually from puberty to adulthood. Doesn't change the fact that 13.5 is seriously low though, but not quite so scarily low as it would be for a 17-18 yr old.

OP, do you know what your husband is saying to your daughter when he sees her? Are you there all the time? I wondered if he was going down the route of "Everyone likes to be slim. Nobody likes to be fat..."

I was wondering this given his own dysfunctional eating and the fact she's worse after he's gone.

Yes I'm often here when he is. Or he takes the other two out. It's just the sight of him that enrages her sometimes no matter what he says. He wasn't great with them and I should have left years ago. I don't doubt in any way that all of this is because of that. The psychiatrist made that clear to him too. And he was gutted about it. He is really trying with them, and from what I've seen he is far calmer with all this than I am. I think it's the calmness that bugs her because she can't crack him. Whereas I will react, which the eating disorder side of her loves.