Guidelines for contact?

[Night Owl Mama]

My son has requested a day leave pass from his residential treatment program (he is there for depression/mood instability) to spend some time with us on the 4th of July. My husband works until 6pm that day so if my son is with us, it will just be me and our 5 other kids. I don't know how I feel about it, honestly. On the one hand, I don't want to discourage him and I know reaching out to family in healthy ways is probably part of his treatment. On the other hand, the last time I was around him he had a violent outburst and I am not sure I want to be vulnerable to that happening again.

I was thinking of taking the kids to a parade at 10:00 so maybe he could just come to that. We may do fireworks later on but I think my son will need to be back in his Residential Treatment Center (RTC) before then. I know I need to set some guidelines and boundaries with him regarding contact but I am not sure where to begin. I don't know how stable he is yet. Yesterday he was a bit irritable when I didn't come at 6:00 to bring him more clothes and instead came at 7:00 but he got over it quickly. He is on the spectrum so time is a black and white concept for him and a big trigger when things don't go as expected. I will have to transport him, he doesn't have a car or DL.

 

[Childofmine]

Hi NOMama,

I know I need to set some guidelines and boundaries with him regarding contact but I am not sure where to begin.

I think you are thinking very correctly here. Set boundaries...see him but on your terms. When things were really bad with Difficult Child, I would not allow him to come here. I would meet him somewhere for a limited amount of time. In a public place. That way, if things got crossed up, or he was high or whatever, I could make an exit.

Laying eyes on him may be good for you. Him seeing his family may be good for him. But it doesn't have to be at your house, and it can be for a limited time. Trust your gut instincts here. Take it slow.

Warm hugs and Happy Fourth! Please keep us posted.

 

[Sister's Keeper]

This is just personal opinion. It isn't based on any theory or anything.

I'm not sure what your timeline looks like, or how events are in your town. Here, the parade is in the morning, fireworks at night.

Personally, I would take the little kids to the parade alone. I think it will be a lot dealing with a lot of little kids AND having to keep an eye on him and worry about his behavior (see my sig, I have lots of little kids, I know)

I would be more comfortable having him at the house for a casual BBQ for a few hours. If you are at home you have some recourse if he gets out of hand. You can call the police. I think that would be harder in a public place.

I would definitely take him back before the fireworks.

I would lay down the rules with him ahead of time. Tell him you will pick him up at X time and you will take him back at Y time. If there are any problems he will go back early. If there are big problems you will call the police.

Of course, this early into his stay they may not grant him a day pass, or....just a thought...you could call the hospital on the sly and tell them that you don't think you or he is ready for a day pass.

 

[BusynMember]

Since he is autistic and also unfortunatrly violent, tell him exactly what his schedule will be. Unless he is on new medications which have removed his violent meltdowns, they could happen anytime/anywhere and he is a man now, probably big.

I like the idea best of seeing him away from home. Maybe in a crowd of strangers he will be less likely to have a meltdown and hurt the younger kids. Of course, autistics sometimes will act out anywhere since some dont care what anyone thinks about their behavior.

Have you ever thought of having him live in agroup home where he can be watched and not around the younger kids? I am very grateful that my Autism Spectrum Disorders (ASD) son is not violent, but I spent years in a parent group for autistic touched families and those autistics who were violent could become very unsafe for teachers, classmates and siblings. Anyone eho got in their way, really.

Thats off topic. Whatever you decide to do, tell him first so there are no surprises. I favor seeing him outside of the home. But you know his behavior best. If he is best at home, do that.

My Autism Spectrum Disorders (ASD) son hates fireworks because of the loud noise. As you know, loud noise is a big anxiety for most with Autism Spectrum Disorders (ASD). For many reasons, its a good plan probably to take him back before those festivities hsppen, just as you plan. But remember that he will hear firecrackers and possibly fireworks from neighbors before you plan to do yours. Maybe get him back by 3:30?

Enjoy!!

 

[RN0441]

Honestly is there any way you can talk to his therapist or something before his visit to see what they recommend based on his frame of mind?

I think that's what I would do if at all possible. You have the younger children which makes it hard and you want it to be as "easy" as possible and not a stressball for you to handle.

That's just me but I'd have to prepare for this a bit.

 

[Ironbutterfly]

I like the idea of taking little ones to parade alone. There is a lot of noise and things going on at parades and that might affect son.

I like the idea of a few hours at your house so that you can call police if you need to- they come to your house vs. taking the risk of him acting out in public with police getting called, etc. BBQ for a few hours then take him back.

Yes, do have a plan, timeline and go over it with him before you leave of what he can expect and not what he thinks his time frame will be for the day.

Also, I like the suggestion to talk to therapist before hand to get a feel of where he is at emotionally, mentally, etc.

Baby steps, few hours for a vist, then see how it goes from there.

 

[Night Owl Mama]

Thank you for all your wise words, friends. We decided to go to a baseball game with fireworks after. Son will ride with me and kids and husband will follow about 30 minutes later when he gets off work. We will stay for fireworks, then go hubby will take son back to center. It will work well because it's a structured setting with a beginning and an end, public setting (he does better in public), and we will have two cars so he can go back at any time if he gets irritable or overwhelmed. He likes fireworks so I am not too worried about that. So at most it will be about 4 hours and I feel comfortable with that time frame and setting.

I spoke to his therapist and she asked if I was willing to meet with my son and his team next week and I am. Son is back on stabilizing medications and told me today he feels amazing. medication management is key to long term stability for him and that will be my number one message to his team next week. They always say he "doesn't qualify" for assisted living or home health care but he needs it! Just because he is verbal and appears "normal" or "high-functioning" doesn't mean he is in ALL areas. He is significantly impaired in some ways and has NEVER successfully managed his medications as an adult. So I hope we can find some solutions since I am unable (and unwilling!) to fill that role anymore.

I will let you know how the visit goes!

 

[Albatross]

Hi Night Owl,

I think you have had some great suggestions and have come up with a great plan I especially like having a set time for pickup and return. I am glad he can come to see you. It sounds like he is working really hard to comply with his program.


I hope everyone has a great weekend!

 

[Sister's Keeper]

Thank you for all your wise words, friends. We decided to go to a baseball game with fireworks after. Son will ride with me and kids and husband will follow about 30 minutes later when he gets off work. We will stay for fireworks, then go hubby will take son back to center. It will work well because it's a structured setting with a beginning and an end, public setting (he does better in public), and we will have two cars so he can go back at any time if he gets irritable or overwhelmed. He likes fireworks so I am not too worried about that. So at most it will be about 4 hours and I feel comfortable with that time frame and setting.

I spoke to his therapist and she asked if I was willing to meet with my son and his team next week and I am. Son is back on stabilizing medications and told me today he feels amazing. medication management is key to long term stability for him and that will be my number one message to his team next week. They always say he "doesn't qualify" for assisted living or home health care but he needs it! Just because he is verbal and appears "normal" or "high-functioning" doesn't mean he is in ALL areas. He is significantly impaired in some ways and has NEVER successfully managed his medications as an adult. So I hope we can find some solutions since I am unable (and unwilling!) to fill that role anymore.

I will let you know how the visit goes!

I can see how he wouldn't qualify for home health care, that is a complicated thing coverage wise, but has he ever looked into or been referred to a partial care/day program?

Also, I don't know where you live, but with an Autism Spectrum Disorders (ASD) diagnosis will he qualify for services under the Division of Developmental Disabilities? In NJ the DDD has an "Office on Autism."

by the way, your plan sounds like a good one. The baseball game sounds about right. Structured, time limits, distraction and 2 cars makes it much easier as far as managing all the kids.

Managing 5 small kids is like herding cats!

 

[Night Owl Mama]

Sisters Keeper,

I am not sure what is available for adults like him. There is an assisted living program but his case manager said he wouldn't qualify. His adaptive skills are really low, especially self care, so I think he could but it would be a fight. I think a lot of kids with his level of autism just get some extra help from parents, live at home a bit longer etc but with his other comorbid conditions that isn't an option. He is the kind who could easily fall through the cracks so I hope we can brainstorm as a team and find something. Even if Job Corps works out, it will quickly go downhill if he stops his medications.

I read your siggy and just wanted to say that my 3 siblings were also raised by my aunt. I was a legal adult by the time my mom's addiction reached the point that she lost custody but just barely. My aunt went from no kids to 3 plus me overnight. It's such a blessing to her and her kids you are able to take them in and raise them (though I doubt she sees it that way....at least my mom didn't.) Hugs! Yes, herding cats, exactly! Haha!

 

[Sister's Keeper]

Oh, no one in my maternal biological family sees it as anything less than thievery. I should also mention, if you don't know, that my sister is in prison, so I am not really sure how they think she will raise these kids, but details don't really matter, do they? LOL

The 7 year old doesn't remember her, and the last time she saw the 4 year old she was a month old. I've had custody of her since birth.

My suggestion to you regarding services for your son would be to 1) discuss partial hospital/day programs with his hospital treatment team when you meet with them. He, obviously needs ongoing services.

2) Contact your state's DDD on your own (hopefully they have a website) and see what, if any, services your son would qualify for. I think that he would qualify given he carries an Autism Spectrum Disorders (ASD) diagnosis. In NJ they have lots of programs that help teens and young adults with developmental disabilities transition into independent living, including employment services. Here, they actually have a whole separate division that deals with Autism Spectrum Disorders (ASD),

 

[BusynMember]

He should qualify for disability. Autism does, at least here. I would try. My son has it and he is not as complicated as your son and is also very verbal. Go visit your county aging and disabilities and they will guide Your dear Son IS impaired. It doesn't matter if he has good verbal skills. He can't function without meltdowns and can't hold a job. These things matter A LOT. It's not just IQ. It's if you can function on your own. He also sounds as if he could be mentally ill.

Trust Aging and Disabilities. Or get a disabilities lawyer. And bring his me f iCal records.

Enjoy your holiday!

 

[Night Owl Mama]

SWOT, you are right, he is mentally ill as well. Mood instability, similar to bipolar but not quite. The mood swings almost always involve violent outbursts. He doesn't get manic. His comorbid conditions plus the autism is what is making it so hard for him to succeed. I also think he may have some personality disorder traits. His father is a narcissist, and when son is angry or feels betrayed, his behavior mirrors his father's to a t. Even things he has got to be too young to remember. It's wired into his dna I swear!

My other son, who is more autistic in mannerisms and such, is so much more functional in day to day life because he has stable moods and better empathy.

 

[BusynMember]

Has he ever presented his diagnoses to Disability? You can't just tell them what you were told. You need medical documentation. Clearly your son may never be able to hold a job because of his outbursts, if nothing else. If you can't work to support yourself, you qualify for disability but you do need to have documentation. But Disability services can really help. And you can work part time. And get help with housing, food ammnd medical.

Usually you need to apply more than once to be approved. It is rare to get it the first time but a few trigger diagnoses will make it easier. Not everyone is capable of earning a living wage due to cognitive differences, mental illness that interfers, autism that interfers, brain trauma which causes damage...it is not shameful to have a disability and to need assistance.