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Refusing treatment

Suchitra

My adult 23 year old son with Asd level-2, severe ocd, washing just hands for many many hours, refusing any sort of treatment at the moment. He has no job, not studying, does not shower, if we ask him to do anything gets agreesive

Not sure what to do, can we move him to a supported residential facility 

I have another younger child and life has just stopped, we can not go out leaving him alone as would not eat on his own for hours, needs constant prompting. 

Has not taken shower over 4 months, not gone out for last 5 months, just stays in his room

, eats barely one meal. 

  • Been in bathroom for more than 10 hrs today, it varies sometimes 2-3 hrs, sometimes for many hours. 

Just got a physchatric appointment for him but I worry he will not go and get very angry but will ask him anyway over the weekend 

We don't know what to do. 

I am myself feel very low most of the time as feel so stuck and not able to help him and get out of this situation.

Only if we can get some respite even for a few weeks and he can be at a safe place, looked after. May be he would feel more responsible and do something.

Please don't get me wrong, I love him so much, but the whole family is under lot of stress due to this. 

Please any advise, thank you so much! 

Parents
  • Suchitra said:
    We don't know what to do.

    Any change will be very difficult for him so whatever you do will cause upset and distress. Knowing this means you are better off chosing the option that brings the best long term benefit (in my opinion).

    Suchitra said:
    can we move him to a supported residential facility

    I would speak to any local autism charities and ask what they know about support and options here. It may be partially covered under local support options and he may find he qualifies for other benefits as it sounds like he is unlikely to get a job.

    The personal hygeine issues and eating routine seem not uncommon and are quite possibly related to poor executive control on his part - a fairly common autism trait.

    Giving advice here is tricky as whatever you do is likely to lead to distress but now you have to consider that the needs of the family now outweigh the needs of the individual so you can get a break.

    In your shoes I would do the following:

    1 - check what support is available from the welfare state, NHS and local autism charities. 

    2 - engage with a psychotherapist who is experienced in helping this sort of patient. Interview them before committing to make sure they know they stuff.

    3 - explain to your son that you need a break and what the options are while you do this. Add that you need some lifestyle changes when you return (eg access to the bathroom and showers once a week) and if he wants to stay with you then he needs to agree a timeline to do this.

    4 - This will probably cause a lot of pushback so let it settle before deciding timelines - if he wants to go into accommodation then tell him what freedoms he will gain from this, the independence etc. Point out that it will only be one lot of change whereas if he stays there will be a change for your travelling, the return then the lifestyle changes so it will be a lot less stress to do it once.

    5 - promote the therapist as someone to help him with the changes - someone to help him understand and advocate for his side in this. Make sure the therapist understands this approach.

    Remember that anything you do will cause distress so it is best to do the right thing for the long run.

    I would also consider getting a therapist for yourself in all of this - it will be traumatic enough to be the instigator but having someone to help you with practical, private advice and support will take a lot of stress off of you.

    Good luck with whatever you decide.

Reply
  • Suchitra said:
    We don't know what to do.

    Any change will be very difficult for him so whatever you do will cause upset and distress. Knowing this means you are better off chosing the option that brings the best long term benefit (in my opinion).

    Suchitra said:
    can we move him to a supported residential facility

    I would speak to any local autism charities and ask what they know about support and options here. It may be partially covered under local support options and he may find he qualifies for other benefits as it sounds like he is unlikely to get a job.

    The personal hygeine issues and eating routine seem not uncommon and are quite possibly related to poor executive control on his part - a fairly common autism trait.

    Giving advice here is tricky as whatever you do is likely to lead to distress but now you have to consider that the needs of the family now outweigh the needs of the individual so you can get a break.

    In your shoes I would do the following:

    1 - check what support is available from the welfare state, NHS and local autism charities. 

    2 - engage with a psychotherapist who is experienced in helping this sort of patient. Interview them before committing to make sure they know they stuff.

    3 - explain to your son that you need a break and what the options are while you do this. Add that you need some lifestyle changes when you return (eg access to the bathroom and showers once a week) and if he wants to stay with you then he needs to agree a timeline to do this.

    4 - This will probably cause a lot of pushback so let it settle before deciding timelines - if he wants to go into accommodation then tell him what freedoms he will gain from this, the independence etc. Point out that it will only be one lot of change whereas if he stays there will be a change for your travelling, the return then the lifestyle changes so it will be a lot less stress to do it once.

    5 - promote the therapist as someone to help him with the changes - someone to help him understand and advocate for his side in this. Make sure the therapist understands this approach.

    Remember that anything you do will cause distress so it is best to do the right thing for the long run.

    I would also consider getting a therapist for yourself in all of this - it will be traumatic enough to be the instigator but having someone to help you with practical, private advice and support will take a lot of stress off of you.

    Good luck with whatever you decide.

Children
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