Complicated Eating Disorder/MS/Bipolar Mom with Stress -- Help!

[coventrysleeps]

Hello everyone!

My name is Martha and I am a BSN nursing student who will graduate in May. I am doing my last clinical rotation at a public health department that makes home visits (it feels like a luxury! it's awesome!).

I am working with a very experienced RN on a very complex case. The mom is 38, bipolar (on lithium), has MS (is on meds for that), but has recently lost about 30 lbs in about 4 weeks because she has stopped eating. She was hospitalized when she was 19 for anorexia, but claims that has not been an issue recently, and was a normal weight before her daughters were born.

Her daughters -- twin girls born 11 weeks early in September due to an abrupted placenta. One girl has a hole in her heart and is small but healthy, but the other one had a beta strep pneumonia, hydrocephaly, and now has a shunt and is profoundly deaf. Mom is stressed out beyond all belief, and there are other economic and family factors that play into this.

At the health department here, we are concerned with Mom b/c the girls are being closely followed. My question is: We MUST get Mom to start caring for herself again, e.g., eating.

How do I encourage someone with unbelieveable life stress to start putting food in their mouth when it's the last thing she wants to do?

Thanks for any help -- PLEASE let me know if I've posted this in the wrong forum, and I will move it immediately -- I'm new to this! I can also provide more specific details regarding the case (not personal details) if requested.

[hbncns35]

First of all, Is she seeing a counselor?

I am not so sure it is your primary responsibility to make sure she eats.

Sounds as though you need to direct her to the people that can help her.

The public health nurse can only play the role of the counselor for so long.

She probably needs twice weekly therapy, support groups for bipolar/anorexia/new moms etc.

Seek out what's available in your community. Is she depressed?

Give her the tools and direction - no one wants to be dependant on someone else. She has to feel like she is doing this for herself, not for anyone else even her kids. Help her to develop a support system that she can lean on and regain control of her life. Introduce her to books that may be helpful for her. Get her involved. Get her focused on some goals and make sure you see the rewards.

Good Luck - Heather

[LoriAlabamaRN]

It sounds as if she needs home visits from a psych nurse if that service is available in your area. If it isn't, then she may need to go into a day program, and the state can help with daycare while she is in the program. She definately needs help, and the burden should not be falling on you.

Lori

[Guppy]

I work with Eating Disorder patients and I can tell you no matter how much YOU want them to eat they are not going to ...it sounds like your patient needs inpatient treatment to get her over this "hump".