Adoption for adults?

November 8, 2008 11:58 PM

What are the options for an adult who's intellectually mostly-normal but who needs a structured supportive program and training in life skills? Bit of a long story inside.

My friend, let's call her Rachel, never had much of a normal childhood. She was born several months premature and spent the first year of her life in hospital. Growing up, her family was dominated by a father who was an obsessive-compulsive religious fundamentalist and a mother who spent most of her time feeling sorry for herself and not doing much parenting.

Rachel grew up depressed, afraid, and insecure. She developed an eating disorder at age 14 and subsequently spent much of her adolescence in hospital treatment programs. She managed to graduate high school and eventually went on to get a community college diploma in early childhood education, all the while dealing with her dysfunctional family and her eating disorder.

Today she's on disability and living in a "supportive" housing arrangement (basically a house with several psychiatric patients living in it). A good part of every year is spent in further inpatient and outpatient treatment (relapses have unfortunately frequent).

Rachel's often mentioned to me that she feels like she needs a new family, and I'm inclined to agree. She's bright, creative, and occasionally hilarious, at least when depression and insecurity aren't rearing their heads. But she's never had to fend for herself in the outside world, never been given the support to do it. And she's terrified at the prospect of being alone.

She just wants to be a productive member of society. My sense is that what's important to her is a living situation that provides a good balance of support and independence. What are her options? Is there such a thing as adult adoption or foster care? Are there supportive communities out there for people in her situation? Anything?

Answers to requisite questions: Rachel lives in Toronto. She can't pay for therapy, even on a sliding scale. Medications are helping a bit with anxiety but not much. Her dad passed away, and her mom's health isn't too good.

posted by anonymous to society & culture (20 comments total)

"Rachel" is not "mostly normal." She needs pretty intensive psychiatric support. It sounds like she'd be a good candidate for vocational rehab. It's usually targeted to developmentally disabled people, and though she may not technically fall into that category, from your description she shares many of the same problems. Such programs focus on life skills aimed at getting people into the workforce, the kinds of things which parents would normally teach but for some reason didn't.

I'm afraid a "new family" isn't something that most people get unless they get married, and "Rachel" doesn't sound like a terribly good candidate for that. She's going to want to make as much use of state and community-run social service programs as she can. Does she have a social worker? Because if she doesn't, she should. Look into group homes. And though I've no idea, doesn't Canadian universal health care cover therapy?
posted by valkyryn at 4:25 AM on November 9, 2008

Goodwill and the Salvation Army are both in Toronto. Both organizations offer jobs, life-skills training, and other support. (The Salvos are a Christian evangelical group FYI.)
posted by headnsouth at 4:32 AM on November 9, 2008

The OP said Rachel was intellectually mostly normal, valkyryn. There's a subtle distinction being made there. Also it's quite clear that she doesn't expect to find or get a "new family', but that's just her way of explaining what she feels she needs.
posted by Chairboy at 5:37 AM on November 9, 2008

"Rachel" grew up with characters for parents, who are obviously difficult but not (apparently) abusive. She is otherwise entirely normal, but she is so scarred by her character-parents that she can't hold down a job?

I think it's time to stop blaming her parents. There is more going on here than bad parenting, and more parenting by others isn't going to solve the problem. The fact that you agree with Rachel's desire to be adopted by a "normal" family indicates to me that "Rachel" is probably you. You needs to grow up and get the help you need. The fixation on getting adopted or fostered, getting a "new" family, seems to indicate that you aren't willing to accept responsibility for yourself and your issues. You obviously believes that everyone had a better upbringing than you did, and getting new parents would magically make you better. You should stop feeling sorry for yourself.

Anxiety and depression need to get treated. Maybe therapy would be helpful, but more complaining about how mean your parents were isn't going to help. You can be a productive member of society; you just needs to stop blaming your parents and start acting like a grown up.

Being a grown up doesn't mean not having anxiety or being depressed, or not having an eating disorder or not having problems coping; it means accepting what's going on and seeking appropriate help, and it means not blaming other people for it. Blaming your parents gets you nowhere. Your childhood happened. You're alive and in one piece. You didn't have perfect parents. Guess what? No one did. I know adults who went through 15 foster parents (many of them abusive) who are in better shape than this. It's not a parenting issue anymore. Just deal with what you've got in the best way you can.

Eating disorders are often helped by prozac. Have you tried that? I think it's in generic now, so the price has surely dropped. Eating disorders are chemical disorders and coping mechanisms, not something to blame on your parents. Once you accept that the eating disorder is YOURS, not your parents', and start to work toward getting better coping mechanisms and taking the drugs that you need, then you can start being a productive member of society.

In short: no, the answer for "Rachel" is not to revert into a child again. Sometimes all of us want to go back to being 4 years old and having everything taken care of for us, but we can't go back in time. But we can gather ourselves together and try to take control of our lives. Being babied isn't going to help Rachel. She needs to accept responsibility for herself.

Growing up is hard, but we all have to do it.
posted by Hildegarde at 6:33 AM on November 9, 2008 [2 favorites]

Growing up is hard, but we all have to do it.

Yeah, Rachel, grow up!

Seriously, I think Rachel needs--in addition to meds and therapy (isn't this stuff free in Canada?)--as many positive human interactions as she can get. She's obviously insecure and untrusting, and you can't form solid relationships when you're like that. She needs to learn that most people are mostly nice and friendly. So, help her get those experiences. At least she's got one good friend.
posted by mpls2 at 7:27 AM on November 9, 2008

If there was a family (yours?) that was willing to take Rachel on, I'm guessing they could sort of "adopt" her by way of her granting them medical/financial/legal powers of attorney so that they would be permitted to work with and help manage her care and her life. I've not heard of any matching programs that would find people who didn't already know Rachel and put them in that position, though.

But in terms of government/NGO provided support it sounds like she's already in the system that "helps" adults with her particular set of problems -- the kind of residence she's currently living in.
posted by jacquilynne at 7:36 AM on November 9, 2008

I think Rachel is exactly right.

What she means by "new family" is this: a good social support system. If you have people in your life who you can relax around, who you know have your best interests at heart, who root for you no matter what yet can lovingly let you know when you are being a bonehead-this is invaluable. Any psychiatrist worth his or her salt will tell you that no matter what drugs or what therapy a patient undergoes, the social support system plays a VITAL role in whether or not a client is able to function well.

If she is surrounded by people who are sicker than she is, it may be dragging her down...I am thinking that what she needs might better be found informally-and the OP is probably in the best place to start helping make that happen.
posted by St. Alia of the Bunnies at 7:37 AM on November 9, 2008 [1 favorite]

Also, my sister in law (in the US unfortunately) was a beneficiary of an adult fostering program, but in her case it didn't work out quite as well as hoped. OTOH she is now married and independent so, I guess it didn't hurt.
posted by St. Alia of the Bunnies at 7:39 AM on November 9, 2008

I can tell you that in Toronto, if a program is aimed at developmentally disabled adults, they are serious about that. They will not accept intellectually normal or even low normal adults - you have to pass tests to be considered intellectually disabled. (We had to fight for a member of my family who is developmentally disabled to be recognized as such.)

---------------------

That said, as noted above, it sounds like she is already in supported living. But it sounds like she doesn't have the connections she needs - and she's not developing job skills or confidence.

I would suggest that she volunteer somewhere. I started this recently - at a time in my life when I have been feeling very upset about my current job, and suffering from low confidence and depression, and it really has helped me. It's given me human connections, satisfying work, rebuilt my confidence - all without the pressure of a paid job. You learn really important job skills: scheduling, responsibility, but also tthinking for yourself and problem solving. I've been making new friends, and forming new social networks. And most of all, I feel like a productive member of society (something my "day" job wasn't supplying).

She could pick anything she is interested in: helping the homeless, volunteering for theatres or small art shows/galleries (the arts community is very socially supportive, especially theatre, and they are always looking for people to help with the grunt work and will train you up to the more complex jobs). There are so many opportunities to volunteer - working with the elderly, working with children, cleaning up creeks. All are so important - and all help you to feel better about yourself, and help you feel like what you do really does matter to society.
posted by jb at 8:03 AM on November 9, 2008

I'm not sure if you think your friend would be a good fit for something like this, but I know of a few organic CSA/market farms that do this kind of vocational rehab program for long term residents w/ disabilities. Here's one near my hometown in Lancaster,PA , Goodwill at Homefields Farm and another I saw a few days ago in the WWOOF USA book, Innisfree Village. It looks like the second one trains and employs the residents in organic gardening, baking, weaving, woodworking, cooking, etc. I'm not sure what the entry requirements are for either place....you might also try contacting some of these places and see if they have any contacts/recommendations for similar operations. Maybe something w/ more of an artistic bent?

Good luck!
posted by pilibeen at 9:15 AM on November 9, 2008

Housing is a big (huge) ticket item. Having a spot in a supported housing setting is nothing to walk away from. Are there negatives at that setting that could be improved? (For example, a rule that needs to be changed, or add wireless internet access and laptop.) Or she could look for another supporting housing program that is a better match. I would not start with changing the living situation, but instead with changing the activities (e.g. volunteering, voc rehab, what others said).
posted by ClaudiaCenter at 9:27 AM on November 9, 2008

She can't pay for therapy, even on a sliding scale.

A therapist with an MD can bill OHIP, but I think you'd need a referral from a practicing MD. On the other hand that shouldn't be hard to get.

My doctor's office (Bridgepoint Family Health at Broadview and Gerrard, which is part of the Bridgepoint Health chronic care hospital) has an on-staff therapist (MSW, not MD) who does CBT among other things and bills OHIP through the clinic.

So there are funded therapy options out there.
posted by mendel at 10:05 AM on November 9, 2008

Could good friends fill this role? I don't know how close you are to Rachel or what your own family situation is like, but living with a few friends, or a friend who is married and has a family, could provide Rachel with structure and support while modeling for her the sorts of things that could be difficult for her.

One of her problems may well be that she's never been able to be treated as an adult and an equal among adults. Being around little kids might actually be really good for her as they would simply treat her as an adult, not as a troubled person who needs taking care of. I know someone in a similar situation and living with her brother's family and being treated as the trusted aunt has really helped her, as has volunteering in the community.

Obviously, anyone who agreed to do this would have to be willing and able to be a caregiver at the times when she needs one, which is a lot to ask. But the benefits to Rachel, and the possibility that she might really rise to the occasion and become a integral part of the family, could be worth it.
posted by hydropsyche at 10:17 AM on November 9, 2008

Rachel has had a rough childhood. So have a lot of people.

Rachel has a lot of emotional and image problems. So do a lot of people.

Rachel needs to do EXACTLY what other successful people, with similar backgrounds do: get into therapy, stick to meds that work, and resolve herself to conquer her demons.

Until she can do those three things, no amount of worry, hair pulling, friendly support, late night phone calls, frantic emails, cries for help, substance abuse, being fired, sleeping all day and all night, over eating, under eating, loosing friends, having bad relationships, and all the rest will get it done.

- Therapy: there is always a way - call around, and keep calling around until she finds something.

- Meds: they do work, finding the right one(s) is a job in and of itself, she shouldn't be discouraged if it takes a while.

- Conquering her demons: this is her life as a healthy and happy adult we're talking about here - the stakes could not possibly be higher. Resolve and determination are paramount.

It's not easy, but I'm convinced that if she just does what millions of other successful people with crummy childhoods do, she'll be fine...
posted by wfrgms at 11:11 AM on November 9, 2008 [2 favorites]

Ummm, hate to interrupt all the 'pull yourself up by your bootstraps' talk, but I'm pretty sure I've come across some studies which showed most people who say, managed to make a good achievement, or managed a pretty impressive rise out of the economic/social class in which they'd been born, appeared to have at least one supportive mentor or rolemodel.
They usually had at least one person, who really believed in them.

There's often an artificial ceiling put on people, by what other people's expectations of them are, and were.
And you can say there shouldn't be, but that's still what you've got. Someone who has never had anyone expect that they could make it to college, generally doesn't make it to college. Why would they go to college? That's not what they, or the people around them have ever planned on them doing. That's not in their worldview.

They don't even have to have liked, or been liked by the person who just, expected that they could achieve these things.

And well. It's really hard to judge a families crazyness by outside perspectives. Like, technically, I grew up in... gah this sounds dramatic 'gang territory' (ie next door neighbours), my single mothers friends were heroin addicts, & they had to improve the security of my school when I was 5 as they were finding needles in the playground, I knew what to say to the cops when I was 3 (my name, age, address, and occupation - "kindy kid" ONLY) - and proceeded to demonstrate when I got separated from my mother and we were held for more than 9 hours by border control when I was 4. My mother left school at 14, was slightly dyslexic, and had a school phobia (damn catholic nuns), other kids thought my mum was a prostitute.
We'd hitchhike and squat in abandoned buildings/warehouses for summer holidays.
I'm not sure what other examples would make an impact -
but, boy, I've met some people who grew up in crazy ^#%$^&$ families, and mine was actually pretty damn good.

Dammit, I have met a lot of people who had the trappings of a normal childhood, a middle class lifestyle, or not flipping around fosterhomes, and that does not compare with the amount of fucked-upness a say, supposedly 'non-abusive' set of BPD or NPD parents can give you, if there was no outside balancing influence.
Its worse ESPECIALLY if outside people seem to think your parents are 'normal'.
If your parents are fucked up, but other people know that - it gives you a measuring stick. If they don't, then well, what are you supposed to think other than that maybe you're the one with the problem? It takes a lot of people, a lot and a lot of trouble to get over stuff like that.

I see no reason that the anonymous poster is actually 'Rachel'. It reflects the worries of many, many people I've met who are concerned by the mental health of their friends.
The word we are looking for, rather than 'family' is, as other posters have pointed out, 'social support' & 'life skills'.

Anyway, that aside, I'm sorry for the long, defensive, mostly unproductive rant - but she's in a supported living environment, therefore outside people have judged her condition is pretty serious, and she's already on meds.

The early childhood education thing sounds like a good route for finding an adaptive mechanism to deal with her anxiety - Tend & befriend.
If she can volunteer somewhere, that might help - only problem being, if the people she is volunteering with or for tend to be older, or mothers, she may not be regarded as a peer by any of them.
Is there any chance she could help out with say, a program for teen mothers?
She has ECE training, and will probably empathise with many of the homelife or emotional problems of the women she is dealing with (ie post-partum depression), while, importantly - being able to help, and offer support, rather than getting bogged down in it.
Doing something like this, and exploring more med options may help the anxiety etc.

And yeah, finding supportive, social environments she can be involved with is very helpful. Anonymous, do you have a way of answering if you an RL friend & in the same state, or an internet friend?
posted by Elysum at 1:50 PM on November 9, 2008 [1 favorite]

Maybe instead of focusing of what a new family (or support system) could do for her she can think of what she can do for a new family?

Would she able to maybe get a position as a live-in nanny? This would get her out of the supportive housing (if she feels her roommates are crazy-making), use her education and feel useful without having to be fully independent (paying bills etc). This could work well if everyone went in fully informed and the family and Rachel have reasonable expectations. Preferably something part-time (and thus costing less money for the family so it is win-win). I know a few families that have live-in nannies even though the mother does not work (or work full-time) so there are positions out there.

But, like others upthread I wonder if something is missing from your story. She did not come from a horrific childhood, she has a college diploma and access to free therapy and medication (I'm in Ontario too so I know how the mental health system works here) but still she can't look after herself? Something doesn't add up. Ultimately, she has to want to be independent for herself and be willing to do the hard work necessary.
posted by saucysault at 2:21 PM on November 9, 2008

Elysum: I'm sorry for the long, defensive, mostly unproductive rant

Not unproductive at all, spot on actually (IMO). No matter the childhood, bootstraps don't work when mental illness is involved. Mental illness needs multiple approaches to deal with it (individual, group, CBT therapies, meds, supportive friends, useful work & structure, etc.).

I'm not sure what the OP means by "adult adoption or foster care" but it doesn't sound like something that would help her friend become the healthy independent person she wants to become.
posted by headnsouth at 2:27 PM on November 9, 2008

I'm not really advocating bootstraps. I'm just saying: stop framing it in terms of shitty parenting. It's clearly more than that. It does no one any good to blame it on parents. The mere title of the post indicates that the family is what's being blamed here.

I'm not saying don't get help. A strong social network is crucial, of course. Leaving the city and going somewhere else, reinventing oneself, meeting new people, getting a job, all these things might help. Therapy, meds, that sort of thing. I don't think she can just think her way out of this.

But I don't think constantly going on about how she was a premie and her mother was self-obsessed is going to do the trick. It's not anyone's fault anymore. She just needs to address her current needs.
posted by Hildegarde at 3:23 PM on November 9, 2008

She just needs to address her current needs.

I agree. What are some helpful suggestions we can provide of ways to accomplish that?

Currently she is:
Today she's on disability and living in a "supportive" housing arrangement (basically a house with several psychiatric patients living in it). A good part of every year is spent in further inpatient and outpatient treatment (relapses have unfortunately frequent).
...She can't pay for therapy, even on a sliding scale.
Medications are helping a bit with anxiety but not much.

The positive:
She managed to graduate high school and eventually went on to get a community college diploma in early childhood education
She just wants to be a productive member of society.

The assessment of needs:
My sense is that what's important to her is a living situation that provides a good balance of support and independence. What are her options?

Given she is already in supportive housing, inpatient & outpatient treatment, what might be missing that is not meeting balance of support and independence?

I'm guessing it's - supportive and not being around 'crazy' people (used in the slangiest, most non-derogatory way possible).
I was assuming that was the root reason for wanting 'adult adoption' - the idea of getting the currently needed support, and yet being around stable, functional people to model from, and therefore move forward.

In a supportive home, that's some form of stability - as far as modelling goes though, it only extends to other people who are in the same situation, and so far, have not been able to leave that environment. Getting to know people who've been in that and gotten out of that and into even MORE functional lives would be good.
Meeting people who are happy and functional is good modelling. Meeting people who have the same disorders and are more happy and functional is also freaking good modelling.

It all comes down to - how can she move forward?

I know at times I've been in vaguely similar, but slightly more functional situations, where I've still felt fairly stuck in my progress, knew I was in an environment where I was surrounded by people who were also unemployed or stuck, and I've tried to figure out what I could do that would help, provide a better situation, in which I could move forward.
I considered things like joining the territorials (part-time army reserve - ya, really), going on outward bound, or going wwoofing (Willing Workers on Organic Farms), etc.
I ended up making gradual progress in other ways, but I still think they would have been reasonable options, and can still consider them in the future.

It doesn't sound like 'Rachel' is currently in a state stable enough for those methods to work, so I'm still wracking my brain for possible options that might better fit her circumstances.
posted by Elysum at 4:01 PM on November 9, 2008

Coming round to this again -
does she actually have a really strong wish-fulfillment, 'I wish I had a new family'?
(wasn't entirely sure if this was her, or projection).

If she does, then that fantasy, can give you some clues about what she thinks she needs, or feels she is lacking. Then you sit, and figure out - how would it feel if she had a new family? (Secure, accepted?) How would she feel that would be different to how she currently was if she had a new family? What would that be providing to her that is different to the current situation?

Then of course, rather than getting fixated on the fantasy, she figures out what needs it represents, and can brainstorm how to get there. I'm wondering if the ECE thing is linked to those needs (eg wanting to care, and be cared for).

(Was just thinking about the difference between fantasy, and the needs those fantasies represent).
posted by Elysum at 7:54 PM on November 9, 2008