Introduction
The one thing to remember with therapeutic
foster care (sometimes called "Intensive Foster Care", IFC for short),
is that you must always expect the unexpected. We were unprepared for all the
trials and all the joy that we would experience while taking care of children with
special needs.
In 2004 our youngest son (Child Y)
was born with Autism. This was not something we were expecting so when we
finally discovered this it hit our family pretty hard. I was in denial for a
long time thinking that he was just delayed or that the arm flapping was just
some idiosyncrasy
of his. (Child Y) did not do many of the things that typical children do such
as cooing, babbling, ect. The diagnosis of autism impacted my
wife much more than myself. The reason for this was due to the fact that she
knew much more about autism than I did. In fact, I knew nothing at all about
it. You might say for those first few years the statement "Ignorance is
bliss" described me. After a few years of struggling through (Child Y)'s
diagnosis and wrestling with God over it, we learned, by God's grace and mercy
and by his power, how to handle it. Do we still have times of frustration and
anger over it? Absolutely, but for the most part we have learned to rely on God
and live with the diagnosis.
The reason I mention (Child Y) and
his diagnosis is because it was through (Child Y) that we decided to do therapeutic
foster care. It was my wife who had the brilliant idea. She said that maybe we
should look into helping other children with special needs, after all God, we
felt, had been preparing us for this kind of work. After a time of prayer and
discussion, we took the plunge and the adventure began.
Short-term vs. long-term placements
One of the first things to
understand when preparing to do therapeutic foster care is the difference
between short-term placements and those that are long-term. The reason this is
important is because there are different challenges to be faced with each type
of placement.
Short-term placements are typically anywhere
from a day to a few weeks in length. These children can often be well behaved,
showing little or no signs of behavioral issues. Your home, family, and
environment are all new and exciting for some children. You may be pouring out
gifts and making them feel special. You have not yet had to discipline bad
behaviors and so the child might see your home more as a vacation of sorts. You
may not run into many behavioral issues if you chose to do short-term and/or
respite care.
There are of course children that
are hard to handle even when they are staying with you for a short time. They
may simply have been in the system so long that they have become bitter and
feel like they are being passed from one place to another or it may be that a
child has just been removed from their home because their parents (or the
living environment) have been found to be unfit for some reason. These children
can feel that you and your home are strange and that you are in some way
responsible for taking them away from their family. As a defense mechanism they
may be distant, difficult, or unresponsive.
Long-term placements can be anywhere
from a few months to a few years or event until the child ages out of the
system. Children that are placed in your home on a long-term basis are more
likely to become attached emotionally to your family. It is also very likely
that your family will become emotionally attached as well. As with many
short-term placements, long-term placements may, at first, feel like your home
is a vacation. The same feelings of newness are often there. This period is
sometimes referred to as the "honeymoon period". There can be a
temptation for new foster parents to overdo things. Going out to eat more often
than normal and always giving the child the choice of where you will eat.
Buying lots of presents, toys, clothing and over doing praise (not that helping
your foster child with self esteem is a bad thing). In short, spoiling the
child. This only contributes to the feeling that your home is a holiday. This
kind of thing happens to many first time parents as well. You want to give your
child more than you had but in the end this kind of parenting often backfires
and the child can become spoiled. Once the "honeymoon period" is over
and you have to start disciplining bad behavior your foster child might swing
in the opposite direction. At first they were the picture of sweetness, very
much like Annie (the foster child from the movie Annie) but now that there are
rules and consequences for breaking those rules the child can become almost
uncontrollable. This can certainly happen, and does, even if you have not
spoiled the child for the first few weeks or months during the "honeymoon"
phase.
Something else to consider when
taking in long-term children is that they become a part of your family, which
is a good thing in one sense because having a permanent home can often help to
stabilize a child, but can also be a cause of pain and loss if that child is
reunited with their biological parents, move to another foster home, or are
adopted. This kind of attachment is not a bad thing as long as you and the
child understand that although this is a fairly permanent placement there is
probably coming a day when they will leave your home. It is also very helpful
for the child because they have learned how to trust, love, and form
appropriate attachments. These lessons will often follow the child wherever
they go.
Physically demanding
Taking care of children is a physically
demanding job. You run around trying to catch them, clean them, feed them, and
play with them. That is true for all kids, but once you add a child that has
special needs into the mix, you have other challenges to face as well. For
example, you may have a child with hyperactivity. That means they run like the
energizer bunny. They keep going, and going, and going. They simply don't stop.
For children with this disorder, it becomes important to keep them busy.
Signing them up for sports or taking them for walks, ect. helps give that child
a positive outlet for all that energy. If the child does not have that outlet
they will very likely display behavioral issues (Possibly hurting themselves
and/or others) or simply be very loud and fidgety. One of our children, who has
ADHD (Attention Deficit Hyperactivity Disorder) will sometimes speak very loud
in a very high pitch voice. He is trying to release some of that built up
energy. These kinds of things can be helpful clues that your child may need to
go for a walk or play a game, something to use up that energy.
There are also lots of doctors
visits and specialist visits to go along with all the other activities. Every
child has to go to the doctors for shots and physicals, but when your child also
has special needs there are all kinds of other visits that come up. You may
have family counseling to go to. The child may have their own therapy as well.
You need to take them to medication visits. That is, there are special doctors
who prescribe and monitor the child and their medications. These are often
different doctors than the family doctor or the pediatrician. With our son (Child
Y) he not only has Autism but has a form of epilepsy and, you guessed it, he
has a special doctor that we have to go and see every so often to check the
medication he is on as well as check blood levels.
So you have the family doctor and
the regular visits as well as therapy and possibly medication doctors, but we
are not done yet; you also need to bring your children to the dentist. Not too
many children like going to the dentist, in fact, not many adults like to
either. But when you have a child that has autism, anxiety, or some other
disorder, it can be an absolute train wreck. Our son would yell and scream and
tremble in fear when the dentist would come close to him with all those strange
tools. It took us years to get him a full dental examination and it only
happened once we found a specialist who treated autistic children. Here is
where you may need to do some research. The local dentist may not be trained to
deal with children who have special needs. That means you will need to ask
other foster parents or parents with special needs children where they go. You
may need to ask your foster care agency if they have a list of dentists/doctors
who deal with these issues. This is simply one more thing to add to the list. So
add another doctor to the already long list. Mom and Dad go to one dentist and
our son goes to another one that is an hour away.
Because of all the doctors,
therapists, and other appointments it becomes imperative that you have some
kind of event planner. My wife uses a plain calendar and we write all the
appointments and which child the appointment is for. Here organization is key. When
you take in foster children you are expected to make and keep all these
appointments.
At other times you have those
emergency visits to the hospital or doctor's office. E.R. visits can certainly
be a normal occurrence for parents in general. Some parents have that
"accident prone child" but with special needs children the visits can
also be fairly regular.
One of our foster sons, (Child X),
was born addicted to drugs which resulted in all kinds of medical issues, from
being born premature and having a very low birth weight to being extremely
fussy. Today he has ADHD (Attention Deficit Hyperactivity Disorder) but he also
has asthma, both are the result of being born addicted to drugs. With (Child X)
there have been frequent visits to the E.R. because of his asthma. Waking up in
the middle of the night to the sound of a child coughing and who is unable to catch
their breath is scary, both for the child and for you, the parent. We have
spent many a night with him in the E.R. or up giving him breathing treatments.
Another one of our foster sons, (Child
Z), woke up one night acting strange and telling us that he was hearing voices
in his head. Off to the E.R. we went to spend the next five hours waiting for
the Crisis team to come and check him out to see if he would be returning to
our home or be moving to an institution.
Not only do you have lots of doctors
visits and other kinds of visits to attend you also have lots of people coming
into your home. When you do therapeutic foster care you have a worker who
visits each and every week to check on you and the child. They make sure you
have everything you need and that child is not being abused or going without,
as well as other things. You also have monthly meetings and quarterly check-ins
where a worker will come and inspect your home to make sure you are up to code
(the home is safe; fire extinguishers, smoke detectors, ect). That doesn't
include the visiting mentors that some children need or the lawyers that some
children have if they are an award of the state. That also doesn't include the
child's adoption worker (if they are going up for adoption). It also doesn't
include that therapist that you may need to work with your child on a daily
basis. We have a wonderful ABA (Applied Behavioral Analysis) therapist who
comes into our home most days of the week to work with our son (Child Y). As
you can see, this kind of work is physically demanding.
There are two keys to managing these
demands in a proper way. The first it to make sure you stay organized. Things
are already physically demanding, but when you are unorganized they become
chaotic as well. And the second thing is to make sure you and your spouse
communicate. You will need a break, some time off. It may be to simply get a
coffee or go to the park by yourself. Whatever that break is you will need to
work as a team and give each other the time you need to relax and recharge. My
wife and I simply say to each other, "I need a moment". Being open
and honest and being able to communicate with each other is imperative.
Emotionally demanding
When doing therapeutic foster care it
is physically demanding, as already mentioned above and your home is often overrun
with people coming and going constantly. Life is full of appointments as well
as doctor visits, therapy visits, and Emergency room visits. These all add up
to create a very physically demanding life.
Once the body becomes tired the mind and emotions soon follow. All
the activities, lots of sleepless nights and long days can drain you physically.
Once that happens, you can become emotionally drained as well. Special needs
children are often harder to care for and depending on their mental functionality
and capacity they may do things that are simply dangerous without understanding
that what they are doing could lead to injury or death.
(Child Y) wandered away from home on
three separate occasions. He isn't trying to run away he's trying to go visit
his Nana. He knows where she lives and could certainly find it, but she lives
about 20 minutes away when driving in a car. Not only that, but there are major
roads that have lots of fast moving traffic. (Child Y) has opened the front door
and tried to go to his Nana's house, but he doesn't put on his shoes so he is walking
barefoot. He doesn't speak much so he isn't going to interact with people. The
first time he did this the police found him and were asking him where he lives.
(Child Y) would not tell the officer, not because he was being fresh, but
because (Child Y) only knows how to respond to certain questions. The officer
would have needed to ask him what is his address not where do you live.
After that episode we took (Child Y)
to the local police station and had him photographed and gave them the needed
information. But that event was extremely emotional. Since then we have placed
alarms on our doors and windows. We have also placed locks on the doors, but
that hasn't stopped (Child Y) from wandering away.
The last time (Child Y) wandered
away was about four weeks ago. The door was opened because we were getting
ready to leave for a birthday party and we were going in and out. (Child Y) saw
the door opened and decided he would take a walk. We don't know why, but (Child
Y) ended up going into a strangers house and turning on their TV and using
their computer. The owner of the house was home and obviously a little shocked
when he saw a strange child in his home who, believe it or not, demanded
something to eat. Thank God almighty that this man was not a child predator or
some kind of dangerous person. This man simply called the police. I was on the
phone with the Police at the same time and my wife was off in the car trying to
find him. Again he was returned safe, but these kinds of things are extremely
emotionally draining.
It is highly recommended that if you
have a child such as (Child Y), who does not speak or speak much, that you take
them to the local police station and have them photographed and also let them know if there are certain
questions that they would need to ask your child in order for them to give the
appropriate answers.
Another area where fostering
children becomes emotionally draining is when the child you have been caring
for is removed from your home for some reason. It could be that the child is being
reunited with his or her biological parents or it could be that the child has
become too difficult to work with and the agency decided that child needs to be
moved to a residential facility. No matter the reason, when that child that you
have cared for, loved, mentored, and shared good times as well as difficult
times with leaves, there are deep emotions that are difficult to deal with. It
doesn't matter how often you remind yourself that this child is only with you
for a short period of time, if that period of time is anything more than a few
weeks (ours were always years), it is as if someone is taking your children
away, because in reality they are. You have loved and cared for these kids,
nursed them back to health when they have been sick and held them in your arms
when they have been hurt or gotten upset. You have been there for the victories
and for the defeats.
Here a strong relationship with God and your spouse is, again, key.
You want to share your struggles and your heartache with God and with your
spouse. You may also need someone to talk to about your feeling of loss like a
good Christian counselor or a close brother or sister in Christ (someone you
can trust). There are lots of foster parent support groups on Facebook and
other online sites but there may also be a group that meets in your local area.
These support groups can often be a great place to meet other foster parents
who understand what you are going through and will be there to give helpful
suggestions. These kinds of networks are also great for researching doctors or
dentists that specialize in working with special needs children.
Adaptability
It is important to keep in mind that
you will need to constantly be adapting to each new situation. Each child
brings their own set of challenges and issues. Each child responds differently
to the demands of family life, school life, and social environments. Each child
responds differently to discipline. What works for one child doesn't always
work for another.
Some children thrive with one-on-one
attention. They need those personal interactions (Of course all children need
some amount of one-on-one attention, but certain children need more of it than
others). If you have other children in the home, you may need to make plans to
have some alone time with each child, paying attention to those that really
thrive in that situation. Other children thrive in a group environment. That
means that if there are no other children in your home you will need to make
arrangements with other parents for play dates or regularly bring that child to
the park to play with other children or sign them up for various sports. Again,
each child is different and each situation is different. Adapt and change is
the name of the game.
Some children are impulsive, not thinking
through the consequences of their actions. One of our foster children is like
that. Before he came to live with us he was in a group home. One day, without
thinking, he decided he would hang from the fire suppression pipes. As he did
the pipe broke and flooded the building. If you have a child who is impulsive
then you may want to walk around your house and your yard looking for potential
problem areas and either making them safe or simply keep that child out of
those areas.
Medications
Many children in therapeutic foster
care are on medications for different reasons. Some are on anti-psychotic medications,
others are on ADHD medications, still others may be on multiple medications for
multiple diagnoses. As a foster parent one of your many jobs is to administer
these medications. Keeping track of a child's medication(s) is of utmost
importance. As you can imagine if a child skips a medication or is given the
wrong one at the wrong time it can cause all kinds of problems. Reactions can
be anything from erratic behavior to suicidal thoughts and more. Diligence is
needed when administering medications. One way to help keep track of the proper
medications and the proper times to give them is to use medication organizers
(Pill organizers). There are a variety of kinds and sizes. If you chose to use
this kind of organizer make sure the agency you work for allows you to use
them. Some agencies do not allow parents to use these organizers, but instead
demand that the pills stay in the original bottles with the original labels on
them. They see this as a way of making sure your foster child is given the
correct pills at the correct times because the bottles will have all that
information on them.
If you are unable to use a pill
organizer you can always use a reminder on your phone or computer to tell you
when the medication is needed and what dosage, ect. Most phones and computers
have programs that allow you to set up reminders with notes. In the notes field
type in what child receives which medications and then set that reminder to go
off at the appropriate time during the day, then simply do the same for all of
your children that are on medications. Again, this is an area of extreme
importance and organization is key.
Extremely Rewarding
It may appear from what I've written
so far that there are more difficulties and challenges than there are joys.
That is simply not true at all! The joys really do out weight the stress and
the struggles. The struggles are real, this is real life with real children who
have real needs, but the joys are every bit as real as well and in my opinion
simply out weight the difficulties (So long as you are doing it for the right
reasons).
When you watch your foster child or
your child who has special needs, play soccer and score their first goal there
is joy there. When you watch as they practice Karate and get their first belt,
you rejoice with them in their achievement. And when your child who has special
needs crosses the finish line after running in the Special Olympics and shows
you their "proud face", you feel that joy deep inside.
It is also extremely rewarding to
know that you are working for God. James tells us that "Religion that is
pure and undefiled before God, the Father, is this: to visit orphans and widows
in their affliction... (James 1:27, ESV)". Jesus made it clear that what
we do for others, we do for him and so keeping that in mind, we are blessed to
be able to serve Christ by taking care of these children.
Some Lessons Learned
Throughout all the pain,
difficulties, and joys we have learned so much. I can only share a few of the
things we're learned because time would simply not allow me to go into detail.
One of the things we have learned
though our experience working with special needs children and foster care is
patience. We are much more patient now than we were before having (Child Y) and
fostering. Are we perfectly patient all the time? Not at all, but have we
grown? You better believe we have. It takes patience to work with your child
who doesn't speak. It took (Child Y) a very long time before he spoke one word.
During that time we learned patience as we used PECK boards and sign language
in order to communicate with him.
When (Child X), who runs non-stop
like the energizer bunny, tries to tell you something, but he is going all over
the place, that takes patience and when the agency you work for or the State
continually wants to do things that you know would be the wrong thing for your
child, that takes patience.
My wife and I have also learned to
rely on each other more. We simply know when the other one is getting worn down
and needs a break. She will say to me "I think you need to go out for a
while" or I might say to her "I think it's time for you to go get a
massage". We have learned to work together better and have learned to rely
on each other.
Probably the biggest thing we've
learned in the 7 years we have been doing foster care and the 11 years we've
been raising (Child Y), is to lean on Christ for our strength. There is simply
no way we could have done any of this on our own, maybe others could have but
we couldn't. Our prayer life is stronger as we daily ask him for strength. We
are always asking him for wisdom and guidance and always asking him to give us
the ability to love and care for these children. We of course pray for them and
thank God that he has blessed us by placing these children in our home.
What is needed
This was mentioned briefly above,
but let me take some time to elaborate here. There are two major things that
are needed when doing Therapeutic Foster Care/Taking Care of Children with
Special Needs.
The first and most important thing
is that you and your spouse have a strong walk with God. You will need to rely
on him and his strength on a daily and many times and hourly basis. It is no
good to have a superficial relationship with God. One where you say hi to him
once or twice a week at the worship service or Bible study. Of course, this
should be the normal life for a Christian any ways, but sadly it is not always
the case. It is important to keep in mind that God is the Creator and Sustainer
or life. He is able and willing to help you through the good times and the bad.
The second thing that is needed is a
strong marriage. You will be tested in all kinds of ways. You will be stressed
and tired. You will get angry and frustrated (Not always with the children, but
many times with the system). You will need to be able to communicate with your
spouse and let them know when you need some time or when you feel overwhelmed.
If your marriage is not strong adding a special needs child into the mix is
really a recipe for disaster. That does not mean that there have not been couples
whose marriages were weak and they took in a child with special needs and their
marriage survived or was even strengthened through the process, but that is
more of the exception than the rule.
Make sure you talk things over
before you jump into Therapeutic Foster Care and make sure the lines of
communication are open. There will always be surprises, but try to talk over
some of the anticipated difficulties and obstacles you imagine might come. It
is far better to talk things over before you have a child placed with you and
while things are clam than to try and do it in the midst of a torrent of
emotions and frustrations.
Be honest as well. If you do not
think you can handle a special needs child or simply do not feel called to do
Therapeutic Foster Care, make your feelings known. If you do not want to do
this and you end up taking in a child it will not be long before you start to
resent your spouse and become bitter over the whole situation. You want this to
be a positive experience for you and these children. So be honest!
Know why you are doing foster care
It is also important to know why you are doing foster care in the
first place. If it is simply for the money there are plenty of other jobs you
could do. Please do yourself a favor and the children in foster care a favor,
do not move forward. If you are only in this for the money, it will not be long
before the money is not enough of a reason to keep you lovingly motivated. You
are likely to get burnt out faster and give up if your sole reason is because
you think this might be an easy way to make a living. If you do get burnt out
and give up that will mean sending that child away to another home or
institution. So please think carefully before you go forward.
Doing it to serve Christ by serving
these children was why my wife and I got started. We believed that God had been
preparing us to do this kind of work. It is my conviction that the main reason
a Christian should do foster care is to serve God almighty, to be his hands.
When foster care becomes hard and difficulties arise, and they will, knowing
that you are working for God helps to keep you focused and motivated.
Conclusion
There are certainly lots of
challenges and struggles when taking care of children with special needs but
there is something extremely rewarding as well. I am always reminded of the passage
of scripture that says: "Religion that is pure and undefiled before God,
the Father, is this: to visit orphans and widows in their affliction... (James
1:27, ESV)". We are here to work and serve our Great God and Savior, Jesus
Christ and one way we have done that is by taking care of children with special
needs. It has been a privilege and a joy, even in the midst of trials and
heartache.
If you have the ability and the
desire, therapeutic foster care is a great way to serve God by serving children
in need.
