Thursday, July 27, 2017

Horses and Zebras

I had cause to take Birdy to Urgent Care recently where I received quite the dressing down from the triage nurse who responded to my assertion that it was "exacerbation of asthma" by telling me that Birdy had a temperature and therefore it was probably only a minor chest infection, adding for good measure, "Just because she's got asthma doesn't mean you have to give her the inhaler every time she coughs."

I had followed Birdy's asthma plan to the letter that day, and the subsequent delay in treatment due to her being classed as not very urgent meant that by the time she was seen her SATs were 88. If you don't know what that means, suffice it to say that it's not good. She was admitted to hospital and eventually put on oxygen.

Apparently, the phrase "When you hear hoof beats, think horses, not zebras" was coined by a medical professor in the late 1940s. The idea is that medics ought to consider the most obvious and likely causes of symptoms before looking at unusual illnesses and rare diseases. It makes complete sense.

Unless you live in the savanna.

In the savanna there are an awful lot of zebras. There aren't many horses. I'm pretty sure that people living in the savanna learn to expect zebras when they hear hoof beats.

At our house, we live in the savanna much of the time. Zebras are not at all unusual, and because we are exposed to them a lot, we have learned to expect them, and to quickly tell the difference between them and horses.

When I hear hoof beats, I know to keep an eye out for zebras. When Birdy does that particular cough, and her throat strains with every breath, I know to take her to hospital and say "exacerbation of asthma". It's not just a mild cough, it's zebras. When she starts to go a little red around her mouth, I ready the anti-histamine and epipen in case a severe allergic reaction is kicking off. Zebras.

Knowing that your children have been exposed to alcohol and drugs in the womb, have been neglected as infants and experienced all the myriad of other early losses, traumas and stressors common to so many looked after and adopted children . . . well, it makes you expect zebras.

With OB, the zebras are sneakier than with Birdy. They are often disguised as horses. Really naughty horses. Really anxious horses. Really oppositional horses. Really angry horses. But nonetheless, they are still zebras.

Friday, July 21, 2017

Extended Family

Sometimes I wonder whether it makes more sense to compare adopting a child to getting married, rather than to the usual way of becoming a parent.

Sure, we adopters don't stand up in public and make solemn vows, but there is a legal process involved. More than that, though, it's the way that adopting a child joins two previously unconnected families together in a long-term relationship of sorts.

I've never been married, so forgive me if I'm off the mark here, but it seems to me as though you don't just marry your partner - you also marry their extended family, their friendship group, their past and their future. It's the old cliche of "not so much losing a son as gaining a daughter" oft repeated by the father of the bride.

When I adopted Birdy and OB, I made a lifetime commitment to both of them. I also inextricably linked myself with two sets of, sometimes shadowy, extended families. I have never met the vast majority of them. In some ways I'm only guessing at the existence of most of them, assuming there are aunties, uncles, cousins, grandparents on both sides, as well as the birth parents and siblings. And yet when birthdays, Christmases and celebration days roll around, they are in my mind, as I imagine our children are also in theirs.

Every so often, a member of these extended families will pop into reality, becoming more than a just a figure in my mind. Most recently, it has been Birdy's birth mum who, apparently, after all this time has asked the social worker to request adding photos as part of our letterbox agreement - that's a whole can of worms I'm skirting around right now. Before that it was OB's half siblings, needing an adopter, and before that Birdy's mum adding two more children to the mix. There was OB's grandma who went to great lengths to send one letterbox letter but then never sent another, and I can't forget the momentous day I saw OB's birth mum walking down the street not far away.

For most adopters there are also foster families, so recently in their children's past, and all the extended family network involved in that life too. It's a huge mesh of interconnected lives that can be challenging to explain to a young child who barely grasps the relationships involved in their immediate adoptive family.

I suppose there's an extent to which we, as adopters, choose our children, rather like a person chooses a spouse (although it's usually more of a blind date arrangement!). What we don't choose is the family they will, even indirectly, bring with them into our lives together. There's no option to walk off into the sunset. There are obligations to be met for the sake of the children involved and we adopters must navigate these murky waters to the best of our abilities, knowing that one day our children will hold us accountable for the decisions we made.

Friday, July 7, 2017

Past Lives

"In a world of shifting family relationships in which children increasingly grow up with a wide range of connections that are seen as normal we need to take stock of why our approach to children in care is different."
(from a family court judgement, 2014)

Kevin Williams, Chief Executive of The Fostering Network shared this quote at a recent conference and it has provided me with much food for thought.

It is undeniably true that many children today grow up within a range of complex family situations with step-parents, step-siblings, half-siblings and other relatives and family friends often woven into their lives. Many, many children are raised with more than one complete family involved in their care to a greater or lesser extent, and for many this means living in more than one home at a time, managing different routines, parenting styles, lifestyle choices and so on.

To glibly assume that this is effortlessly managed by these children would be over-stating it in my opinion, but nonetheless, there is an expectation in blended families that most children will maintain relationships with all family members unless there are pressing reasons against it. Everybody must find a way to manage it.

It is very tempting to make comparisons between these situations and the situations of children who have been taken into care. If children in blended families maintain all their relationships, why can't looked after children? In my experience, once a child arrives in foster care, they lose their connections with their friends and wider family members in one fell swoop. Contact services are stretched, so supervised contacts are reserved for closest family - parents and siblings; perhaps sometimes a particularly close grandparent - and a whole network of other important relationships becomes nothing more than a memory.

With each transition, the ties become even looser. If a child moves on to another foster placement, there seems to be no standard practice requiring any contact with the former carer. The child loses not only the foster family they might have lived with for months, but also all of the extended family and friends network of which they will have become a part.

At transition to adoption, more ties are cut. During intros, the adoptive family are unlikely to meet any of the people who are important to the child other than those who actually live in the home with them. The foster grandparents, aunties and uncles, the family friends and community relationships are no more than shadows to adoptive parents who have enough to contend with as they become an instant family. How can we expect them to consider the swimming teacher who took a special interest in the child, or the nursery worker who was their key worker and cried when they left, or the neighbour who often invited the child to 'help' them in their garden? In reality, they may not even know about these people, reliant as they are on what information they are given.

Instead, adoptive parents are given instructions about how they should continue contact with a child's most immediate birth relatives, and all other relationships are at risk of being left in the dust.

A child will carry memories of all of these people with each transition, even if they are unable to articulate just what it was that made each of these people so important to them. And yet in some cases, adoptive parents are warned against making any contact at all with former foster families in case it upsets or unsettles the child.

It's a heartbreaking situation, and Williams's quote holds out the tempting promise of a utopia where relationships from previous families are cherished and even maintained in perpetuity. And why not? If kids from broken relationships can manage it, why can't kids who have been brought into care?

And yet, we must be realistic. We must not pretend that children in blended families maintain these family ties effortlessly. Sometimes it takes a lot of effort from the adults and the children involved. It is not easy. And these ongoing relationships are usually happening in situations where none of the adults involved have been a proven danger to the children.

There are many ways in which the situation for children who have been taken into care is nothing at all like the situation of children in blended families. With looked after children, we may be talking about family members who harmed them, or who neglected them, or who looked on and couldn't help, or whose lives were chaotic making them unreliable in the extreme. We are talking about foster carers who may have fostered dozens of children making maintaining meaningful ongoing relationships with every one of them untenable in the long run. We are talking about adoptive parents trying to create new and lasting attachments from a standing start with children who are still aching from the dismantling of whatever attachments they may have held on to previously; children for whom the very sight of a person with a lanyard causes utter panic because they think they are about to be moved on once again.

It is not straightforward. I met many of OB's extended family network - more than most adoptive parents ever would. And yes, I feel for his paternal grandma and his aged great grandparents and his very young uncle, and his half siblings, all of whom had little or no control over the situation. Some of them will never see him again. I feel for OB who has lost every one of them. Some of them may have had the capacity to be a powerful force for good in his life, and yet to be in direct contact with any of them would catapult us into an unknowable situation. I am the one who has to make that decision and bear the weight of responsibility for it while being uncomfortably conscious that it is OB who will live with the consequences of what I decide. I weigh up the possibilities of him feeling as though he belongs in all his families, against the risk of him feeling as though he belongs in none of them.

In drawing my conclusions, I have precious little to go on except the often conflicting advice of professionals and other members of the adoption triangle, and my gut. And it's not enough. I can't rely on anecdotal evidence as each situation is virtually unique to the individuals involved, and it's hard to see how rigorous research could overcome the ethical considerations. I would like to see better lifestory work, more lifestory training for foster carers, and a more holistic approach to recognising and celebrating all the diversity of a child's relationships, but I don't know if that is really the whole answer. I do know that whatever the answer is, it needs to be based on more than ideology and wishful thinking.

Saturday, July 1, 2017

Little Climber

Since before Birdy could even walk, she has been a climber. Stairs, chairs, tables, bookcases - all challenges to be surmounted in her eyes.

I've lost count of the number of times some wide-eyed person has alerted me in panicked tones to my daughter's presence atop a precarious summit. She would be laughing, fearless, while the adults around her fluttered and worried and attempted to coax her down without spooking her.

It's not that she has no sense of danger. She doesn't attempt to launch herself off high walls but waits for assistance. She approaches stairs with caution (although she did once tumble down half a flight), and shouts for help when she's stuck on the climbing wall at the park. I'm not nervous in that respect. Having said all of that, she's had her share of falls, and always has a crop of bruises on her shins.

At first I tried to stop her climbing, saying "No!" in very firm tones. "We don't climb." It was all water off a duck's back. We do, apparently, climb, and no amount of saying the opposite was going to make any difference.

So then I started trying to make the entire house a climb-free zone. It was impossible. There was simply no way to arrange the furniture such that it did not form an enormous obstacle course, and I've mainly given up on it. The only routines I've kept from that effort are to keep the safety gate to the kitchen closed (she uses the drawer handles to climb up onto the kitchen counter where the knives are), and to keep the dining chairs stored in another room (she uses them to climb onto the table, and from there to the other side of the kitchen counter where the knives are!).

In the end I decided that, since I could not stop her climbing, my best option was to teach her to get down again safely. It didn't take much education - she's a natural, and the extra padding of her nappy helps!

These days, she can often be found sitting on the very top of her Ikea kitchen, dangling her legs over the side while 'reading' her books, or balancing on top of her transporter truck ride-on trying to reach things she shouldn't reach, or standing on top of the slide shouting to the entire neighbourhood (that one still gives me the collywobbles to be honest).

I can't change Birdy. She's a climber. All I can do is help her to be a safer, more controlled climber and then be there if she falls. This is basically parenting as I see it.