Lindsey, age 11, arrived at Casa Pacifica from Ventura County Medical Center’s Children’s Unit. Her history included manipulation, tantrums, opposition, defiance, self-injurious behaviors and medical insubordination with her type I diabetes. She had been removed from her parents’ home due to their inability to monitor and maintain her diabetic condition, and had attended only two weeks of school the entire year. When Lindsey did not get her way, she would either refuse her insulin injections or refuse to eat once receiving her insulin, which would place her in a potentially life-threatening situation. She had been hospitalized on an emergency status several times due to her manipulation and health negligence. Once, at the age of 8, she was in a coma for a week and a half. Casa Pacifica had to be uniquely prepared for Lindsey’s tendency to combine these behaviors with a life threatening disease. Prior to her arrival, the staff attended a thorough diabetic training and was involved in meetings to better prepare for Lindsey’s medical and behavioral issues. Our McDonald’s Cottage supervisor, staff, social worker and nurses worked side by side to develop a plan for success for Lindsey.
When we first met Lindsey she was extremely scared and unwilling to leave her family. She was unresponsive to our staff - she wouldn’t even make eye contact - and began to display her described behaviors almost immediately. These behaviors were often triggered when her visits with her family needed to come to an end. She would attempt to leave Casa Pacifica with them, and would cry and scream uncontrollably, often making herself physically ill. One of her screaming tantrums lasted nine hours—without interruption. At first, Lindsey refused to attend classes and participate in cottage activities. Despite much encouragement, she would often remain in her room. Eventually Lindsey would calm down and, during those times she would interact slightly with staff and peers. We realized that when Lindsey was calm she would be compliant with her diabetes program. Through support, verbal reinforcement, active listening and encouragement, our staff gave Lindsey the consistency that she needed, and continued to set limits by not giving in to her tantrums.
The McDonald’s Cottage team also implemented a special intervention plan that provided Lindsey with family visits only when she would remain compliant with her diabetes and cottage programs. Although at first Lindsey had a hard time accepting this, it didn’t take long for her to become 100% compliant! It took only five (tough) days to reach Lindsey. She has since made such a remarkable turnaround. She has made healthy and close bonds with staff members across campus. Lindsey has visits with her family on a daily basis and has just recently begun to go on off-campus passes with them. Very importantly, Lindsey’s family has been supportive of Casa Pacifica’s structure and policies.
Lindsey is outgoing, friendly, and nurturing. She has a great sense of humor, enjoys entertaining her peers and staff, and loves to make others laugh. She continues to be smart and independent with her diabetes program and radiates great health. Above all, she has a beautiful smile and shares it with everyone. It took the entire community of Casa Pacifica to make this success story happen. This effort proved to benefit not only one child’s health and well being, but also all of the children in our care by uniting us as an agency, team and community.
Note: Lindsey’s name and photo have been changed to protect her privacy.