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Fostering Health in Youth and Young Adults

Posted By Leslie Starsoneck, Wednesday, June 22, 2016
Updated: Thursday, June 9, 2016

Leslie Starsoneck is a consultant to the Fostering Health NC at the NC Pediatric Society.  

Roman Rys aged out of care and served as a member of the Fostering Health NC state advisory team.  

Working as a consultant to Fostering Health NC is one of my favorite projects. Maybe it’s seeing information shared that didn’t use to be shared because of misconceptions about privacy rights or habit.  Maybe it’s the collaborative nature of unusual suspects working together to improve the conditions of children for whom life doesn’t seem to be all that fair.  Or maybe it’s talking to youth who have “aged-out” of the foster care system to learn from their experiences--like Roman. 

When it comes to his education, to say that Roman has beaten the odds is a vast understatement.  The obstacles encountered by youth aging out of foster care are difficult to contemplate (click here for a snapshot by America’s Promise).  Despite these obstacles, on May 6th, 2016 Roman graduated from East Carolina University with a Master’s Degree in Social Work.  Roman is a past member of Fostering Health NC’s state advisory team and a representative of SAYSO (Strong Able Youth Speaking Out). Recently, he shared his thoughts with me about the importance of medical care and a relationship with a provider in the lives of fostered youth. 

Like a lot of children and youth, Roman started to see a new doctor when he went into foster care and was placed with a foster family in a different county. For Roman, this was not only a new relationship, but it also represented the beginning of regular medical care which had been sporadic before entering care.  He went to the doctor because he was told to go but came to realize why it was important to receive regular care and to appreciate the relationship he established with the doctor.  When he turned 18 and “aged- out” of care, Roman struggled with just having a permanent place to live and found himself unprepared for the decisions he would be responsible for making about his medical care. He didn’t receive guidance about how to put his care into place and looking back, thinks that would have been very beneficial.  Roman suggests this kind of information be presented in a variety of ways to youth aging out. He thinks that the information would have been best coming from his DSS social worker but also should have involved a positive adult role model with whom he had a good relationship, like a mentor, youth pastor, teacher, foster parent, LINKS Coordinator, therapist, or a guidance counselor. 

He also wonders whether foster parents are trained to answer questions about aging out of foster care and medical care.  (For a great resource from the AAP about ways to help prepare youth aging out for becoming responsible for their medical care, click here).  

Like many other youth, Roman put things into place out of necessity.  At 18, he developed a serious medical condition that forced him to get his health insurance in place, and to choose a doctor. He still struggles with complying with medical advice from time to time.  But now he understands that youth like him are more likely to experience problems and that it’s much better to have everything in place--like insurance, a doctor, a pharmacy--so that you’re ready if something does happen.  As a leader, he’ll share that message with other youth who are aging out of foster care.

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Foster a Healthy Future

Posted By Lindsay Terrell, MD, Wednesday, June 1, 2016
Updated: Tuesday, June 7, 2016

Lindsay Terrell, MD is a Duke Child Abuse and Neglect Fellow.  She is mentored in her role by Aditee Narayan, MD, MPH, Duke Child Abuse and Neglect Fellowship Program Director

Seven years ago in medical school, on my rotation through the emergency room, I met a teenage boy in foster care.  He had been through many foster homes over the past several years.  I remember how he talked about his “homes” – all were discussed in a matter-of-fact way; in the same way he would have told me about his school options.  This was not how a child should ever describe his home.  Now at Duke where I see children in our Foster Care Clinic, I wish I could tell that teenager how he inspired the direction of my career.   My career goal is to improve the medical care of children in foster care.  I want these children, when all else may feel impermanent, to have consistent and complete medical care.

To this day I still enjoy my conversations with children in foster care because, like my conversation with that teenage boy, they challenge how I provide care.  I have learned to ask simple questions, such as “what do you like or not like?” Or “what else can I do to help you?”  Recently, one teenage girl answered that she would like me to tell her foster mother she wants to spend more time with her – to bond.  What a simple, yet insightful request.  By listening to these children opportunities arise to impact their lives beyond standard medical practice.

I have so enjoyed these simple conversations that I now ask foster parents personal questions, such as “what inspired your interest in becoming a foster parent?”  One woman told the story of a newspaper article she came across twenty years ago.  I was so fascinated that I attempted to find the article, in part because I know I will never be able to track down the teenager that inspired me.  To my surprise I found an article published in 1996 that meets her descriptions.  I was amazed that an ordinary article inspired such a change in her life.  Another woman answered that she saw the “need to be a ministry to children and birth families.”  Learning the inspiration behind fostering has made me more appreciative of others in our community that recognize and attempt to serve this enormous need. 

I also ask how these parents do what they do. Most credit patience, love, and support of a spouse, extended family, and community.  One woman noted: “it really does take time, energy, sweat, and tears but… seeing a child progress and change what their future can hold when someone invests time and energy in them, gives me hope.”  The hardest part? Foster parents talk about time management, communicating effectively with all people involved, keeping safe boundaries, and of course “seeing my children when they have to leave.”  

Foster parents are not alone.  Any pediatrician who has cared for a child in foster care knows that it requires community support, time, energy, occasional tears, boundaries, etc.  In many ways the task is simple; as one foster mother said, “just jump in… care deeply for these children.”  Both nationally and locally, changes are being made to improve the care of these children.  In 2006, the AAP prioritized the health needs of youth in foster care.  A taskforce was charged with increasing awareness, knowledge, and skills of pediatricians in the treatment of foster children.  Locally, the North Carolina Pediatric Society’s Fostering Health NC initiative is working to make measurable improvements in health outcomes for NC’s foster population.  

Do you feel inspired?  Want to make a difference in your area?  I encourage you to educate yourself, utilize available resources from the AAP and the NC Pediatric Society.  You can have an impact on your local foster children.  While the challenges are many, I can assure you of this truth articulated to me recently from a foster mother: “You will get out of it more than you will give.” 

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