I think my sister has Munchhasens (LONG)

Nurses General Nursing

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Specializes in primary care, pediatrics, OB/GYN, NICU.

I have a family situation that I am extremely concerned about and don't know what to do. I could really use some advice. My parents are in their early 80's and took my older sister (age 47) into their home 5 months ago to care for her. My sister has Lupus, but 1 year ago she really went down hill. She took to her bed and stopped eating. She refused to go to the doctor. Her husband finally took her to the ER after she fell down the stairs and gashed her head. At the hospital they found stage 4 bedsores on her sacrum. One was the size of a silver dollar and down to the bone. She developed osteomylitis. She weighed 100 lbs. She was put in a nursing home and after six months used up all the insurance benefits (it was a very nice one in California.) Her husband said he was unable to care for her so my parents took her in (they live in Oregon.) She starting receiving excellent medical care, was put on Lexapro and seemed to be getting better. However, any time anyone would mention "wow, you are doing great." or tell her she was getting better and start expecting her to do more things, she would suddenly take a turn for the worse. Examples: She was unplugging her wound vac and her sores would get infected again...she developed pancreatitis and diverticulitis but would refuse to eat right and then end up back in the hospital...she won't do PT because it "hurts too much" and was still using a walker after 5 months. At Thanksgiving when we were all together and the walker started getting too easy and my brother mentioned that perhaps it was time to graduate to a cane, she had a "fall" and is now back in a wheelchair. She won't even use her arms to move the chair, she insists my parents push her! She uses a bedside commode. If she had cooperated with PT she should be getting herself to the bathroom on her own by now. A few weeks ago the hospital discharged her to transitional care in a nursing home because she needed IV antibx Q 6 hrs for yet another infection. She called my parents at 6 a.m because "she couldn't stand it and wasn't getting any sleep." They immediately went to pick her up and take her home. My mother would get up at night to administer her antibx. My sister "was too squeemish to twist on the cap". When i visit my parents I see how exhausted they are. I've offered my help whenever I'm there and tried to tell them they need in home nursing care or she needs to be in a nursing home. I thought of moving her in to my home, but I have 3 kids, a full time job and a very small house. And My husband refuses to even be around her. Plus, She would have to establish with different doctors if she was here. It's like she WANTS to be an invalid. Her wounds are healed, her weight is normal her labs are good and she's on the right meds. Why does she keep making herself sick? Why does she refuse to do anything to get better? My parents refuse any help! They think they can do it all themselves. "We're family - it's our job!" So, they too are part of the whole sick situation! Please, have any of you ever encountered a situation like this? What can I do?

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There's not much you can do about their neurotic maladjustment.

It stinks, but it's their mess, and I wouldn't get in the middle of it.

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Not sure how you'd get it in the States, but maybe some cognitive behavioural therapy?

She's sick, that's for sure.

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her problems are much too deep-rooted.

i feel badly for your parents.

she belongs in a nursing home, bottom line.

leslie

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Specializes in ED, ICU, PACU.

It sure sounds like a mental disorder and should be treated as such. In addition, from what you describe, there seems to be codependence problems there also, which are common when dealing with a mental disorder. Not sure what a nursing home can do for her; but, a psychaitric facility may be of help.

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Specializes in Med/Surg.

Well she is family and you should be caring for her. I do think that respite care and home health agencies should be discussed and encouraged for overnight care. Mho

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Specializes in Nursing Student.
Well she is family and you should be caring for her.

It is true you should take care of family, but if they're not trying to help themselves, it only stretches so far.

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Has she had a psychological evaluation as of yet?! She needs one and TODAY. She's mentally ill. I would see if you can try and get the ball rolling in this direction ASAP. I would speak to her doctor about what has been going on and share your observations with them. I bet they respond by getting an evaluation and the appropriate doctors involved.

Your parents while well meaning sound like classic enablers. You can't force them to put her in a nursing home or mental health facility while she can't care for herself but that's where she needs to be. I'd say more the latter. Perhaps the doc will suggest that.

Your sister sounds like a master manipulator. She's not well and needs psychological help. Healthy people who are mentally stable don't live this way.

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It is true you should take care of family, but if they're not trying to help themselves, it only stretches so far.

Absolutely. Really, they're not helping but enabling her--big difference.

It's hard to give suggestions because you have no power over her. She clearly needs a psychological evaluation. You may also wish to point out to her that when your parents are no longer able to do all this, no one else is going to put up with her crap, so she'll have to choose between cooperating with care or going to a nursing home. And don't you DARE think you have to "take care" of her when she's this manipulative. No way, no how.

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Specializes in LTC,Hospice/palliative care,acute care.
Well she is family and you should be caring for her. I do think that respite care and home health agencies should be discussed and encouraged for overnight care. Mho

Really? How judgemental.The parents are elderly and may soon need care for themselves. If the husband can't care for her then she should stay in LTC. Her behaviors were not learned overnite-it looks like a lifetime of manipulation and co-dependency.Certainly outside agencies need to be involved-the parents need objective input.

In a situation like this the siblings are not held responsible legally. There is not much you can do since your parents discharged her to their home-when that train de-rails maybe you can convince your parents to take care of theselves and set limits for your sister. As for funding for LTC she would probably qualify and her husband would only have to spend down her half of their assets.An elder care lawyer consult on your parents behalf may help you.

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Not sure what a nursing home can do for her; but, a psychaitric facility may be of help.

give a much-needed break for the elderly parents.

at that age, i feel badly the parents are caring for her medical and psych problems.

it's too much.

leslie

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Specializes in Cardiac Telemetry, ED.

My own personal theory is that some people adopt the "sick person" identity out of their need to feel loved and to be taken care of.

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