Munchausen Syndrome by Proxy

RyanSofie · Jun 11, 2010

I have a patient whom I believe is a victim of Munhausen by proxy. The patient is not a child but an elder. The patient is ventilator dependent at home, is on tube feedings and is cared for by a daughter. The daughter has cared for this patient for many years at home and prior to that cared for her father who was also vent dependent at home. The daughter has manipulated the patients medications frequently and has caused the patient significant crises. The latest is with holding thyroid medication and as a result the patient going into severe hypothyroidism , and hyponatremia. The daughter then refused to have patient transfered to hospital and instead began adminisitering a teaspoon of table salt vis the feeding tube every 6 hours . The patient has CRF Stage 3 and as a result of this also had anasarca. The daughter has removed medications for blood pressure causing the patients B/P to soar. All those involved in the medical care of this patient know this daughter is intentionally creating crisis with the patient . The daughter spends her time vocalizing her theories and "treatments" to family members and insists it is the medical providers fault the patient is in crises. It is heart breaking to see this patient suffer but how does a practioner intervene in such a situation. APS ( adult protective services are useless) and physicians have not voiced any alarm despite their knowing of the medication manipulation and with holding of prescribed interventions.