‘More in sickness than in health’: a case study of Munchausen by Proxy in the elderly

Abstract

The case of a 69‐year‐old male with features of Munchausen's Syndrome by Proxy is described. The identified patient was referred to 25 different medical teams, over a four‐year period, through the insistence of his 55‐year‐old female companion, an ex‐nurse. Significant factors relating to the diagnosis of patients with Munchausen by Proxy are discussed, and comparisons made between the syndrome as originally described in children and those features presenting later in life. Munchausen by Proxy involving the elderly, may also involve abuse. The authors wish to draw attention to some of the systemic issues involved in such a process, and discuss possible interventions. Attention is also drawn to the difficulties in management of this particular case, and the possible widespread prevalence of less florid and therefore, unrecognized cases in the elderly. Copyright © 1989, Wiley Blackwell. All rights reserved