Anthony Conejos
Taylor College
Mrs.Brooks
2/26/2015
Anthony Conejos
Munchausen By Proxy
Munchausen is a mental illness, in which a person repeatedly acts as if he or she has a physical, emotional or psychological disorder when, in truth, he or she has caused the problems. People with factitious disorders act this way because of an inner need to be seen as ill or injured, not to achieve a concrete benefit, such as financial gain. They are even willing to undergo painful or risky tests and operations in order to get the sympathy and special attention given to people who are truly ill. Some will secretively hurt themselves to cause signs like blood in the urine or cyanosis of a limb. Cyanosis is the condition occurring when the blood supply is cut off to a particular part of the body and the skin takes on a dusky blue color. Factitious disorder imposed on self is associated with severe emotional difficulties.
Originally called Munchausen syndrome, named for Baron von Munchausen, an 18th century German officer who was known for embellishing the stories of his life and experience. He was known to invent fantastic stories of his adventures, including his riding cannonballs and traveling to the moon. Munchausen by Proxy however is where a parent is in need to gain attention and does so by inflicting harm or illness on their child. The adult deliberately tricks others, mostly medical professionals, and may go as far as to actually cause symptoms in the child through poisoning, medication, or even suffocation. In most cases 85% of the time the mother is responsible for causing the illness or symptoms. (Stanton)
Typically, the cause is a need for attention and sympathy from doctors, nurses, and other professionals. Some experts believe that it isn't just the attention that's gained from the "illness" of the child that drives this behavior, but also the satisfaction in deceiving individuals who they consider to be more important and powerful than themselves.
Because the parent or caregiver appears to be so caring and attentive, often no one suspects anything is wrong and that the parent is doing a great job being a parent. Diagnosis is made extremely difficult due to the ability of the parent or caregiver to manipulate doctors and induce symptoms in their child. (Stanton) Often, the perpetrator is familiar with the medical profession and knowledgeable about how to induce illness or impairment in the child. Often the perpetrator works in the medical field, some cases they have even been Registered Nurses. As a nurse we say that we will do no harm, and these people do it to their own children for their own attention. Medical personnel often overlook the possibility of MBPS because it goes against the belief that parents would never deliberately hurt their child.
Most victims of MBPS are preschoolers although there have been cases in kids up to 16 years old, and there are equal numbers of boys and girls. Symptoms are very hard to tell with Munchausen by Proxy since the parent or caregiver is creating these symptoms at their own leisure and discretion. It can be anywhere from stomach upset, other body aches and pains, trouble breathing or sleeping. Some more common symptoms presented by victims of Munchausen by Proxy Syndrome include suffocation, induced seizures, bleeding, or poisoning that presents as vomiting or diarrhea. The abusive parent may describe symptoms in their child that do not exist. The symptoms may get worse only when the suspected caretaker is present or recently visited and may improve when the perpetrator is absent. (Cleveland clinic)A great sign of MCPS is that when the child is away from the parent or caregiver, symptoms tend to subside. Often though the child does get sick and have actual symptoms because the child is on several medications that are not medically needed for that child. The parent does research on the medications and which medications will react with certain ones, trying to come up with the most negative reaction possible. When they go to other doctors they do not say anything about other visits with other medical professionals. If a doctor will not help them they will be on their way back in to the phone book and on to the next doctor. Parents get away with multiple treatments and surgeries that were not needed, while the parents soak up the attention like a dry sponge would in the ocean. Another good sign is when the parent isn’t happy about “good news” with their child. Good news means that they will not be continuing diagnosing. Which would cut down on the attention the parent is obtaining from the medical professionals. Many times they will not take no for an answer and tell the doctor stuff like “I thought you were going to get to the bottom of this” making the doctor feel guilty and continue care and treatment.
MBPS is a psychiatric condition and in some cases, the perpetrators were themselves abused, physically and or and sexually, as children. They may have come from families in which being sick was a way to get love. So they don’t know any other way to get attention.(Cleveland Clinic) The children are the one suffering from MBPS, many times severely. When cameras were placed in some children's hospital rooms, some perpetrators were filmed switching medications, injecting kids with urine to cause an infection, or placing drops of blood in urine specimens. They had no idea they were on camera so they felt as if they would get away, but they were doing it while in the hospital for treatment to prolong the care and get more attention from the medical team. Many parents suffering would be on first name basis with all the staff and bring donuts in and basically be the life of the party. When in reality there was no party at all. Common conditions of MBPS are failure to thrive, allergies, asthma, vomiting, diarrhea, seizures, and infections. Those are fairly easy things for the parent or caregiver to make happen in their child. The long term prognosis for these children depends on the degree of damage created by the illness or impairment and the amount of time it takes to recognize and diagnose MBPS. Some extreme cases have been reported in which children developed destructive skeletal changes, limps, mental retardation, brain damage, and blindness from symptoms caused by the parent or caregiver.(medicinenet) Often, these children require multiple surgeries, each with the risk for future medical problems. A lot of psychological damage can happen to the children. They can think the only way that they will be loved if they are ill. If MBPS is suspected it is required by law to report it. Sometimes after a parent is charged, they start making their child more sick to “prove” that this is all real, which is endangering the child even more. If the parent denies the charges usually the children will be taken away from them.
For a person suffering with Munchausen by Proxy syndrome the only way they will get better is if they admit to having a problem, if not treatment will do very little or nothing to them. Admitting you have a problem is the first thing needed to fixing a problem. Sometimes catching one in the act will make them admit it, even then sometimes they won’t. It can only be treated with psychological therapy and teaching them ways to create relationships without illness. There is no way to prevent this disorder, if suspected treatment and investigation should be done immediately.
References
Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 36. http://www.medicinenet.com/munchausen_syndrome_by_proxy/page3.htm#what_are_the_signs_and_symptoms_of_munchausen_syndrome_by_proxy http://my.clevelandclinic.org/health/diseases_conditions/hic_An_Overview_of_Factitious_Disorders/hic_Munchausen_Syndrome/hic_Munchausen_Syndrome_by_Proxy
Nursing Diagnosis * Failure to thrive related to lack of nutrition as evidenced by Munchausen by proxy syndrome. * Risk for infection related to injection/inhalation/digestion of harmful bacteria as evidenced by Munchausen by proxy syndrome.
