Anyone heard of Factitious disorder ?

[Kaz1956]

My DH has a senior cousin aged 68 who 7 months ago lost his partner. We are relatives so are the main support people in his life; and that's not easy for us. We believe the cousin to be uNPD and that's not new.
A month ago the cousin received a diagnosis of a minor hairline hip fracture. He's a fit and active man so the treatment was four weeks on crutches and physical therapy. At the hospital where he was diagnosed he was told to go home after 1 day. He refused to go home.
Talking to him he was inventing reasons that didn't make sense not to go home which to us appeared highly exaggerated. I'm a nurse and rehabilitation specialist so have some understanding of what was going on.
In the end the hospital gave up and as he wouldn't leave supported him to book into a rehab hospital and he's still there. As of tomorrow when he's reviewed by his specialist I expect he'll be told he's fine to walk on the affected leg and to go home but even now he's saying he can't manage.
I suspect he's got Factitious disorder previously known as Munchausen Syndrome and it's doing my head in. I just don't know how to deal with it as he's convinced virtually everyone that he's gravely incapacitated. Examples
* He's insisting on being moved everywhere by wheelchair or ambulance if it's to an X-ray.
* He has his 73 year old frail sister taking him out for a few hours by wheelchair.
* He says he can't use crutches to mobilise so will only walk 10-15 steps (his words). Also says that even after 3 weeks of rehab he can't use crutches on stairs.
* He gets very angry if I suggest that he has more capacity to manage than he's demonstrating.
* Is saying that even if he's signed off to walk without crutches tomorrow (guaranteed outcome of his pending specialist visit), he can't manage at home alone and won't go.

I've come to the opinion that he's got undiagnosed Factitious Disorder triggered by his uNPD and bereavement and that he just doesn't want to go home and put an end to all of the narcissistic supply he's been able to generate.

When I gently said yesterday that he would have to go home he got very angry, saying that there needs to be a an elaborate support plan in place as he's so disabled before he could consider going home. He will actually be able to walk as well as me after tomorrow and he's a man who walks daily, swims and goes to the gym regularly, so in reality a fit person for his age.

The main issue we have is that he's demanding our buy in to his distorted reality and we just can't do it. Simultaneously he's putting pressure on us to bring him to our home to stay so that we can care for him.

I'm pretty used to dealing with uNPD and we are trying to Medium Chill our way through this but the disconnect between his reality and ours is causing so much stress for us.

Any suggestions on how to handle this out there ? Thanks

[Rose1]

A lot of us here have heard of Munchausen disorder. It seems to come with pd at times.
As far as your cousin I would suggest that you let the hospital deal with it. And under no circumstances allow him to be brought to your home or made your responsibility.
It seems they will probably try as an easier solution . He probably needs some psychiatric help if it really is that
If not then some further evaluation for fear and depression maybe? In any case not something you can provide.

[Poison Ivy]

I think this type of behavior is very common. I was going to say "in older people" but I think it's not unusual for people of any age, especially people who show other narcissistic-type behaviors, to overstate their illnesses, injuries, or disabilities and to try to get more attention with this behavior.

[Kaz1956]

As far as your cousin I would suggest that you let the hospital deal with it. And under no circumstances allow him to be brought to your home or made your responsibility.

That's great advice. I think I'm quite triggered ATM by it all. Time to take a step back 🙂

[SaintBlackSheep]

My MIL was like this, and it's exhausting. My heart goes out to you. But the good news is that he is an adult, and he is not in your custody, so this is fully "his stuff." I would just let him manage "his stuff" 100% on his own. This is between him and the hospital. It's totally not your job or responsibility, and in a big way, this is just another narcissistic issue that he's trying to make your problem, but he can't do that unless you let him. This is just like any other flying monkey a narc can throw your way, like "who will drive me to the airport?" or "I expect you to name your newborn after me." or "These bills are due and its the LeAsT YoU cAn Do fOr mE!" It's only your obligation to tow the line if you allow it to be. So just don't.

And believe me, I know it's MUCH easier said than done! Hang in there! Stay strong! I would not even try to help him come up with other solutions. I would let the hospital social worker deal with him, and when he eventually realizes his only option is to go home and resume taking care of his own self, either he will or he won't. But that outcome would be true even if you bent over backwards to accommodate him--either he will take care of himself or he won't!

Follow his demands to their logical conclusion--you already know you won't be moving him into your home so you can give him sponge baths and bust your back pushing his able-bodied self around in a wheelchair. And you already know nobody else is lining up to do so, so the outcome is the same no matter what. He can full well take care of himself, and either he will, or he won't.

[Kaz1956]

Thanks so much SaintBlackSheep, I needed to read this. His specialist (who he insisted being taken to by ambulance) saw him last Thursday. He was told he's fine now and to get on with life without crutches. He apparently walked out of the specialist's office - an Easter miracle !

His take; I need to stay at the rehab hospital till Saturday, and they apparently agreed to him using it as a hotel; then I'll go to my sister so she can look after me and then, she will take me home on Monday. Also, I need a walking stick as I'm very frail....Lord, help me ! How he can say this rubbish with a straight face I have no idea.

We had long term plans to go to the theatre next Thursday. He's saying that he still wants to go, followed by a long pause while I'm supposed to jump in and arrange his transport or take him. I held out and just said I'm sure you'll work it out. Shocked silence at his end...

DH and I have decided that this is so much more than a grieving friend/relative situation and that the cousin is using every narc tactic to try lever us into an enmeshed situation that we don't want any part of.

Yes, it is exhausting SaintBlackSheep, we actually do have very full lives ourselves and you don't want to be fending off flying monkeys constantly but it's giving us real insight into what his husband lived with before he died. We always knew his main role in life was to keep the cousin pacified and pleased but what he must have lived with....

Anyway, we are fully resolved to STAY STRONG and wrangle this under control !!

[bloomie]

Kaz1956 - you are handling this with such strength, resolve, and unity with your DH! Bravo!!

We know that medically speaking the very best and most loving thing we can do for anyone is for them to do as much as they can for themselves for as long as they are able. You are doing that for this family member and that is what love, respect, and kindness for him and yourself looks like!! 

[walking on broken glass]

That's so familiar. My sis at some point had convinced my parents that she had lupus and was really ill 
Turns out the lupus went away on its own and she was healthy again, but not before she received lots of parental attention and had all sorts of medical tests run for her.