The diagnosis of Munchausen by Proxy (MbP) is well recognised with children as the victims, but remains infrequently reported in later life. Older frail adults may also become victims of this syndrome. In this study we report a case of an older adult with a diagnosis of dementia and her son being the perpetrator. We discuss the diagnosis of MbP in older adults and review the available literature on MbP for this population. We also highlight the clinical features that should alert the clinicians to this diagnosis as it has considerable impact on the victim’s health and consumes disproportionately large health care resource.