Daughter from California syndrome

"Daughter from California" syndrome is a phrase used in the medical profession to describe a situation in which a hitherto disengaged relative challenges the care a dying elderly patient is being given, or insists that the medical team pursue aggressive measures to prolong the patient's life. In his 2015 book The Conversation: A Revolutionary Plan for End-of-Life Care, American doctor Angelo Volandes ascribes this to "guilt and denial", "not necessarily what is best for the patient".^[1]

The "daughter from California" is often described as angry, articulate, and uninformed.^[2]

Medical professionals say that because the "daughter from California" has been absent from the life and care of the elderly patient, they are frequently surprised by the scale of the patient's deterioration, and may have unrealistic expectations about what is medically feasible. They may feel guilty about having been absent, and may therefore feel motivated to reassert their role as an involved caregiver.^[3]

The phrase was first documented by a collective of gerontologists in a 1991 case report published in the Journal of the American Geriatrics Society, titled "Decision Making in the Incompetent Elderly: 'The Daughter from California Syndrome'".^[4] In the paper, Molloy and colleagues presented strategies intended to help medical staff deal with the difficult family members of mentally incompetent patients.^[5]

In California, the "daughter from California" is known as the "daughter from New York";^[6] the "daughter from Ontario" is a Canadian variant.^{[4]: 396: Editor's note to the title.}

References

1. Volandes, Angelo (2015). The Conversation: a Revolutionary Plan for End-of-Life Care. New York: Bloomsbury. pp. 60–61. ISBN 978-1620408544.
2. Byrne, Nicola (2008). Psychiatry: Clinical Cases Uncovered. Wiley. p. 72. ISBN 9781405159838.
3. Bruera, Eduardo; Portenoy, Russell K., eds. (1997). Topics in Palliative Care. New York: Oxford University Press. p. 317. ISBN 0195102452.
4. Molloy, David W.; Roger M. Clarnette, E. Ann Braun, Martin R. Eisemann, B. Sneiderman (April 1991). "Decision Making in the Incompetent Elderly: 'The Daughter from California Syndrome'". Journal of the American Geriatrics Society. 39 (4): 396–399. doi:10.1111/j.1532-5415.1991.tb02907.x. PMID 2010590. S2CID 44780093.{{cite journal}}: CS1 maint: multiple names: authors list (link)
5. Steinberg, Maurice D.; Youngner, Stuart J., eds. (1998). End-of-life decisions: a psychosocial perspective (1st ed.). Washington, D.C.: American Psychiatric Press. p. 92. ISBN 0880487569.
6. Grisso, Thomas; Appelbaum, Paul S. (1998). Assessing competence to consent to treatment: a guide for physicians and other health professionals. New York: Oxford University Press. p. 159. ISBN 0195103726.