Daughter from California syndrome

{{short description|Medical slang in palliative care}}

"Daughter from California" syndrome is a phrase used in the American 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 California, the "Daughter from California" is known as the "Daughter from New York";{{Cite book |last1=Grisso |first1=Thomas |title=Assessing competence to consent to treatment: a guide for physicians and other health professionals |last2=Appelbaum |first2=Paul S. |date=1998 |publisher=Oxford University Press |isbn=0195103726 |location=New York |page=159}} the "Daughter from Ontario" is a Canadian variant.{{rp|396: Editor's note to the title.}} The "Daughter from California" is often described as angry, articulate, and uninformed.{{Cite book |last=Byrne |first=Nicola |title=Psychiatry: Clinical Cases Uncovered |publisher=Wiley |year=2008 |isbn=9781405159838 |pages=72}}

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{{'"}}.{{Cite journal |last=Molloy |first=David W. |author2=Roger M. Clarnette, E. Ann Braun, Martin R. Eisemann, B. Sneiderman |date=April 1991 |title=Decision Making in the Incompetent Elderly: 'The Daughter from California Syndrome' |url=https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.1991.tb02907.x |journal=Journal of the American Geriatrics Society |volume=39 |issue=4 |doi=10.1111/j.1532-5415.1991.tb02907.x |pages=396–399|pmid=2010590 |s2cid=44780093 }} In the paper, David Molloy and colleagues presented strategies intended to help medical staff deal with the difficult family members of mentally incompetent patients.{{Cite book |editor-last=Steinberg |editor-first=Maurice D. |editor-last2=Youngner |editor-first2=Stuart J. |date=1998 |title=End-of-life decisions: a psychosocial perspective |publisher=American Psychiatric Press |isbn=0880487569 |edition=1st |location=Washington, D.C. |page=92}}

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.{{Cite book |title=Topics in Palliative Care |date=1997 |publisher=Oxford University Press |isbn=0195102452 |editor-last=Bruera |editor-first=Eduardo |location=New York |page=317 |editor-last2=Portenoy |editor-first2=Russell K.}} In his 2015 book The Conversation: A Revolutionary Plan for End-of-Life Care, American physician Angelo Volandes ascribes this to "guilt and denial", "not necessarily what is best for the patient".{{Cite book |last=Volandes |first=Angelo |title=The Conversation: a Revolutionary Plan for End-of-Life Care. |date=2015 |publisher=Bloomsbury |isbn=978-1620408544 |location=New York |pages=60–61}}