Daughter From California Syndrome

Daughter from California syndrome is a phrase used in the American medical profession to describe a situation in which a previously disengaged relative challenges the care being given to a dying elderly patient, or insists that the medical team pursue aggressive measures to prolong the patient's life; in California the same figure is called the daughter from New York, and in Canada the daughter from Ontario, and such a relative is often described as angry, articulate, and uninformed. The phrase was first documented in a 1991 case report in the Journal of the American Geriatrics Society by the gerontologist David Molloy and colleagues, who presented strategies to help medical staff handle difficult family members of mentally incompetent patients. Because the daughter from California has been absent from the patient's life and care, medical professionals say she is frequently surprised by the scale of the patient's deterioration and may hold unrealistic expectations about what is medically feasible, with guilt and denial over her past absence sometimes driving a wish to reassert her role as an involved caregiver, according to the physician Angelo Volandes in his 2015 book The Conversation.