Is there a conflicted surrogate syndrome affecting quality of care in nursing homes?

Is there a point at which family complaints about care cease to be constructive and become excessive and counterproductive? Do excessive complaint behaviors represent a "conflicted surrogate syndrome" that is indicative of psychopathology in the family member or family system? Can this psychopathology result in avoidance behavior by the nursing staff sufficient to result in poor care? While many family/resident complaints are valid and should be viewed as constructive there are occasions when excessive complaints by the family of a nursing facility resident are a result of psychiatric illness or psychological problems in the family member(s) or are evidence of an abnormality in the family system. This series of brief case reports is offered to create discussion of what might be termed a "conflicted surrogate syndrome" that may result in avoidance behavior by staff and consequent poor care.