The Caretakers

©Dr. Aparna Govil Bhasker

I recently treated an 80 years old diabetic lady for a gangrenous gall bladder. By the time she presented to us, she was in severe sepsis. It was a difficult surgery. After the surgery, I met her son and grandson and explained her condition to both of them. She had to kept in the ICU for a few days in view of her age and associated conditions. Over the next few days, whenever I visited her on my rounds, I would ask for the relatives so that I could explain the clinical progress to them. However, every time I would be disappointed as no one would be around. The old lady was practically left all alone in the hospital. The staff informed me that the son and the grandson took turns to visit her every night for a short while. No one stayed by her side during the day.

Elderly patients sometimes tend to get neglected by their families. This is especially true for elderly women. They are a vulnerable in every way and an extended illness can sometimes push things to the brink. With this thought, I discharged her hoping that they would take care of her at home. For some reason, I kept thinking of her from time to time during the next week.

A few days later, they brought her to my clinic for a follow up. The old lady was in good spirits however, the attendants were extremely hassled and worked up, once again, reinforcing my thought process about neglect. They had a whole lot of complaints about her not heeding to any medical or dietary advice. The more I heard from them, the more I judged them for taking care of her poorly and treating her like a burden they were forced to carry. I felt bad for the old lady and wished I could do something to make things better for her.

After I finished checking her dressing, I asked for her son and daughter in law to come in. I gave them a nice little speech about the need for emotional support after surgery and chided them for not being there for her at the hospital when she was admitted.

After my monologue was over, they revealed that for the last two decades they had been taking care of five senior citizens at home. Father, mother and three unmarried sisters of the father lived with them. The old lady was his aunt and not his mother as I had assumed. His parents had passed away a few years back but the couple continued to take care of all the three aunts. Two of them were completely bed ridden and dependent on them for everything. All of them were octogenarians. None of them had any source of income. The gentleman and his young son were the only earning members of the family. The family along with the three aunts lived together in a small two room apartment in a Mumbai chawl. They were barely making ends meet. Frequent hospitalizations of the family members had set them back financially and they were perpetually under debt. The husband and his son had no option but to go to work in order to survive. The wife needed to be home to take care of the other two aunts. Getting help was an extravagance they could not afford. Every day was a struggle. With their meagre resources in terms of time and money, they were trying to do as much justice as they could. It was impossible for anyone of them to be at the hospital 24 by 7. In their eyes, the hospital was a safe place where they knew that the old lady was being taken care off well and being supported by the staff. They did as much as they could in the given circumstances.

I was amazed at how much they were doing. The couple had not only taken care of their parents, but were also taking care of the extended family. Contrary to my assumption, they had gone beyond the call of duty.

People lead tough lives. When we meet them in the hospital, we get to see a very small glimpse of their lives. As doctors, all our attention is on the patient’s well being and in the process sometimes we tend to judge the care takers. While the patient is the recipient of all our care and empathy, the caretakers usually get no credit.

After they finished narrating their story, the couple smiled and looked as though a burden was off their chest. Sharing a piece of their life with me, would not really change much for them. However, a little less judgement and a bit of empathy would probably make their journey slightly more tolerable.

As for me, by digging a bit deeper, I lightened my own burden of judgement.

©️Dr. Aparna Govil Bhasker