Monday, 6 July 2015

When we turn caregivers to parents: Balancing love and duty, ambition and resentment.

Credits: Pritha Chatterjee, Alifiya Khan, Premankur Biswas, Tabassum Barnagarwala and Debesh Banerjee. 

It was a cold, snowed-in Philadelphia night last December when Sambuddha Chaudhuri, 31, received the phone call. It was his father at the other end, his voice sounding “suddenly very old, very tired”. “My mother, a cancer survivor, had gone for a routine check-up and the doctor found some lumps near her breast. My father had called to inform me that there was a possibility of a relapse,” says Chaudhuri. A decade ago, when he was a medical student at Midnapore Medical College near Kolkata, his mother had been detected with ovarian cancer. “It was in an advanced stage, but she was pronounced cancer-free within a year,” says Chaudhuri. His mother, Kanika, resumed her job as a professor of education in a south Kolkata girls’ college and Chaudhuri left the country after his MBBS to pursue a PhD on public health from the University of Pennsylvania, US. “When my father called, I couldn’t sleep all night. They insisted that I stay back, but I just couldn’t,” he says. By next evening, he had bought tickets to Kolkata and had that crucial talk with his PhD guide. “Not shifting was never an option for me. I needed to be there,” says Chaudhuri.

Age can be a cruel mistress, but it’s not hard on the old alone. As Shoojit Sircar’s recent blockbuster Piku shows, filial responsibility can be tough on the next generation as they grapple with their responsibilities, trying to strike a balance between love and duty, between their professional aspirations and personal lives. As their roles reverse, life changes in irrevocable ways for the caregivers and their parents.

Oncologist Indranil Chatterjee took a break in his studies when his mother was diagnosed with acute depression. She died in 2005. 

When New Delhi-based chartered accountant Raman, 42, quit his job with an accounting firm in 2011, he thought it would be a brief sabbatical. After his father’s death, his mother, then 65, had been living alone in their Raipur home. She fractured her hip after a fall and Raman and his six siblings flew in from different parts of the world to be with her. The accident had been severe. Their mother hadn’t been able to get up or get to the phone in the living room. She had managed to drag herself till the bathroom, where the domestic help found her 16 hours later, sobbing because she had wet herself and was in great pain. “We hung around till she recovered, it took about two months. After that, everyone had to leave. My mother, who had always been fiercely independent and would refuse to leave the house my father had built, asked me if she could come and stay with us in Delhi for a few days,” says Raman.

But after the hip fracture, she broke her ankle, then her thigh bone from minor falls and what was supposed to be a brief visit became a permanent shift.
Doctors diagnosed her with osteoporosis: her bones had become brittle and made her prone to accidents. She needed round-the-clock supervision. Raman decided to take a break to tend to his mother, only her condition never improved and she became bedridden. He never went back to his office.

Age can be a cruel mistress, but it’s not hard on the old alone.

Giving up his cushy job also meant re-orienting his life. His three children were studying in expensive schools; his wife had given up her career in advertising after their second child. Now she had to return to work. “Those were hard times. My mother refused to take my wife’s help, she always found faults with everything she did. So I had to change her diapers and help her bathe. I took to sleeping on the floor in her room because she could call at any time,” he says.

Even though their lives have finally fallen into a rhythm — Raman has his own practice now — it was often difficult because his mother continued to shun his wife. There were tears and fights, but now, both husband and wife have become reconciled to the elderly woman’s hostility. They even find it amusing. “She tells me that I have always been the laziest of her daughters-in-law, but I have to dress her, brush her hair and cook her food. Even though she cribs through all of it, she won’t have a help looking after her,” says Raman’s wife with a laugh.

India has a growing population of the elderly — 10 crore people are above 60, according to the 2011 Census report — but our facilities for geriatric care have not kept up. Earlier, large households and family networks would bear the responsibility of taking care of the old. Now an entire generation of urban Indians, who had left towns and cities to strike out on their own, who had become accustomed to living atomised lives in big cities, are having to switch paths, give up jobs or scale down their ambitions, to take care of their parents — and confront questions of mortality.

Indore-based Soumya Roy, 54, quit State Bank of Indore’s industrial finance branch in Indore in 2004, rejecting an offer to move to Delhi to join a new commercial branch for high-profile corporate clients. His father was 82, a diabetic with heart ailments and had recently undergone a hip replacement surgery. His mother was 75 then. He was already the chief manager at his workplace, with a promising career ahead of him. But he chose to give it up to help his elder sister, Snigdha, now 62, look after their parents. He took up various financial management teaching assignments before settling down as a media and communications teacher. “My sister was a school teacher and since her timings were fixed, I had to get flexible working hours. Becoming a visiting faculty in colleges made me available at all times,” says Roy. The siblings never married and Roy now has moments of doubt when he wonders if he did the right thing by giving up his career. I wanted to keep them alive for as long as possible. I am not sure my father would have lived so long if I had prioritised my career. But they never offered to move to Delhi. They had always lived in Indore,” he says. His father passed away at the age of 91, but his mother, now mostly bed-ridden after two pelvic fractures, needs constant supervision.

Unlike others her age, 25-year-old Kanika Sharma does not go for a movie or a coffee with friends once her work is over. She rushes back to her home in Subhash Nagar, Delhi, to cook an evening meal for her mother, who undergoes dialysis thrice a week and requires constant care. Since 2003, her mother, 49-year-old Neelam Sharma, a former social sciences teacher at Ramjas School, Anand Parbat, has been suffering from severe kidney infection, which causes bouts of breathlessness, fatigue, and vomiting. In 2010, she had to be put on a dialysis regime, forcing her to quit her job.

Kanika Sharma with her ailing mother Sheela Tilak, 60, an ENT surgeon in Pune, has been looking after her 90-year-old mother, Kamal, for more than a decade now, choosing to remain unmarried so she could do justice to her career and her parent. She remembers her initial resentment at having two live-in helps look after her mother. “I’m not used to people watching me, judging my every move. But I reminded myself, it’s for her and slowly, it became bearable,” she says. The bigger changes, though, were having to give up on overseas conferences and surgeries. “Earlier, at least once a year, I would travel abroad, but now I can’t leave my mother behind,” she says.

Though the idea of being responsible for the care of one’s parents is seemingly ingrained into Indians, inviting them back into one’s life is a fraught exercise. Eight months ago, Pune-based Devansh Mehta, 46, decided to move his wife and children to a rented apartment after his father, who suffers from Alzheimer’s and dementia, went missing once again.

It was a frantic time for the family, made worse by police insinuations of neglect and torture at home. “My wife was already under a lot of pressure. She works, looks after our children and takes care of our father. She couldn’t handle it anymore. That’s when I decided to get a full-time caretaker for my parents and move my family out,” says Mehta.
For both the ailing and their caregivers, the toughest part is accepting the transformations of time, of watching parents come close to losing control of their lives. “My mother has always been an independent woman. Seeing her like this breaks my heart but I need to be strong. Even at home we never treat her like a patient. But I have to become her mother at times when she gets stubborn about things,” says Sharma, a PR professional, who has hardly taken a holiday in the past five years.

It was the silences that got to Indranil Chatterjee. When his mother was diagnosed with severe depression in 2001, Chatterjee had completed his MBBS from Guwahati and was supposed to take his crucial postgraduation entrance exam. He returned to his hometown in Dibrugarh, Assam, to be with her. “For months together she would just sit at a place and not talk. It was painful because she was a really jovial person,” says Chatterjee, who is now an oncologist with the Thakurpukur Cancer Hospital, Kolkata.

Many a time, Chatterjee would feel his mother slip away. “I felt like I had lost my mother. She was a different person. That almost broke my spirit,” says Chatterjee. Over two years, Namita made slow progress. “There were days when I would serve food to her and she would stare at it without eating and then in the evening she would have moments of lucidity when she was the same person again, talking to me, enquiring about my studies,” remembers Chatterjee. Eventually, his mother got much better, enough to live by herself in 2003. “But I never got my mother back. This person was a pale shadow of her,” says. In 2005, she succumbed to a heart attack. “I tell myself she had lost the will to live,” he says.

Old age is a stripping away of health and ability, but most of all, a sense of autonomy. Many conflicts among caregivers and the ailing involve the latter’s reluctance to cede control, and slip, without so much as a fight, into a second childhood. Dr Om Prakash, an expert in geriatric psychiatry at Delhi government’s Institute of Human Behaviour and Allied Sciences, says, “If your partner’s parent comes to stay with you, you start feeling like you have lost your autonomy. To cope, you start expecting the elderly to give up their decision-making abilities and live on your terms.” The elderly do not have it easy at all. “Almost 40-50 per cent have medical ailments. With age, ability to cope or adjust decreases, and this sudden loss of freedom leads to more stress,” says Dr Prakash. With old-age homes being places where they feel unwanted, and a complete absence of geriatric care, this is a crisis that is only going to grow.

For the Mehtas in Pune, the crisis was solved by the compromise of separate homes. The new routine has given their life some semblance of sanity, Mehta says. “After the children leave for school, my wife checks on my parents and leaves for work. In the evenings, I go there directly after work and have dinner with them. We spend all our weekends together. In the meantime, I have installed additional child locks in the entire house and kept watchmen to ensure that my father doesn’t go out alone. It’s hugely expensive but this way, I can look after my parents and my wife and children,” he says.
It’s 8 PM, a rare cool June evening in Gurgaon. At 41-year-old Ashima’s apartment in a Gurgaon highrise though, everyone is screaming. Earlier in the day, her 84-year-old father, a retired diplomat, had sneaked out for an afternoon walk and got caught in the showers. He returned home three hours later, by when the family was frantic. “He refuses to carry a mobile phone. He leaves the house when he pleases. We were going crazy, knocking on neighbours’ doors, calling the guards, just wondering if we should go to the police, when he walks in dripping, laden with four bags of vegetables,” says Ashima, still fuming. Her father has changed and is enjoying his favourite honey tea as she calls her brother to complain.

At a strapping 5 feet 11 inches, with a barely discernible paunch under his kurta, Ashima’s father is fit for his age. He is clearly someone who is refusing to go gently into the good night. As his daughter rages, he smiles, waiting for the storm to blow over. “Once you are over 80, everyone expects you to fall ill, have some surgeries and get bed-ridden. I come from a zamindar bari in Kolkata,we used to walk 15 km a day, go for shikaar. In my service days, I always exercised. Now they expect me to stay locked in. It’s useless fighting with them over it, so I just go out whenever everyone is out or sleeping,” he says.
An IT professional with a start-up she has set up with her husband in Noida, Ashima has always been the one to look after her parents, since her brother, eight years her junior, has a transferable job. “My husband lost his parents early, he likes having my parents around. My son is deeply attached to them, so I don’t want them to live anywhere else. But at least thrice a week, I have to rush back home, because of some emergency or the other that involves my father,” says Ashima. Her father, seated next to her, smiles. “I don’t want to move out either. We helped raise her son while she built her career. Why should we move out now?” he says.

He has begun writing poetry lately, he confides, to make sure he is not growing senile as Ashima keeps telling him. “But every time, I want to read out my poems, Ashima walks off. I know she doesn’t appreciate my writing. But after I die, you wait and see, she will be the one to get my poems published,” he says with a guffaw. (The family did not want to be identified.)

HelpAge India came across this beautiful piece of writing through Harini Calamur's tweet.

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