Bindu Nath was 82 years old and suffering from incurable cancer of the lungs. He was totally bedridden and had bone metastatic.

As luck would have it, his wife had also passed away two years prior due to cancer. Bindu Nath lived with his elder son and daughter-in-law in East Delhi. The family is not very well off, but the house they live in is owned by them.

He is survived by two sons and a daughter, all of whom are happily married.

Age was not on Bindu Nath’s side, so he was denied any curative treatment, however, his son and daughter-in-law took excellent care of him at home.

CanSupport got Bindu Nath’s referral from AIIMS. He was not in a condition to visit the hospital for symptom management, so the hospital referred him to CanSupport for palliative care at home.

The palliative care team knew that the first meeting with the patient and their family was crucial to establish rapport. Therefore, on its first visit to Bindu Nath’s house, the team tried to create a warm, friendly atmosphere. They also shared with the family what all support they could give to Bindu Nath and them. The family was very accepting of the team and very thankful for getting support that too free of charge to facilitate Bindu Nath experience an easy, pain-free life despite having cancer.

Pain management and nursing issues were identified as the primary needs of Bindu Nath to maintain his quality of life.

Following a discussion with the family, the team picked up that the family had chosen not to reveal the illness or the prognosis to Bindu Nath. They all behaved in front of him as if all was OK. The team accepted the sentiments of the family and assured them they would also not divulge the prognosis.

The Team doctor, after having talked with Bindu Nath and the family, took the needed steps to manage Bindu Nath’s pain and other prominent symptoms, which caused him discomfort.

As Bindu Nath was bedridden, the caregivers were advised on how they could care for him appropriately at home. The home care team also provided an air mattress to help avoid any bedsores. Catheter care was well taken care of by the team nurse. Dietary needs of the patient were explained to the family. The team also advised the family members on what would be the right positioning for Bindu Nath in bed so that he may experience least breathing trouble as the illness would progress.

For a palliative care counsellor, it’s necessary to provide psychosocial care and not just focus on physical symptoms. The counsellor tried to listen to Bindu Nath empathetically to understand his inner feelings and emotions and eased him into sharing whatever was going on in his mind. He shared his feelings of loneliness after he had lost his wife, and that even though his family pretended in front of him that he was fine, he was very much aware of his disease and prognosis.

Despite having a caring family, he didn’t like to be in a state of dependency. He also expressed his wish to breathe his last breath in his village. Through such conversations, the counsellor realised that Bindu Nath all along knew his prognosis and had accepted it well. The team then informed his son and daughter-in-law that Bindu Nath was aware of everything and that they should not pretend he was fine and would recover soon.

The team bridged the connection between Bindu Nath and his family and helped them get closer.

Further, the team shared with the family, Bindu Nath’s desire to visit his village. While on the one hand the family was happy to hear this, on the other hand they were sad that due to his physical condition, taking him to his village in Bihar, which would take 17-18 hours from Delhi in a car, was not a possibility.

The team advised Bindu Nath to have patience and as soon as his health would stabilize, he could be taken to his village in Bihar, in an ambulance or a private car. The counsellor also suggested to the family to hang a photo of Bindu Nath’s wife in front of his bed and encouraged the grandchildren to spend time with their grandfather, talking or listening to him so to minimize his loneliness.

During one of his counselling sessions with the team counsellor, Bindu Nath shared he was conscious of his illness and that he only hoped to die with no discomfort or pain. He also added that he appreciated his children for supporting and cherishing him. He expressed his eagerness to visit his village to attend a ceremony for his one-year-old grandson that was set a month later. The counsellor asked what did he consider of his physical condition, did he think he could travel. To this, he responded he knew it would be difficult.

Active listening by the counsellor and the team helped Bindu Nath feel relaxed and comfortable. He wanted the team to visit him again and again. The team decided to see him once every week. The team also suggested that he could attend the ceremony of his grandson in the village over a video call or Skype and that way he would be able to “attend” the ceremony. The team helped him become part of the ceremony on Skype which gave him so much joy.

This way, the home care team was with Bindu Nath right till his last breath.

Bindu Nath took off for his heavenly abode on 11th of February 2022, peacefully at his home with all his family members surrounding him. His body was taken to his village for the last rites, as per his last wish.

“Rest well, Bindu Nath” – Home Care team, CanSupport