“Caregiving often calls us to lean into love we didn’t know possible.” – Tia Walker I never truly understood the meaning of this statement, until I’ve had my share of experiences in the Palliative Care Unit while dealing with patients struggling with end of life diseases and their caregivers. I was of the opinion that I had to only care for a patient who was diagnosed with a debilitating illness as their life was now shattered due to them having to bear both the physical and emotional pain. I was so wrong! For the past year, I have been working as a Senior Nursing Officer in the Palliative Care Unit at AIIMS Mangalagiri. Having been very much interested in the psychological aspects of life, I was motivated to pursue Psychiatric Nursing during my Post Graduation. When I began working in the Palliative Care Unit, I was very enthusiastic about ‘counselling and taking care’ of the patient’s psychological needs. During my journey however, I came to realize that along with the patient, the patient’s caregiver was also going through a lot of anguish and torment. I observed that it was not only the patient’s life and routine which has been distorted, but that the caregiver’s life was also in a dilemma. I learnt that I was needed to not only care for the patient, but that I also had an obligation towards comforting their caregiver too. My experience has taught me that every caregiver’s story is unique. I once had a patient with stage 4 breast cancer with distant metastasis and who was completely bedbound. She was in her 40’s and had a beautiful family; a loving husband and two sons. When the family learnt about the diagnosis, they were shattered. The husband was reluctant to reveal the condition of the disease to his wife. With all treatment options exhausted, the family was counselled and advised for home care with best supportive palliative care. The patient was started on morphine as she was suffering with intense pain. During each of our visits, we witnessed the family go through a lot of dilemma and emotional burnout. The husband being the only bread winner, was forced to leave his wife at home and go to work to meet the needs of the family and his wife’s treatment. Their elder son lived geographically far away from home, which left the younger son to be his mother’s primary caregiver. We noticed that this child was going through so much emotional turmoil as he had to witness his mother’s agony from close quarters and that he also anguished for his own future. Initially quiet during our visits, as days passed on, he became more acquainted with us and started sharing his concerns. We continued to counsel the husband and the son and kept them updated regarding the patient’s prognosis and expected outcomes. Though initially apprehensive, over time, the family became more and more understanding and accepting of the patient’s condition. I still vividly remember the last time we visited the patient’s home. She was lying on the bed, and shared her concerns with us. She asked innocently “Will I be able to walk again?”. This broke my heart. You see, despite palliating the patient’s physical pain and offering counseling support to the family, yet, we failed to break the collusion since the husband pleaded with us to not share the prognosis with the patient. I was therefore able to only swallow my distress and respond to her by saying, “We will work together to make you feel better”. A few days later, the patient’s son rang to inform us of her passing. He told us that his mother was as calm as a leaf, when she lay on her bed, the day she passed. It was heart wrenching for me to hear of the news. I could only imagine how the family had been feeling. While we tried to comfort the patient’s husband and her son, I was astonished with the manner in which they responded. They were composed and were in fact telling me that their loved one had a serene death as that she was now relieved from the horrendous pain that she suffered for long. They went on to thank us for relieving the physical pain of their loved one and for all the support our team had offered to them towards the end of her life. I thanked God and saluted the family for their spirit. That day I truly learnt and understood that to be able to provide satisfactory care for our patients, we must deal with the patient and their caregivers as a single unit of care. While working in the palliative care unit over the past year, I’ve had the opportunity to learn various aspects of life such as empathy, positive communication, importance of building trust, etc. I have now learnt the true meaning of ‘Putting yourself in someone else’s shoes’ each time I work with my patients and their caregivers. I am sure that several of my nursing colleagues in palliative care also experience the same joy and satisfaction that I experience each time I able to really relate to the feelings of my patient and their caregivers. I urge each of us to take the time to be compassionate while caring for our patients and their caregivers who are often also walking the challenging journey along with their loved ones. Let us remember to treat each of them in the way that they truly want to be treated. About the Author: Ms. Joshna Chatada is a Senior Nursing Officer at the Palliative Care Unit, in AIIMS, Mangalagiri, Andhra Pradesh. Note: This article is a republication from the September 2024 edition of the Indian Association of Palliative Care’s (IAPC) e newsletter.