She was not meant to be in hospice. On paper, she did not qualify. Breast cancer on palliative chemotherapy, tamoxifen, stable. Not terminal. But life had already taken away everything that makes living recognizable.
An accident confined her to bed. A head injury blurred her mind. A fractured femur ended her mobility. And then, eight days later, her elder son her primary caregiver died suddenly of a massive heart attack.
After that, the world closed in quickly.
The landlord asked them to vacate within a week. The other children did not want to keep her. The daughter’s husband offered thirty thousand rupees a month. No place clean, safe, and humane would accept a bedridden woman with dementia and behavioral issues at that budget. They came to us carrying not just a patient, but a decision they were ashamed of making.
We took her in.
She screamed sometimes. She scratched. She became aggressive without warning. The neurological injury and dementia showed themselves not as forgetfulness but as disinhibition. Yet there were moments of startling clarity not cognitive, but procedural. Her hands remembered what her mind could not.
She stitched.
With no needle, no thread, no cloth , she stitched. She made imaginary pleats and asked me to hold them while she worked. Sometimes I did. Once, I pretended the needle pricked my finger, and she immediately apologized and corrected the way I was holding the fabric. In those moments, I wondered what was happening inside her head.
Later, I realized it didn’t matter.
Her body was remembering a former life boutiques in Delhi, creation, competence, dignity. When memory dissolves, the body insists on identity. All I had to do was not interrupt it. So I held the pleats.
She took her tea at a precise temperature. Too hot or too cold, and she refused. On difficult days she would throw tantrums and refuse food except when I fed her. She allowed me.
Her daughter came every day.
She sat with me for hours. She spoke of guilt about her brother, about money, about boundaries she had drawn to survive his verbal abuse. She believed those boundaries killed him. Grief does that it invents causality where there is only collapse. She was on medication for chronic depression, but what struck me was not sadness. It was fear. Fear of judgment. Fear of relatives. Fear of having chosen wrong.
She is a trapped in I feel a relational surveillance, the fear of how relatives, society, and imagined audiences judge her choices. The accusation of placing her mother in a “charity institution” becomes an internalized verdict: I have failed as a daughter.
You could almost touch the suffocation in her chest.
I didn’t correct her guilt. I allowed it to breathe. I let her speak. Sometimes I joked , bad jokes, light ones. Laughter is not disrespectful to grief; it is a brief loosening of its grip.
Later, I met the live-in partner of the deceased son, her twin sister, and their mother. The mother was angry. She said no one helped her daughter’s partner, and that was why he died. Pain always looks for a witness before it looks for truth.
I told them quietly that the sister felt guilty too.
Something shifted. At the next visit, I saw them hugging, talking, lighter.
The other son visited few days. His wife is not willing to keep his mother with them due to unresolved past. He didn’t talk. He didn’t cry. He just sat. I never tried to fill the silence. Silence is not absence; it is communication without language. Some grief does not want words it wants company.
Yesterday, something changed.
He smiled.
He told me I danced well at the hospice Christmas party. I laughed and told him about how I visited a tarot card reader during a fundraising, how she said 2026 would be my year, how I was thinking of learning tarot because it’s a lucrative business.
I told him my family warned me that psychic reading would make me even more dangerous because I can already predict their intentions..especially my children’s.
He laughed.
A real laugh. Sudden. Unprotected.
In PC we often meets people who do not fit criteria, but whose suffering fits nowhere else.
This woman did not qualify for hospice by prognosis, yet her life had already crossed multiple endings: loss of mobility, loss of cognition, loss of home, loss of son, loss of financial identity, loss of social protection.
Medicine labels her non-terminal; reality had already made her existentially terminal everything that made life intelligible had collapsed.
Should we stick to care ethics of relational responsibility or rule adherence? Are the social problems separate from disease?
The daughter’s paralysis is it moral failure or cognitive overload under grief, class anxiety, and gendered expectation.
What gave me peace was Hannah Arendt words evil or suffering often arises not from cruelty but from thoughtlessness under pressure.
And finally a gentle reminder!
Palliative care is often misunderstood as end-of-life medicine. In truth, it is meaning-preserving medicine. It intervenes when identity fractures faster than physiology. It treats what psychiatry calls complicated grief, what philosophy calls existential nausea, and what sociology calls structural abandonment.
We don’t fix anything but we do something radical. We stay ..be it holding imaginary pleats, we stay…tolerating silence…we stay allowing guilt to speak up….we stay..laughing at absurdity during grief…but we stay…..especially in a system obsessed with outcomes….YES WE DARE TO VALUE MOMENTS……
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