Often, caregivers need help too

A businessman panicked on learning of his wife’s cancer, and killed her, their pet Labrador, and himself. The tragedy underlines the need to counsel the terminally ill and their caregivers, say doctors.

Last week, a Bengaluru businessman killed his wife, their pet dog and himself soon after he got to know she had cancer.

Atul Upadhyay (58) and Mamata (53) were residents of Annex Sycon Polaris Apartment, opposite Gayatri Vihar in Sadashivanagar.

The police found a death note in which Upadhyay spoke about Mamata’s cancer. He bludgeoned his wife with dumbbells, threw the dog from the fourth floor of their building, and jumped to death from the terrace of his apartment.

Atul Upadhyay

When a spouse or a loved one is diagnosed with a serious ailment, it has a huge bearing on the mental health of the caregiver too, says Dr Raghu K, consultant psychiatrist, BGS Gleneagles Global Hospital.

“The patient goes through a pattern -- denial, anger, depression and finally acceptance. In the West, psychological support is given, but in India, it is not provided unless it is specifically asked for,” he says.

He suspects the diagnosis could have been ‘the last straw on the camel’s back.’

“If the patient is going through difficulties on the personal, professional or social front, such a diagnosis could add to the stress,” he says.

Dr Roshan Jain, senior consultant psychiatrist, Apollo Hospitals, describes the tragedy as ‘a rare incident.’

“But incidences of psychiatric disturbances around cancer are high; research says 50 percent of ailing patients or close ones could have depression,” he says.

Educating and guiding the patient about the condition helps reduce psychiatric morbidity, he adds.

“All patients suffering from conditions like cancer should be referred to a psychiatrist or psychologist, which doesn’t happen. Patients suffer a lot of stigma too,” he says.

He observes some organisations do have psycho-oncologists but the referral rates are low.

“Knowledge is power. Without knowledge about one’s condition, often a cancer patient is left anxious and uncertain which can make them fear a grim future. If the quantity of years of a patient cannot be worked on, there should be enough support to be able to work on the quality,” he says.

Dr Sabina Rao, consultant - psychiatry, Columbia Asia Hospital, observes that most people take care of loved ones with serious ailments with grace and bravery.

“Occasionally, the illness can overwhelm the patient and the caretaker to the point of harm but such incidents are rare. Chronic, complicated illnesses can be draining emotionally and financially. Many facets of the family’s life change, some times forever,” she adds.

She suggests people diagnosed with chronic health problems seek support from close non-judgmental friends and family.

“Seeking professional help is a good step during such tough times,” she adds.

Not being able to accept one’s situation can often lead to extreme reactions, points out Sophia Sharon, assistant lecturer (sociology), Mount Carmel College.

“In this case, it looks like the person didn’t have the spirit of acceptance. It is not easy for a person to accept such shocks and here he couldn’t see his wife suffer. People lack tolerance nowadays. The concept of socialisation is very important too,” she says.

She adds that “accepting the stigma associated with his wife’s condition could also have triggered the extreme reaction”.

“More social interaction and adjustments with family and peer circle should help handle such situations better. People must talk out and share time with each other,” says Sophia.

‘We have no professional medical care system beyond a hospital’

India has done little in developing care for the terminally ill, and the situation isn’t great in other countries either.

GeorJo Pius, public relations manager, Bangalore Hospice Trust–Karunashraya, says, “End of life care is a global issue.”

According to him, in 2016-17, around 14 lakh people were diagnosed with cancer in India.

“About 87 per cent of them went to the doctor for the first time when already in an advanced state of cancer. There is no system in place to address their concerns; there is no professional medical care system beyond a hospital,” he says. Karunashraya is a hospice located in Marathahalli.

About 70 per cent of the patients it works with are advanced stage cancer patients who are bedridden.

Qualified counsellors at the hospice counsel patients and their families, and also, on request, help them spiritually.

“We also hold art and craft therapy and entertainment programmes for the patients,” he adds. Karunashraya has a 73-bed inpatient facility with three homecare teams across the city.

For details, call 080 4268 5666.

‘Learn from such incidents’

“Such incidents should turn into lessons: if something so drastic has happened, what is the picture we are missing out on? Did we do anything right or wrong here?”

— Dr Roshan Jain, Senior consultant psychiatrist