At Peace

I have lived such a happy life, I want my death to resemble that, I am not scared of dying, I just want it to be peaceful.

This is the story of Sheila*, a 72-year-old woman, who lived in Mumbai and had a big family that loved her and supported her till the very end. Through her interactions with her and her family, you could see the love she had for her family. Even when she felt particularly unwell, her main priority was the wellbeing of her family. She would often say: “I have taken good care of my family and so have they of me; I have travelled so much; and seen so much in my life. It is a fulfilled life, one that I have lived well. But now all I want is just no more pain.”

Sheila was diagnosed in 2022 with primary cancer in her Breast that had metastasized to her lungs, abdomen, and kidneys. She underwent right nephrectomy. Due to her age and deteriorating condition, she was advised not to undergo aggressive treatments and instead shift to palliative care. After hearing this news, her family decided to enrol Sheila into the service of a palliative care physician who had been working in this field for many years as a private doctor. However, Sheila and her family were both not comfortable with the services provided. This is when they reached out to PALCARE, and Sheila was enrolled in December 2022. At that time, her family was told that she only had 3 months to live, which was very painful for them to hear. But they understood the reality of the situation and wanted to do everything in their capacity to keep Sheila comfortable.

When PALCARE enrolled Sheila, she was not aware of her diagnosis as well as her prognosis, which naturally but led her to question the treatment plan advised by PALCARE, as she was seeing no improvement in her health, but only a further deterioration. She questioned what the point was of taking any more medicines. The PALCARE team shared these concerns to her family and explained the importance of Sheila being made aware of the true state of her disease and condition. After some persuasion, her family finally agreed that she be told the full truth, and the team was able to disclose to Sheila her diagnosis and prognosis.

At first, the news was a lot for her to process and it seemed unfair to her that she had to experience so much distress only to eventually be given such a poor verdict. Her main cause of distress was that she was in intense pain, was continuously vomiting, and her appetite had decreased sharply. One question she would never fail to ask the team on their visits was whether she would ever feel better.

Through subsequent follow up visits by the PALCARE team, Sheila’s symptoms were mostly brought under control and she was able to manage small activities at home. On one of PALCARE’S visits, the team even took her to a temple nearby for her prayers. Besides Sheila’s symptoms being brought under control, the PALCARE visits served to create a safe space for Sheila to share her feelings, her concerns, her memories. This helped Sheila look at her cancer with a different perspective. And even while the disease was slowly progressing, this did not mean she had to suffer, be in distress or not enjoy the time she had left, doing the things she loved, while surrounded by her family members.

The PALCARE team was not only able to be there for Sheila and support her but also support her family. During the enrollment visit by the PALCARE team, the family seemed extremely anxious and scared as to how to provide care for Sheila. But the PALCARE team was always there for them, to explain Sheila’s care plan, to listen to them, and address their worries and concerns. The family would often reach out to the team via a phone call to share how they were doing and seek support on how they could help Sheila better.

Gradually Sheila’s disease progressed further and her condition further deteriorated. But Sheila and her family had by now both accepted what was happening, and they wished for her to not suffer much. On 25th February 2023, Sheila passed away at home, and as her daughter-in-law shared, she passed away exactly how she wished – peacefully, without experiencing much distress.

During the bereavement visit, Sheila’s son and daughter-in-law expressed how much they miss her and how hurtful it is to lose someone who had always been there for them. But, they added, what they were most content about is that through it all, her wishes and decisions were respected. Both the son and his wife had always heard from others that end of life for cancer patients is painful. And they were truly grateful that this was not true for Sheila and that she had a relatively pain-free death. They were very thankful and appreciative of the PALCARE team for being there for Sheila and them through this difficult process.

*Sheila is a pseudo name for the purpose of confidentiality*