Senior Needing Psychological Support in Terminal Illness

I met a woman last month, a former professor from Patna University. She had cancer, and it had spread. Her family was doing everything right. They were giving her medicines on time, her food was soft and easy to eat, and they had a nurse coming to help with baths. But she just stared at the ceiling all day. She wouldn’t talk. She wouldn’t eat much.

Her son asked me, “Doctor, we are managing her pain. Why is she still suffering?” The answer was simple. We were treating her body, but we were forgetting her mind. Her pain was not just physical. It was psychological. And in Patna, this is a pain we often ignore.

Today, I want to talk about this invisible pain. When someone is facing a terminal illness, their mind goes through a storm. Fear, sadness, anger, and anxiety can be just as bad as physical pain. As a doctor, I’ve learned that caring for the mind is just as important as caring for the body.

The Pain We Can’t See

When we think about a terminal illness, we think about physical symptoms. Pain, breathlessness, weakness. We are good at asking about these things. But we don’t often ask, “How are you feeling in your heart?” or “What are you thinking about?”

Psychological pain is real. It’s not just “being sad.” It’s a heavy weight. It’s the fear of what’s coming next. It’s the sadness of leaving loved ones. It’s the frustration of not being able to do simple things anymore. It’s the feeling of losing control over your own life and body.

In our culture in Bihar, we are not very comfortable talking about feelings. We tell people to be strong. We say, “Don’t cry.” But for someone facing the end of their life, these feelings need a place to go. If we don’t let them out, they fester inside and make everything worse.

Why the Mind Matters So Much

From a doctor’s perspective, the mind and body are deeply connected. A person’s mental state can directly affect their physical health.

When someone is very anxious or depressed, their pain feels worse. Stress can make muscles tense up. It can make it harder to sleep. Lack of sleep makes pain even worse. It becomes a cycle.

A troubled mind can also affect the body’s ability to heal. It can lower immunity. It can cause stomach problems and loss of appetite. So, if we only treat the physical symptoms and ignore the mind, we are only doing half the job.

This is where an integrated care model is so important. The doctor manages the medical side. The family provides love and support. But we also need to address the psychological needs, maybe with a counselor or a specially trained nurse who knows how to provide emotional support.

Signs That a Senior Needs Psychological Support

So how do you know if your elderly loved one is struggling psychologically? It’s not always obvious. They might not say “I am depressed.” But there are signs you can look for.

Withdrawal: They stop talking to family members. They don’t want to see visitors. They stay in their room all the time. This is different from just needing some quiet time. This is a complete pull-back from life.

Loss of Interest: They no longer enjoy things they used to love. If your father always loved watching cricket but now doesn’t even look at the TV, that’s a sign. If your mother loved listening to her bhajans but now asks for silence, pay attention.

Feelings of Being a Burden: This is a very common and painful feeling. They might say things like, “It would be better if I was gone,” or “You all would be better off without me.” They might refuse care because they feel they are causing too much trouble.

Anger and Irritability: They might get angry over small things. They might snap at family members who are trying to help. This anger is often not about the small thing. It’s about the big thing they are angry about – their illness.

Talking About Death All the Time: While it’s normal to think about death, if it becomes an obsession, if they talk about it in a very dark or hopeless way, it’s a sign they need help.

The Danger of False Reassurance

When our loved ones are scared or sad, our first instinct is to make them feel better. We say things like, “Don’t worry, you will be fine,” or “Be positive, you will beat this.”

I know this comes from love. But for someone with a terminal illness, this can be hurtful. It’s what we call false reassurance. They know they are not going to be “fine.” When we say this, they feel like we don’t understand. Or worse, they feel like they can’t be honest with us about their fears.

It closes the door to conversation. They think, “If I tell them I’m scared, they will just tell me not to be scared. So what’s the point of talking?”

Instead of false reassurance, try validation. Validation means acknowledging that their feelings are real and okay. Say things like:

• “That sounds really scary. It’s okay to be scared.”
• “I can’t imagine how hard this must be. I’m here with you.”
• “Thank you for telling me how you feel. Let’s go through this together.”

How to Give Psychological Support at Home

You don’t need to be a psychologist to provide psychological support. As a family member, your presence is the most powerful tool. Here are some things you can do.

Just Listen: This is the hardest and most important thing. Sit with them. Be quiet. Let them talk. Don’t interrupt. Don’t try to fix their problems. Just listen. Sometimes, just saying the fears out loud makes them a little smaller.

Ask Open-Ended Questions: Instead of “Are you okay?” ask “How are you feeling today?” Instead of “Do you need anything?” ask “What’s on your mind?” This invites them to share more than just a “yes” or “no.”

Share Normal Life: Don’t let every conversation be about the illness. Tell them about your day. Talk about the children’s school, a funny thing that happened, what you’re cooking for dinner. Normalcy is comforting. It reminds them that they are still part of the family, not just a patient.

Give Them Control: Illness takes away so much control. Give it back wherever you can. Ask them what they want to wear. What they want to eat. What time they want a bath. Let them make small decisions. This helps them feel like a person, not just a patient.

Touch and Physical Comfort: A gentle hand massage. Holding their hand. A light touch on the shoulder. A soft blanket. These things communicate care without words. They can be very calming.

The Role of Faith and Spirituality

In Patna, faith is a big part of life. For many seniors, their spiritual beliefs are a huge source of comfort when they are facing the end of life.

Don’t be afraid to bring in their spiritual practices. This might mean:

• Playing religious music or chants
• Reading from their holy book
• Having a priest, pandit, or imam visit for a prayer or blessing
• Helping them perform their daily rituals if they are able

For some, spirituality is not about religion. It might be about sitting in the garden, listening to the birds, or looking at old family photos. It’s about connecting with something larger than themselves.

Ask them what gives them peace. Then help them have more of that.

When to Seek Professional Help

Family support is crucial, but sometimes it’s not enough. There are times when you need professional help.

Seek help if you see these signs:

• The person talks about wanting to die or ending their life.
• They refuse to eat or drink for a long time.
• They seem to be in a state of panic or extreme anxiety all the time.
• They don’t respond to you or seem to be in their own world most of the time.
• They are not sleeping at all for many nights.

In Patna, finding a geriatric psychologist can be hard. But help is available. Talk to the doctor. They might prescribe medicines to help with anxiety or depression. A home care service might have a nurse or counselor trained in psychological support. Some hospitals like PMCH have palliative care teams that include psychological care.

Caring for the Caregiver’s Mind

Providing psychological support to someone is emotionally draining. If you are a caregiver, your own mental health matters too.

It’s okay to feel sad, angry, or helpless. These are normal reactions. Don’t bottle them up. Talk to someone you trust. Another family member, a friend, or a professional.

Take breaks. You cannot be a good caregiver if you are running on empty. Even a 15-minute walk by yourself can help you recharge.

Remember, you cannot fix their sadness. Your job is not to make them happy all the time. Your job is to be with them in their sadness. That is enough.

Psychological Support and Chronic Diseases

Many seniors in Patna already live with chronic diseases like diabetes and high blood pressure. A terminal illness on top of this can feel overwhelming.

The stress of a new, serious diagnosis can make their existing conditions worse. Blood sugar can go up. Blood pressure can become hard to control.

This is where trend tracking is so important. Don’t just look at one blood pressure reading. Look at the trend over several days. Is it consistently high? If so, stress might be a factor. Managing the psychological stress can help manage the physical condition.

Preventing Crises at Home

A psychological crisis, like a panic attack or a severe bout of depression, can be scary. Families often rush to the emergency room when this happens.

But with the right support, many of these crises can be prevented or managed at home. Having a plan helps. Know who to call. Know what medicines to give if prescribed for anxiety.

Sometimes, just knowing what to do can prevent a crisis. If the person feels panic coming on, a simple breathing exercise can help. A cool cloth on the forehead. A calm voice saying, “I’m here, you are safe.”

Home care services can be a big help here. Having a 24×7 helpline to call means you don’t have to make a difficult decision alone in the middle of the night. A trained professional can guide you on what to do.

Final Thoughts: Caring for the Whole Person

When we care for someone with a terminal illness, we have to care for the whole person. Their body, their mind, and their spirit.

In our focus on medicines and physical symptoms, we must not forget the person inside. The person who has fears, hopes, and a lifetime of memories. The person who needs to feel loved and valued until the very end.

Psychological support is not an extra. It is not a luxury. It is a basic part of good care. It is a kind and compassionate thing to do. It is what we would all want for ourselves.

Here in Patna, we are strong families. We know how to love and care for our elders. Let’s extend that care to their minds and hearts as well as their bodies. Let’s give them the gift of peace.