Empty Nest Syndrome

Mr. X and Mrs. X were admitted in COVID-19 Hospital with fever and cough. After 7 days, hospital authorities informed Mr. X’s son that Mr X has passed away. Mrs. X was not in good health either. Son from Australia arranged funeral services for father’s last rites. No one attended cremation ceremony. There was a feeling of constant worry for his mother lurking at the back of his mind added to a lingering sense of guilt for having left parents behind in India.

Thousands of Indians emigrate abroad every year: for higher education, lucrative jobs and better lifestyle. In this process they leave behind all that they wished to escape in India, but at the same time knowingly or unknowingly they leave biggest treasure – their parents. These are the folks who toiled away several years of their youth, spent a chunk of their retirement savings, took out loans and made sure they left no stone unturned to get their children their destination. It is on their stooped shoulder that children stand tall so that they can reach unimaginable heights. This is what most Indian parents do. They are often perceived as the lucky ones whose children fulfilled their dreams of leaving Indian shores and settling abroad. But between the broad smiles, behind the cheerful exterior and in those moist eyes lies an untold story- A tale of loneliness, anxiety, fear and uncertainty. The anxiety of being away from one’s children in time of illness and emergencies sets in. Moreover, worry for the safety and wellness of their children takes over their minds.

Simple chores and mundane errands like going to the bank, buying vegetables, fruits from market or paying a bill become a challenge. Going to the doctor or dentist becomes an ordeal. They are lucky if still fit and healthy to live on their own and if other children live close by. Otherwise parents may have to depend on neighbors, other relatives and friends. Then there is the social loneliness. No one to celebrate festivals with and no one to cook special meals. Such parents may come together forming kitty groups and meet up, alleviate some of the loneliness and share experiences.

Parents visit their children abroad and seemingly spend quality time with their grandchildren and all seems well. They are expected to look after the house, cook, baby sit the grand children and they dutifully oblige. But often parents are elderly and it is difficult to adapt to new surroundings where the lifestyle is different from what they are used to in India. Using strange gadgets and equipment around the house like a washing machine, dishwasher, using the cooking hob, wearing unfamiliar winter clothing-all become daunting tasks. Not being able to go out alone by public transport and being dependent on one’s children to go everywhere, is something that takes time to get used to. Not having any company of their age is another factor to come to terms with. The weather is the biggest adversary, especially when it’s bitterly cold compelling them to stay indoors for fear of falling down or falling ill. Ill health is a big worry as medical insurance will not pay for a lot of conditions and the last thing they want to do is, be a burden on their children in any way. Most parents bring along their medication from India for all the time they stay abroad and are constantly worried about their medicines falling short or if they need new medication. Spending time with grandchildren can be challenging too as they may not understand their ‘foreign’ accents and have a hard time communicating if the grandchild does not speak their language and they themselves speak limited English. One of my patient who was recovering from after effects of chemotherapy for breast cancer visited USA and stayed for 3 months to look after her grandchild. While she returned home, she remarked that she worked as a glorified Aya in USA. She did everything with a sense of duty. Although her duty was completed many years ago when children became adults and left their shores, leaving them to fend for themselves. But “Mool Sey Sood Pyara” meaning grandchildren are dearer than children.

What about son’s duty towards his parents? What does he give them beyond materialistic happiness and intermittent bouts of satisfactions? Making them a visa to relocate abroad is not always desirable, feasible or possible. Most parents prefer to stay on in India in their own homes, persevering independently until they can. It is too much to expect them to start their lives anew in a foreign land. They are happy for their children, proud of their achievements and watch their progress from a distance. Although, the fear of ageing without their children and uncertainty of how life will unfold is at the back of their minds, they will rarely, if ever, give the glimpse of this unease. There are no easy solutions for these issues. Children have made a choice of leaving their home and their parents. Having chosen this way of life, children realize that we pay a heavy price for our choices. They learn that money cannot buy their parent’s happiness. The least they can do is to be grateful and thankful that they have wonderful parents.

According to a Ministry of External Affairs report, there are 31 million Non-Resident Indians (NRIs) residing outside India. Advancing age and the loss of motor function makes performing day-to-day activities a daunting task, requiring care for senior citizens on a 24/7 basis. Question is how can these elderly be helped? The best old-age homes provide emotional comfort with dedicated caregivers helping out with everyday chores, scheduling appointments with doctors and hospitalisation when required. They get medical care, support services to do their housekeeping, laundry and transportation, a basic menu designed on their nutritional needs or customized food in case of illnesses. The moot point is, can old-age homes ever make up for the absence of their children? It is tough to adjust to an old-age home, to enjoy a level of comfort or intimacy. Loneliness is stressful for the elderly, with no family or relatives, more so during festivities. They can do much more for their parents, even without their asking. They can visit them frequently, make sure there is no “Empty Nest Syndrome” during vacations, spend quality time, ensure their safety and well-being, provide them trained caregivers, convince them to move close to better medical facilities, find suitable old-age homes. Emotional support in the form of frequent phone and video calls is necessary to make up for their absence.

The Indian joint family system is almost extinct; innumerable seniors are living alone, or with caregivers in old-age homes. This number will only grow, with more and more of them requiring old-age homes, caregivers, emotional support and continuous handholding.

Dr. A.K. Dewan
Director – Surgical Oncology