When Your Loved One Falls Ill …

Dr. LIAO Wei Ming, Carmen

Honorary Consultant in Psychiatry

Specialist in Psychiatry

A retired high school teacher in her eighties, Mrs. Chan had always been in robust health and full of vitality. She still tutored her 14-year-old granddaughter, often sharing heartfelt conversations with her.

During holidays, Mrs. Chan enjoyed warm family gatherings with her daughter’s family, sharing meals and joyful moments. She managed to stay in good health, keep her mind sharp and age gracefully with a balanced diet, regular sleep, and daily tai chi.  

However, Mrs. Chan began to experience abdominal pain and constipation early last year, sometimes even 10 days straight. It made her unable to eat, even feel nauseous and unwell.  She was diagnosed with rectal cancer during an urgent hospital visit, as CT scan showed that a large tumour was causing bowel obstruction near the anus, and had already spread to the liver and lungs, i.e. the advanced stage.

Well aware of her age, Mrs. Chan did not opt for major surgery after careful consideration. She chose to let nature take its course and live with the tumour, only undergoing colostomy as a palliative measure.

It was a blot from the blue to Mrs. Chan and her family. Despite much persuasion and discussion, she refused further radiotherapy or chemotherapy. Her family respected her wishes, and determined to help her live out the remaining days as comfortable and peaceful as possible.

One Person’s Illness, A Family’s Sorrows

The family was in deep sorrow, as Mrs. CHAN, once able-bodied, had become bedridden and in need of constant care within a few weeks. Obsessed with negative thoughts, Mrs. Chan saw her life as a burden to her loved ones, rife with suffering and devoid of hope, and wanted nothing but an early end. Drained of spirit, she preferred to withdraw from social life and lie in bed,    awaiting her final rest.

As a doctor, Mrs. Chan’s daughter felt heartbroken and guilty for not being able to do anything about her mother’s condition. All these memories turned into waves of tears and pain in the stillness of night. Nothing was more important than caring for her mother: she rushed home after work to monitor her mother’s temperature, blood pressure, heart rate, blood sugar, and oxygen levels, not to mention checking with the caregiver about her mother’s diet and mental state. She could not help thinking that her mother might get worse if she failed to take good care of her. The anxiety kept eating away at her, and  gradually became caregiver stress.

Fortunately, Mrs. Chan’s daughter enjoyed great support from friends and colleagues, who checked on her and  listened to her struggles. It helped her navigate her emotions and overcome challenges ahead.

Meanwhile, Mrs. Chan’s granddaughter was devastated by her grandmother’s sudden illness. She could not help crying, now well aware of how close yet far death could be, and how fragile life is. Witnessing her grandmother’s decline in health and her mother’s attention divided, she began to feel the weight of grief. She also worried about her mother’s ability to cope with the pressures of caregiving, sometimes feeling anxious and fearful about losing her loved ones.

Turning Sorrow into Strength

Noticing her granddaughter’s emotional turmoil, Mrs. Chan began to discuss with her the value of life and the reality of loss. It helped them both process their feelings. Her granddaughter also managed to learn some nursing skills while taking care of Mrs. Chan, such as changing colostomy bags, and discovered the joy of giving and helping others.

Community nurses also paid regular visit to Mrs. Chan’s home to assess her mental and physical needs. Mrs. Chan was able to adjust to the new reality over time, and witness the growth of her granddaughter, embraced by the love and care from all around her. This also helped Mrs. Chan rediscover her own worth and find new meaning in life. She began to feel grateful and find peace within, realising that her presence also gave her caregivers some purposes.

Safeguard Mental Health Despite Vicissitudes of Life

As the population ages, the situation faced by Mrs. Chan has become more common. The mental health challenges brought by physical illness and life stresses can significantly impact both patients and caregivers.

While all these negative thoughts are natural and typical reaction during the adjustment process, they may also be early signs of depression. Mrs. Chan’s family also needed to go through the adjustment period while bearing the pressure of caregiving, which can lead to varying levels of anxiety and depression.

Typically, the adjustment period may last from a few days to weeks after a major life change, with emotional fluctuations being normal and often gradually subsiding through self-regulation. However, if anxiety or depression becomes frequent, intense, and persistent—accompanied by irritability, mood swings, or physical symptoms like headaches, stomach pain, chest pain, insomnia, or weight loss that disrupt daily activities, thinking, and normal life—it may signal a mental health concern requiring attention.

“Mental Health First Aid” involves identifying individuals in emotional crisis and providing initial support before professional help is available. This approach aims to alleviate pain and distress, prevent worsening of mental health, and ensure the safety of the individual and others. Early and appropriate support can play a critical role in preventing deterioration during the initial stress response.

If you notice someone struggling with mental issues, it is of utmost importance to show care and concern for them even in seemingly hopeless situations, always ready to listen and support whenever they are willing to open up. We need to first validate their emotions with empathy, and allow them to articulate their pain and stress at ease and at their own pace.  Try to provide related information, and if necessary, seek referral to appropriate organisations or healthcare professionals, can also help prevent further decline in mental health and resolve crises in a timely manner.