By Bhuvanaa Shreeram

A cousin is going through a heart wrenching dilemma. A dedicated son and a senior management executive in his late 40s, he is facing a challenge that mirrors what many families are going through today.

His 75-year-old father, once a vibrant and independent man, has been diagnosed with a terminal illness. Medical bills are piling up and all of his parent’s savings and insurance resources have been used up. His son is going for masters to the US in 3 months and his daughter is preparing for her 12th grade board exams. With a sister in the US, he and his wife are the sole care takers. He is wondering if he should dip into his retirement savings to pay for some new treatment the doctors are suggesting. This might extend his father’s life a bit but with no guarantee of reversing the illness or even improving his quality of life.

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What should he do?

This story isn't unique to just this cousin of mine —it is becoming the narrative of an ageing population grappling with the promises and pitfalls of modern medicine.

Health Conditions - Then and Now

We were reflecting on how quickly the golden years his father had anticipated has turned into a prolonged twilight of medical appointments, treatments, and growing dependency.

Dr. Atul Gawande’s observations in "Being Mortal" came up a few times and resonated deeply with us. Gawande discusses the transformation in life's final chapters over the years — how, in the past, individuals lived healthily until their swift decline and quick death. But today, medical advancements have created a protracted phase of morbidity. Many fall ill in their 60s, linger through a decade or more of serious health issues, face an extended period of intense, often invasive, medical interventions till death happens in the 80s.

Modern healthcare delivers a long life, yes - but at what cost?

The Financial Strain and Emotional Toll

The emotional toll on families is profound. Children in their prime working years, like this cousin of mine find themselves torn between the dual demands of supporting their ageing parents and managing their own lives and careers. The financial strain is equally daunting. Studies highlight that the most significant healthcare expenditures often occur in the final year of life. Every decision to approve another treatment is a decision about resource allocation, often driven by emotion.

What really is the point of it all? Who is it helping?

The result as we witness is not just financial depletion but emotional exhaustion as well. Families watch their loved ones not just fade away and stay as fond memories, but linger on in states that neither honour the life they lived nor offer solace to those left behind.

What could be solutions?

No perfect answer and a few balanced, practical and humane ideas here :

• Long-Term Care Insurance: The US has insurance policies similar to term plans that provide for regular payouts in case someone lives beyond a certain age. We have no such policies in India yet.

• Assisted Living Facilities: Living facilities that provide for comfort, medical attention and nursing care in an environment that celebrates life.

Dr. Gawande mentions in his book the story of Dr. Bill Thomas and the fantastic work he did with Chase Memorial Nursing home, New Berlin in 1991. He attempts to address the “Three Plagues of nursing home” life: boredom, loneliness, and helplessness. He sets up a facility with two dogs, four cats, and 100 birds.

• Living Wills: How about making Living Wills mainstream? This would empower patients to make decisions about their own health care when they are still of sound health and mind. And in the process, relieve their families from making painful decisions during emotionally charged moments.

• Acceptance Orientation: Every individual and family will benefit greatly from some sort of spiritual guidance that will help them live with acceptance and embrace the finality of life with peace and grace.

Conclusion

This is a reminder of the need for a shift in how we manage the intersection of health, ageing, and care. It calls for a thoughtful approach that respects both life and the inevitability of death, ensuring that the final years can be lived with dignity and meaning. The challenge is not merely medical or financial but fundamentally human—how to honour our loved ones' lives and legacies in ways that resonate with respect, love, and dignity.

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(The author is a certified financial planner, co-founder and head of financial planning at House of Alpha Investment Advisers Pvt. Ltd. Views expressed are personal and do not reflect the official position or policy of Outlook Media Group and/or its employees. The article is for information purpose only; please consult your financial planner/s before investing.)