Gold Award Winner — Think Piece Category
IFP 50-Hour Writing Challenge 2026
Theme: Cause Without a Rebel
Writing for me is a stress buster and definitely therapeutic. Some of the most difficult moments in my life have found their way to pen and paper, and many a time I have resolved them through writing. So, when the IFP Writing Challenge was announced, and the theme shared - Cause Without a Rebel - I brought to mind various themes close to my heart. Each of them was recognisably a cause. They were issues that most people would agree deserved attention, and just when I started to put my thoughts into words, my mother called out in pain. She needed my help.
I put my pen down and went to her. It was an ordinary interruption. Just not the way I put my pen down – with a flash of hurried aggression. The behaviour was foreign to me, and that realisation unsettled me even more.
When I returned, I looked at what I had written and struck out everything. The cause I wanted to write about was not something outside of me. It had appeared briefly in the hand that set down the pen—and had been silenced by the caregiver in me who rose to help.
I picked up my pen again and wondered if I was doing the right thing. Would my family read it as resentment? Am I guilty of turning a personal reaction in the moment to public grievance? The fact that I rejected the "cause' for fear of appearing selfish was a case in point that caregiving IS a CAUSE.
By mid 2019, I moved in with Amma. Dad was in poor health, and Amma was caring for him almost single-handedly. Truth be told, Dad was soft-spoken and very accommodating with his siblings and parents. But with his wife and children, the stubbornness was at a different level. All the more, his dependence on Amma was evident. She was the one person around whom he felt safe and secure.
My moving in upset him. Perhaps he felt guilty. He was convinced that his illness had come in the way of my independence and social life, and repeatedly tried to persuade me to go back. I asked him a simple question: “Amma is there for you. But Dad, who is there for Amma? What if she needs help when helping you?” It was like a lightning bolt struck him. He went silent. Not because he disagreed, but because he recognised the truth in that question. More of recognition. It was me giving voice to a reality that had perhaps lost itself amidst the everyday routine of care and more care.
For the first time, my mother did not flinch or insist on her independence. She smiled, looked at my father, and that was an indication that the matter was settled.
I could not do much for him in his illness or for her in the responsibility of caring for him. I could hold Amma’s hand, get her what she needed, and be there for her. I could make sure she wasn't carrying it alone.
My father died in the latter half of January 2020, a few months before the COVID lockdown. Much later that year, while speaking to a friend who had come to offer his condolences, I heard myself say, “Thank God he died before the lockdown. He wouldn’t have survived it.”
I was shocked at what I said and even more so when my friend said, 'I understand'. That one spontaneous outburst from me was unlike me. I questioned my integrity. Was it relief speaking? Was I relieved that Dad didn't have to go through the terror and isolation of the lockdown? Relief that my mother didn't have to care for him through COVID? This shock took the form of guilt and then shame.
In retrospect, I realise that caregivers are not only responsible for managing another person's suffering. They watch their own thoughts. And these thoughts are, for them, evidence that they may not be good enough. And today, I was that kind of a caregiver. Questioning myself, my integrity and my commitment.
Today, yet again, I see myself in that same chain.
In the last couple of weeks, Amma's BP began swinging from one end of the pendulum to another. High to very low. Convincing her to see a doctor was an effort of a different kind. The next 24 hours were a series of consultations with doctors and diagnostics. Several tests later, we got a report with the words 'grossly normal' written on it. Seriously? And was that supposed to make me feel good? Was that reassurance of some kind? The symptoms were still visible, so how was that reassuring at all?
Amma looked at the words 'grossly normal' and giggled. She covered her embarrassment by calling herself a “drama queen.” I guess she needed the moment to become lighter. Let's remember one thing - clear reports do not necessarily clear a caregiver’s mind!
Then came the debate, or should I say argument, with regard to her medication. If she took the prescribed medicine while her pressure was low, would it fall further? If she did not, what if it shot up again?
“I don’t think I want to take this,” she snapped.
Seconds later came the frightened reversal: “But what if it shoots up again?”
The doctor could prescribe, and reports reassure. The patient may change her mind. At home, someone still had to decide whether to take the tablet in her hand.
The caregivers chain, incidentally, travels across cities for me. My aunt, someone I care deeply about, lives alone, is recovering from cancer and guards her independence fiercely. She panicked on noticing blood in her urine, but waited nearly two weeks to tell us.
My concern took the form of anger within minutes – sadly, an anger that I couldn't give voice to, and then translated into guilt. She is single, suffering, frightened, and alone. This is not fair of me. Perhaps she was just trying to gain control of her life in ways that only she understood. So, I picked up the phone, pushed my anger out, and spoke to her in a manner that any "good girl" (sarcasm intended) was taught to do.
At this point, let me tell you that the one skill that we as caregivers quickly pick up is the art of staying calm and translating panic to a well-crafted smile! And that is exactly what I did. The smile is short-lived, though. The panic and frustration have to make way for some behaviour, and the smile and silence end for reasons that are ridiculously inane. As a caregiver, I can stretch my patience through ERs, wait outside ICUs for some 'good news', take work calls while en route to clinics and hospitals, and communicate work-related decisions with absolute clarity while cooking. And then one day, something happens.
It could be as simple as your wi-fi is off and your internet stops working. You realise that the ONLY way to connect with the outside world is through the internet, and all hell breaks loose.
The router is restarted with unnecessary force. Anger is unleashed upon the service provider, the electricity board, the government, inefficiency in general and, best of all, the airwaves.
There is an irony in it. Electricity and the internet are the infrastructure of connection. Their brief failure exposes another connection that has been weakening for much longer—the one between mind and body. The mind keeps saying, “Carry on.” The body responds through exhaustion, irritation, sleeplessness and the longing to escape into deep sleep.
The external connection fails for ten minutes. The internal one has been failing for months.
The word “cause” usually evokes something larger than the home. It belongs to protests, petitions and public campaigns against an identifiable wrong. A cause has a demand. It often has a slogan. If it is fortunate, it finds a rebel.
The India Against Corruption movement demanded a Jan Lokpal. It brought people together at Jantar Mantar and Ramlila Maidan, and found its defining figure in Anna Hazare. It also brought Arvind Kejriwal into the national limelight. More recently, the anger surrounding NEET brought students onto the streets, with Abhijeet Dipke emerging as a recognisable face.
Such movements are never ever the work of one person. Yet public memory prefers to put a face to a cause. A rebel helps us recognise the cause. The cause, in turn, creates the rebel.
Caregiving offers none of these conveniences. To begin with, there is no villain.
At the risk of some melodrama, it resembles one of those old black-and-white films: the sole breadwinner, the mother perpetually slogging in the kitchen, the father coughing in bed and the younger sister waiting to be married. 3 Idiots played with the trope beautifully through Raju Rastogi’s home.
There is suffering, sacrifice and one person expected to hold everything together.
The caregiver is not a victim—or refuses to be seen as one. The person requiring care is vulnerable and loved. Nobody formally appoints the caregiver. The need appears, someone responds and, before the family has discussed it, a role has been assigned.
Empathy is not the missing ingredient. Families need the work of care to be recognised and shared. Support comes naturally. It may even feel effortless—until it does not.
Exhaustion is often treated as failure. It means that, as a caregiver, I am not eating well, not sleeping enough. In short, I am not taking care of myself. My fatigue indicates poor self-management, not the result of carrying this torch of caring for too long. The day I accept the self-evident truth that providing care comes at a cost can sound like an accusation against the person who needs it.
At the age my siblings and I have reached, we see this everywhere. Every friend has an ageing or unwell person who needs care. Our conversations are an exchange of war stories - all related to hospitals, medicines, emergencies, stubborn parents and the impossibility of being in two places at once.
We tell ourselves that we are venting. When in truth, it is a lot more than that. It is, in fact, a sense of relief that comes from discovering, “I am not the only one.” That relief, in fact, carries a second truth. If this struggle is the story of every second home, clearly it cannot be explained by one individual's inability to cope.
A private burden that is widely shared, systematically ignored, and unequally carried IS DEFINITELY a cause.
The vulnerable person is not the villain. Neither is the caregiver. But a story doesn't need a villain to show injustice. Sometimes the antagonist is an assumption. It's a belief that love will provide limitless labour, families will somehow manage, and the person doing the caring will ask for nothing.
India’s elderly population is growing rapidly. The India Ageing Report 2023 places its decadal growth rate at approximately 41%. People over sixty are projected to constitute more than 20% of India’s population by 2050. By 2046, they may outnumber children below fifteen for the first time. [UNFPA–IIPS, India Ageing Report 2023]
While we count those who will need care, we pay less attention to those expected to provide it.
Among Indians aged fifteen to fifty-nine, 41% of women performed unpaid caregiving for a household member on a given day, compared with 21.4% of men. Among participants, women spent approximately 140 minutes a day providing care; men spent 74 minutes. [MoSPI, Time Use Survey 2024]
A 2019 HelpAge India study found that 29% of caregivers experienced a moderate-to-severe burden and 15% experienced a severe burden. More troublingly, 25.7% believed fatigue and frustration led to aggressive behaviour towards the older person. [HelpAge India, Role of Family in Caregiving: Challenges and Responses, 2019]
These findings take me back to the moment when I put down my pen rather too forcefully, and my anger was directed at an innocent router. There is no excuse for aggression or neglect. They simply warn us what unsupported care can eventually become.
What, then, does “family care” mean to the healthcare system?
As soon as medical intervention is complete in the hospital, the patient is discharged, and Family care takes over. This literally translates to several concerned people waiting at home or by the phone, and giving tons of advice from experience to the one caregiver tasked with managing medication, monitoring symptoms, and recognising any deterioration.
God forbid, if the family is just one person. Family care, then, is just plain fiction (even science fiction!). An alternate universe that permits an ageing population to be cared for by a supposedly dependable structure. Hospitals discharge the patient, and most often the family structure is one woman, often unpaid, insufficiently prepared, not at all trained, and expected to absorb all the physical and emotional strain of that responsibility.
The system works because someone in every family agrees to become the system.
Healthcare must first recognise that person. Many of us no longer have a family doctor who knows the patient and the family’s history. We enter an OPD, see the available doctor and carry the medical story from one specialist to another. Once home, when symptoms and prescriptions conflict, we turn to Google and, increasingly, AI.
The family doctor once remembered the family. The search engine remembers the query.
Technology can explain terminology. It cannot always connect medical history, current symptoms, personality, fear and home circumstances. If healthcare transfers responsibility to a caregiver, it must also provide continuity, clear guidance and a reliable point of contact.
Employers must recognise eldercare too. Childcare has at least entered workplace conversations. Eldercare is still managed through annual leave, private explanations and the goodwill of an individual manager. An ageing country cannot pretend that its workforce goes home to households in which nobody needs care.
Care must also be shared beyond siblings and extended family. Caregivers need counselling and peer-support groups. Most families need affordable, trained home-health assistance. Older people living alone constantly need reliable community-level emergency support. The primary caregiver needs respite without having to prove that a few hours away are necessary.
There is a proverb: it takes a village to raise a child. Clearly, we expect one woman to care for the village when it grows old. The problem was never family responsibility. It was the assumption that the responsibility is limitless, done by one person, and of course unsupported
I remember telling my siblings, “When I worry, you worry.” It was me offering reassurance - telling them they could relax because I was watching over Amma.
In that one utterance and promise, I had taken responsibility for deciding when worry should begin.
But when should I worry? What signs must I recognise? I now worry that I may not know when to worry; and with this I assume the responsibility all over again.
Even after everything I have written, I remain willing to carry the responsibility. I will continue checking, calling, accompanying and doing what needs to be done. Writing has not made me reject responsibility. It has made me question why accepting it should mean accepting it alone.
Perhaps care needs something as ordinary as a carpool. We share journeys to reduce cost, conserve fuel and make them easier. Caregiving is also a journey, but we allow one person to drive until she is too exhausted to continue.
I continue to hesitate to call myself a rebel. The word suggests someone brave, loud and more certain than I feel and am. When I finish writing this 'thinking piece', there will still be medicines to check, calls to answer and decisions that cannot be postponed merely because I have found a conclusion.
My only visible rebellion will perhaps remain that one moment when I put my pen down with more force than necessary. I became aware of it, felt ashamed and went to help. But when I returned, I did not pretend it didn't happen.
Some may call this tiredness, others resentment or selfishness. But if, as a caregiver, I must remain silent to prove that I love, then silence itself is definitely part of the problem.
I am not asking for permission to stop caring. All I need to know is why it should require the caregiver to disappear. Not every cause needs a heroic rebel. Sometimes it needs just one ordinary person to stop cooperating with the silence.
I do care.
I will continue to be a caregiver.
But I need not be here alone.
The last caregiver in the chain should not have to break before someone asks who is caring for her.
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© 2026 Dr. Anuradha Rao. All rights reserved. This article may not be reproduced, republished, translated or adapted without prior written permission, except as permitted by law. Brief quotations may be used with proper attribution and a link to this original article.
