Age at interview
Age at start of caregiving activities

Madhu (72 years old) lives with her husband and other family members and has three grown children. Madhu has cared for her husband since he had a heart attack 29 years ago and he has recently undergone bypass surgery. Madhu’s mother had a chronic stomach condition that required surgery at two different times but she passed away following complications from the second operation. Madhu has had to make important work and lifestyle changes in order to adapt to her husband’s illness. She is now retired from her work as a real-estate manager but an active volunteer in multiple cultural organizations to help immigrants with their new life in Canada.

When Madhu was 42 years old her husband suffered a heart attack. At that time she was in charge of running her household, including the raising of their two teenage children. After three weeks Madhu’s husband was discharged from the hospital and advised to make lifestyle changes such as adopting a healthier diet and increasing his physical activities. Madhu was advised not to share any worrisome news with her husband. This advice changed her life radically: She was no longer able to share everything with her husband and, on top of that, she had to learn to live with increased levels of anxiety and responsibility.

Eight years later, Madhu’s mother underwent surgery for a blockage in her stomach. Her mother, who lived with the couple, did not speak English and was strictly vegetarian. Because of the language issue, Madhu spent a great deal of time at the hospital helping to facilitate communication between her mother and healthcare professionals. At the same time she also had to be home with the children and her husband and prepare vegetarian food for her mother at the hospital. This was a difficult period and Madhu was pleased to have her sister-in-law come over to support the family and share the work. In the four year period following this surgery, Madhu and her mother tried to find a balance between Madhu’s efforts to help with her care  and her mother’s efforts to do things herself.  Madhu’s mother passed away following a second surgery for similar medical problems. Madhu still regrets not having spent more time with her mother during her illness even though she had limited her own activities to accommodate time to provide care for her mother and husband.

Madhu is pleased with the medical care that her family has received in Canada and feels fortunate to be in a part of the world where she receives good care. As a child, she had fled Pakistan with her mother at times of partition and became refugee in India. After finishing schooling Madhu immigrated to Canada and got married and now has three children. In spite of the good medical care she has received, she has experienced periods of feeling isolated, missing the moral and community support that existed in India. Madhu increasingly worries about the limited availability of adapted healthcare services for people with another cultural background now that she is aging.

Madhu wishes that there were more opportunities for immigrants with a medical background to work or volunteer in the Canadian healthcare system. This way, medical professionals from India would get the chance to get to know the Canadian healthcare system and, at the same time, healthcare professionals would learn more about cultural issues with regards to providing medical care for particular ethnic and immigrant groups. Madhu values the Canadian healthcare system and makes great efforts to improve it, contributing to improving other people’s situations is her own way to give back to society.


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But slowly you learn it was fear. The first few nights, I could not sleep when he came back home, that it might something happen. So it was a very scary situation. I didn’t know […] what situation is really kind of…what you call…most serious, because you do get some kind of pain and chest pain, but they didn’t do a surgery that time, there was no surgery was done.

He will still today, if he goes somewhere and takes the car and go to do things, if he’s not home for a couple of hours or if he’s taking more time, I have a fear. It still comes to me. I hope everything is okay. And now we have a cell phone, so give him, but if for some reason you have to go somewhere else at least give me a call. So those things were not there in the 80s.

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Well, the only thing is don’t tie everybody with the same rope. Everybody deals with different way, and, I mean, we have excellent doctors, we have excellent care, but [from a] culture point of view, sometimes they don’t understand. I mean, I’m vegetarian. Last time when I was in the hospital a few years back, I had some breathing problem and all—I think I got a virus or I don’t know what I had, but I was in the hospital for two weeks. As soon as you say “vegetarian,” food is a big problem there. They will just give you a salad or a just piece of one roll and that’s it. So vegetarianism, I think, is another education. Now, what we are learning healthy food what we are eating. Meat is not the only thing really that keeps you healthy. There are other people living also, and as we call vegetarian or some other restrictions. I think this was… they just did not understand. Like, “What do you eat?” Every time I have a people that are asking me question: “What do you eat then? If you don’t eat meat, then what did you eat?” I say, “You people were like this in the 60s when I came with this question.” When I came in 62 in Canada and people thought I cannot live if I don’t eat meat because it is a cold country. And I say, “Okay, when I am about to disappear, I will think of, but right at the moment I don’t feel like eating meat.” And I am still vegetarian. I have lived so long. So, I think that is… I mean, that they are having really in the hospital, as soon as you use that word, you just get salad and live with it.

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Well, sure. It is very rewarding. Rewarding means that when you see the progress that the patient is making, right? Well, that’s very rewarding. Of course, it’s mainly on medication or the system, but [also] how the family or caregiver have helped the patient. You can see the signs on the patient’s face. Keeping them happy; if you could do that and, I think, you feel good that whatever we are doing we are doing right, right? It is rewarding, sure. I mean and as an end result, it will sum up of course unfortunately [that] the patient does not improve with certain kinds of sickness, but others of course with time they feel better, and so that makes you happy. And that’s what I feel.

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Oh life lesson? Be very happy, be positive. I’m always happy. People say, “You laugh a lot,” and I say, “Why should I cry?” […] I think, be happy, make others happy, give back to the society, because somebody helps you when you need help. Somebody [is] always there, right? And we should also try to give back to the society when others need help. So whatever little we can do.

[…] And be happy. We are very lucky, we are very fortunate where we are. And look what’s happening around the world. People are living in camps, refugee camps and killing each other and we are in the, we are very fortunate where we are and we should always be happy. Try to help whatever little one can do to others, at least offer.

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So that was part of my culture, I mean, so that’s our duty. My sister-in-law came from USA to help when my mother was in the hospital. I never even thought of that I could go out to get any help for her. I say, “Well, we are supposed to give help.” That’s all I knew, that’s all I knew at that time. But the moral support, I think, I was looking somebody [who] could come and talk, or even if, whether I’m doing a good job or not a good job or anything more has to be done. Somebody else has to tell you sometime. You cannot be your own judge. So that is moral support. “Okay yeah, this is okay. This, maybe she would like. You can do this,” or even little things makes lot of difference. That sometimes I miss because the culture I come from, neighbours come. There are more relatives. You have so many relation your mother’s side, father’s side, cousins, their family. So, they all come and sit with the patient and give you little break or moral support—that was missing here. And that really I felt, I wish I had more family members here.

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I still think, looking at that situation, that if any one of us, if we reach to that situation where we need constant help, so how we are going to manage? Our children are away, being a small place—all of our community’s case—they are not in [city in NB]. They are all away working, I mean, they are highly professional. So how they are going to look after us from that far? For us, going closer to the children also is not answer because they are so busy. They have their own lives, their own children, and so going there we lose our network, our friends with whom we have lived at almost 50 years. So it becomes very difficult for new immigrants. What I feel [is that] you can’t leave the town where you lived so long, and then what you need is your family and family’s not there. And our network is very small. Some of those people are already, they are sick at our age. Some of them are already gone; they are no more.

So, I am really concerned about the senior situation in small centres, in the nursing home or in a retirement home, what type of care we will get here. Luckily, I can speak English; I have no problem, but there are people who do not speak English. Or if one gets—oh God knows what we get’if you’ve got Alzheimer’s, […] the second language disappears. [The] only language you can speak is your first language, which you learn your mother tongue. And here, if that situation comes, who is going to understand you, or who is going to take care of you? So, this is a concern. I mean, we don’t know what happens after 10-20 years, 10 year or 5 years, nobody knows the future. But my concern is that, I want to say that that we must look into these issues. When we are having immigrant populations and when they are senior, when they cannot take care of themselves, whether the system is ready to serve us. [Do] they have facilities? There’s not only medical facilities, but moral support. Friends, or community? Do we have that to look after us? So, I think that’s my concern.

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My education was only through my doctor. But they told me how to take care. “Life,” he said, “well your lifestyle will be very different”, and certain medication he has to take which he never had before—also taking care of the food or lifestyle. I think those days especially, they advised me [to] cut down all the fats in your food, and salt, and sugar, and all kind of stuff, which was new all of a sudden because we never had any such problem. But this was a serious matter […] after heart attack. He was 3 weeks in hospital, and when he came home, it was kind of a difficult time because I didn’t know what to do, how to take care [of him]. But, I heard that he should not be getting any exciting news to excite him or worry him. So this becomes really hard with the kids when you cannot even talk. Anything that you want to share, which might affect him, might deteriorate the situation. I think now the heart attack patients are different, but those days the situation was really different. We were told not to talk [about] this, not to talk [about] that. All of a sudden you are not [only] taking care of the patient, but also the children just by yourself. We were not [even] telling [him] if the children [had] some problem in school. […]Raising teenagers, you have to do all that yourself. But slowly you learn it was fear. [The] first few nights, I could not sleep when he came back home, [because I was worried] that something might happen. So it was [a] very scary situation. I didn’t know what situation is really […] most serious, and because [he would] get some kind of pain and chest pain [although] they didn’t do a surgery that time. So, you don’t know at what time, what is the more serious, [and] what is a less serious. So, [when] any little thing happened, I was calling the doctor, [or more often] taking him to the hospital. But then you learn that these symptoms are not as serious. Making the decision, which [symptoms] are serious, and which are not serious was a big responsibility on me.

Text transcripts

But anyway, after the six weeks or so, we came home and I think when I came to [a city in Maritimes] I was feeling a bit better because my doctor was here, and if [the] need arise, I can take him to the hospital. There we were completely cut off. So slowly, he was recovering and other thing [that] I have seen [is] they give you more medication. He started like blood pressure medications—he was taking [medications], but the doses were kind of a small dose. And then he just started the cholesterol level to reduce, though he never had high cholesterol. And then the muscle pain started, and we… more