A terminal illness is a disease that cannot be cured and is expected to lead to death, usually within months or years. It includes advanced cancer, late-stage heart failure, ALS, kidney failure, and certain brain diseases. But the diagnosis impacts more than the patient, it changes the mental world of everyone around them.
In South Asia, we live in joint family systems where caregiving is a shared but often overwhelming responsibility. The focus isn’t just on treatment but also on making the remaining time meaningful, even if no one knows what to say or how to act. And because death is often a taboo subject, people struggle with understanding what to do or how to feel.
For most, it begins with shock, a kind of numbness that makes it hard to even register the reality. After that, it becomes a mix of doing the chores of care and silently carrying the fear of loss.
The Emotional Journey: From Shock to Acceptance
When a terminal diagnosis is announced, the brain goes into defense mode. Emotions swing in all directions: denial (“This can’t be happening”), anger (“Why us?”), guilt (“Did we miss signs?”), and sadness.
One woman from Lahore shared, “When my mother was told she had pancreatic cancer, I stayed strong in front of her but cried every night alone. I couldn’t even tell my kids because I didn’t know how to explain.”
This is common. In South Asian families, grief starts early, even before death. Psychologists call it anticipatory grief, mourning someone who’s still alive. It’s filled with confusion, especially when you have to act normal at work or for children.
The road to acceptance doesn’t come with one moment. It arrives slowly, when treatments stop, when the patient says, “I’m tired,” or when you realize you’re counting weeks.
Daily Life Changes and the Weight of Caregiving
In most Pakistani households, hospice care isn’t available, so family members take on full-time caregiving. This includes:
Bathing and feeding the patient
Giving medications
Managing pain
Staying awake at night
Handling house chores and children at the same time
A 22-year-old student from Multan shared, “My father had liver cancer. I dropped my semester and took care of him. At times, I hated my life. But now, I feel grateful I was there when he needed me.”
Caregiving is an act of love, but it also brings burnout, stress, and loneliness, especially when caregivers get no emotional support. Many people also feel guilty for being tired, not knowing it’s okay to feel that way.
The Role of Faith and Culture in Coping
In our culture, religion becomes a lifeline during terminal illness. Many families find strength in Islamic teachings, Hindu mantras, Sikh prayers, or Christian verses. Whether it’s praying for a miracle or preparing spiritually for death, faith gives meaning to suffering.
One man from Karachi said, “My sister had breast cancer. She knew she would die. But every morning she read Surah Yaseen and smiled. She gave us strength.”
Cultural norms also shape coping. In many households, showing emotions is seen as weakness. People hide their pain, especially men. But this emotional suppression can lead to mental breakdowns later. That’s why open conversations, even through religious or cultural lenses, can ease the emotional load.
Real Stories: Voices from Families Who Faced Terminal Illness
Here are three anonymized but true stories shared by readers from Pakistan:
A Daughter’s Love (Lahore)
“My mother had ovarian cancer. I was her caregiver. She said, ‘I don’t fear dying, I fear leaving you.’ After she passed, I felt broken. But also peaceful, because we had said everything we needed to.”
The Silent Father (Hyderabad)
“My father had lung cancer. He didn’t talk about death, but he made sure his will was ready. On his last day, he held my hand and said, ‘Be kind to your siblings.’ That became my life goal.”
he Youngest Son (Faisalabad)
“We never told my 9-year-old brother our mother was dying. He thought she was ‘just sick.’ After she died, he cried for a week and then asked, ‘Is she sleeping with the stars?’ We said yes.”
These stories aren’t just memories. They are proof that pain and love can co-exist.
How to Cope: Psychological Tools and Tips
If you or someone you love is facing terminal illness in the family, here are ways to ease the mental and emotional load:
Emotional Support Tips:
Talk openly: Don’t hide feelings. Let sadness, fear, or anger come out.
Create a memory journal: Write about or with your loved one.
Make time meaningful: Even short conversations or laughs matter.
Accept help: Let friends cook meals or babysit.
Speak to a counselor: Even one session can bring clarity.
Daily Coping Tools:
Take deep breaths when overwhelmed
Keep a short daily routine (2–3 non-medical tasks)
Set one quiet time for prayer or reflection
Join online or local support groups
Remember, you don’t have to be strong all the time. Being present is enough.
When Children Are Involved: Explaining Illness to Young Minds
In many South Asian families, children are kept away from sickness and death. But they notice silence, tears, and closed doors. They feel left out.
Experts suggest:
Use simple, honest language: “Grandma is very sick. The doctors can’t make her better.”
Answer questions calmly, even if it’s hard.
Don’t lie (“She’s going on a trip”), it creates fear of abandonment.
Let them say goodbye in their own way, a hug, a drawing, or a prayer.
A child psychologist in Islamabad said, “Children grieve too, but they heal better when they’re included.”
Finding Meaning in the Pain: Life Lessons After Loss
Losing someone to a terminal illness leaves a hole. But over time, many find a new purpose:
Some become mental health advocates
Others support cancer patients in hospitals
Many just become kinder, quieter, more grateful human beings
A man who lost his wife shared, “I still talk to her picture every night. But I also started helping orphans in her name. That’s how I survive.”
Grief doesn’t end. It changes form. And it often teaches us what really matters.
TL;DR
Coping with a terminal illness in the family is a deeply emotional journey filled with shock, caregiving stress, and gradual acceptance. Faith, family support, and emotional expression play vital roles in healing. Real-life stories from South Asia show how people find meaning, strength, and peace, even in the face of losing someone they love. Whether it’s through caregiving, prayer, or quiet reflection, healing begins with honesty and connection.
Imran Shahzad, M.Sc. Psychology (BZU, 2012), shares real-world mental health tips and emotional guidance in simple English for everyday South Asian readers.