Children Uphold Parental Care Traditions

On April 15, 2025, renowned urologist  Uttam Kumar Sharma diagnosed a 75-gram prostate gland, large enough to block urine flow. The family was urgently notified that the prostate required reduction to 17-25 grams to avert serious complications. Their level of concern increased considerably. A lightning message travels to the USA, where three daughters eagerly wait for the message. With the message now read and understood, three sisters put their heads together, and a unanimous decision is reached that the eldest sister, Sheela Chand, must represent them in Kathmandu and attend to their sick father. That father is me. 

She arrives in Kathmandu on 10th May 2025. After a day's rest, she turns her attention towards the hospital. She assumes the role of a "chargé d'affaires" for the family with her sick father lying on the hospital bed where he is now waiting to be taken to the operation theatre. Prof. Dr. Uttam Kumar Sharma did the operation, and to everybody's satisfaction, it was a great success. The story does not end here. It begins from here! 

A story like this showcases how fast children living and working abroad react to any health situation that befalls their parents and the like at home.  Now, the question arises as to what degree children should assume responsibilities towards their parents in sickness and how they feel about this. 

Children studying or working abroad could experience a mix of emotions when their parents fall seriously ill. 

Many may take deep concern and guilt for being far away from home, and some may also struggle with frustration and helplessness, especially if they are overwhelmed by academic or job pressures. Another difficulty in providing direct support can be the distance, leading to feelings of isolation or resentment toward the situation rather than the parents themselves. 

Also playing a major role are the cultural expectations, with some children feeling a strong duty to return home as fast as possible. In contrast, others could be encouraged to focus on their studies despite personal distress. It is of utmost importance to take note of individual personality, family dynamics, and the level of communication between the children and their parents. 

Children often play a crucial role in supporting their parents during serious illnesses.  Many factors influence this, including cultural expectations, financial stability, healthcare access, and family dynamics. Some parents may rely heavily on their children for emotional and physical care, especially in cultures where filial duty is deeply ingrained. Others may have alternate support systems such as extended family, professional carers, or community resources. In societies with strong healthcare infrastructure, parents may receive medical and social support that reduces their reliance on their children. 

In Nepal, this may not always be possible because parents heavily rely on their children, or, in one way or another, someone has to come and take care of them, for example, taking them to the hospital for investigations and, if need be, an extended stay in the hospital, which entails a very strong sense of duty of children towards the parents. 

Ultimately, the level of dependence varies, with some families striking a balance through intergenerational living arrangements while others navigate these challenges from a distance. 

There is also good news for children from their parents because they do not have to rely solely on the children alone when they fall sick. The level of dependence varies based on cultural norms, financial ability, healthcare access, and family setups.

Some parents prefer maintaining independence, relying on medical professionals or social networks, while others find comfort in family care. 

Intergenerational living arrangements can offer a balanced approach, allowing parents to receive support without overwhelming the children. So far as intergenerational living in many traditional societies is concerned, elderly parents live with their children by sharing constant care and emotional support. There are still common places like Nepal, India, and parts of Africa where urbanisation and migration have led to the decline, making caregiving even more challenging. The other aspects are migration and long-distance care. I mean to say that many families today are spread across different countries and continents. In cultures with strong family bonds, like Nepal, children may feel compelled to return home when their parents fall ill. Others rely on video calls, financial support, or hiring caregivers to bridge the gap. As I said before, this emotional conflict is especially prevalent in Nepali and South Asian communities facing generational migration. 

Gender roles in caregiving in this context in many cultures: daughters are traditionally expected to assume caregiving roles, while sons may provide financial support. However, caregiving roles are shifting in modern societies, and sons are increasingly involved in hands-on care. Some cultures prioritise emotional presence where being close to a sick parent carries significant meaning; others emphasise practical caregiving by ensuring physical needs. This type of caregiving is extremely popular in Nepal. 

However, how caregiving is perceived evolves with modernisation, economic shifts, and changing family structures. 

Certainly, expectations of parents during sickness or poor health often reflect their need for security, love, and reassurance. In a situation when children cannot physically care for them, parents often appreciate regular communication, such as phone calls or video chats, to feel connected and supported. Many parents hope their children will recognise the efforts and sacrifices they made while raising them, particularly when they now require. One thing is for sure: illness can bring families closer or create emotional distance. Parents often hope their children will maintain strong family ties, ensuring that relationships endure beyond health challenges. 

In Nepal, for example, parents often seek reassurance, kindness, and presence from their children, even if they are far away. A simple conversation or message can provide immense comfort. I'm sure that this is quite the same also in other countries where the parent-child relationship remains always crucial. Like in many cultures, children are expected to assist with daily needs, such as preparing meals, managing medications, or accompanying parents to medical appointments. Our Nepali family tradition often calls on their children to cover medical expenses, especially in societies with higher healthcare costs. It is a universal fact that parents hope their children will recognise the care they once provided and reciprocate in times of need.  The expectation is particularly strong in cultures emphasising filial duty; hence, there is always "amour sans fin" (endless love). In cases such as this, there is never a sugar-coated approach to emergencies from children. 

In many countries, including Nepal, parents expect their children to provide physical care and spiritual and emotional reassurance, whether through prayers, rituals, or being present. 

Finally, having gone through this health ordeal and the care and support I received from my dear wife, Bhuwan Thapa Chand, my beloved daughters – Sheela, Sheetal, and Shirush – my friends and relatives, a feeling of gratitude urges me to express my heartfelt thanks through this article to all of them! My gratitude also to this esteemed broadsheet newspaper, The Rising Nepal, and its Editor-in-Chief Bhimsen Thapalia, for allowing me to speak to everybody on the health issue and allowing me to show tolerance, respect for others, and, above all, the freedom of the human spirit!

(The author is a retired broadcaster.)