26 July,2026 07:38 AM IST | Mumbai | Arpika Bhosale
Brain stroke survivor Rupesh Jadhav (centre) shows how much progress he’s made in mobility as his son Rohit (in light blue), and Romila Palliative Care’s Dr Ashutosh Joshi (in purple) and nurse Kunda Ravinde (in red) watch. PIC/SHADAB KHAN
In the run-up to my father's death in February 2021 due to a brain stroke, he was almost unrecognisable, and it had nothing to do with the way he looked.
Until then, my father - or Pastor Bhaskar Bhosale, as he was known to his parish - had an exceptional track record of never giving up, be it in a career setback or a personal one. His "life hack" was to simply "power through", while also enjoying every second of it. So when he suddenly fell sullen and disappeared into himself, we weren't prepared, nor did we understand it.
The stroke that took him came at the end of a series of small ones that began in 2016 and eroded his mobility, taking away his passion to drive, memory, speech, and his unique brand of humour.
So, a few weeks ago, when someone mentioned that palliative care in Mumbai has now become more nuanced, it sparked my curiosity. No longer is it thought of as an end-of-life measure; it can also help manage chronic illness like kidney failure, or heart and brain diseases. Most importantly, it helps with depression and anxiety for both the patient and family.
Could this have made it easier for my father, or at least helped him - and us - to come to terms with the inevitable while still enjoying the precious time we had left together?
It's perhaps a similar question that drives a few in the city whom we've encountered over the course of this story, who have turned their grief into a way to empower other patients and families.
It is specialised medical care for anyone living with a serious illness, providing relief from pain, physical symptoms such as nausea, fatigue), and emotional stress (counselling for patients and caregivers), and even assist patients and their loved ones in making informed decisions regarding their care and bodily autonomy (such as with a living will).
Roohi Shaikh is grappling with grief after losing her mother in June
After a short wait outside a building in Jogeshwari's Patliputra area, a woman walks out and gives us a small, shy smile. Roohi Shaikh, a 47-year-old homemaker, lost her mother Neima Khan on June 6.
"My mother had already had ups and downs [in health] for over 15 years, but in 2019, a stroke left her bedridden. In the end, she lost her hearing, speech, and memory," she says.
Like most stroke cases, that first episode dealt a difficult blow, but as Roohi and her mother would discover, there was a lot of life yet to be lived - in Khan's case, seven years after the first stroke.
Roohi and Abdul Shaikh at her late mother's residence in Jogeshwari. The couple are in the bereavement stage. PICS/SHADAB KHAN
Roohi and her husband, Abdul Shaikh, had been worried about how to best care for their ailing mother. It was during a visit to Cooper Hospital that they learnt about Romila Palliative Care. "At the time, we were told that they help people who take care of people like my mother. To be honest, I never knew that this kind of care exists," Roohi recalls, "They would come and meet her.
Even though she couldn't speak, they would hold her hand and keep talking to her. They'd ask how she was doing, even though she couldn't reply," she says, repeating the last line as if this particular act of humanity afforded to her mother was what she was most grateful for.
We walk up the narrow staircase peculiar to MHADA homes, straight into the flat where her mother breathed her last. The one-room-kitchen with chalky-pink walls is no bigger than 600 sq ft, and it took the entire family's efforts to scrounge up the rent.
A real-life example of what palliative care entails plays out before us, as the family struggles with the question, "Did we do enough?" Romila team leader Dr Ashutosh Joshi reminds them: they did everything they could.
When Roohi seems guilt-ridden, Dr Joshi tells her: "Madam, you have done so much for your mother; sometimes even people who have the means to do this for their parents, don't." "Let us be thankful that she passed on without too much agony and at home, surrounded by her loved ones," he adds.
To us, he says, "Palliative care also means to reduce pain. We make sure that we give the patient a comfortable life, not because they are nearing death, but because they are not - their disease is something they will have to deal with for a while."
Sometimes, it's the family members who need their pain to be eased, even after the patient has passed on. As we leave, Dr Joshi says, "We will have to give more bereavement counselling than initially given; Roohi is struggling."
Dr Bhavika Hotchandani from the Romila Palliative Care Centre tells us about how Mumbai is learning about patient care one by one
Our first point of contact in the palliative care sector in Mumbai is Dr Bhavika Hotchandani, director of Romila Palliative Care Centre headquartered in Bandra West. The centre itself was the result of its founder, Dr Armida Fernandez, losing her daughter Romilla to cancer while the latter was in her 30s.
Hotchandani, who has been in the industry for at least a decade, says she is frustrated on hearing people say that they do not think palliative care is for their loved one, because they are not dying. "True support isn't just physical - it spans the psychological, social, and spiritual dimensions of a patient's life,"she says.
"Restoring Autonomy: Chronic illness often takes away independence. Giving patients back choices - even small ones - about their treatment and care restores a sense of self and control to people accustomed to directing their own lives," she adds.
The staff not only do monthly or weekly house calls depending on the patient's health, but also train the family in basic healthcare. Some of this involves administering injections or a bottle of saline, if needed. Each home visit can go on for as long as three hours.
At the same centre in Bandra West, patients with different levels of mobility also drop by for checkups and physiotherapy - this is all provided for free, including medical materials like adult diapers and even grains for those in the economically weaker section.
What piques our interest the most, though, are the home visits, where the work unfolds in real time. So at the first chance we get, we accompany team leader Dr Ashutosh Joshi and retired nurse Kunda Randive on two such visits.
Rupesh Jadhav, 46, was hit by a brain stroke in 2022
Jadhav Chawl is located on Sahar Road, a few meters from the Hotel Suba International. The chawl is one storey below the road level, and when we dip under the tree that marks the entry of Rupesh Jadhav's small home, we see him seated on a plastic chair beside a small table holding the clutter of his everyday life - his medication, hair oil, and other household items.
When you look closer, you see the signs of a stroke that has taken away movement on his right, his speech and - like most in his situation - his patience too, as his two sons Shubham and Rohit tell us. Shubham, the eldest, was in his third year of college when his father suffered a brain stroke in 2022, while Rohit had just appeared for his Class 10 exams.
Shubham recounts the progress since they started palliative care in 2023. "When we got him home from the hospital, he was in and out of consciousness, speech was almost zero. Today, he is walking around and alert enough to understand what is happening around him," says the elder son.
"The first six months were the worst. We were not sure what to do, but when they [Romila] told us that physio would help, we took him to the centre every week. Now we are just so grateful to them," he adds.
Joshi then asks Jadhav to walk and show how much progress has been made, and tells him to continue to exercise. As we leave, the younger son, Rohit, seeks advice from Dr Joshi and nurse Kunda Randive. We move aside to give them some privacy.
Finally, Dr Joshi repeats a mantra that we had heard him tell Roohi earlier. "Pyaar, mohabbat, aur seva: remember this mantra when you feel that it's getting too much. It's our mantra, but it works for the families of patients as well."
Pheroza Billimoria turned her grief into action, founding Palcare - a palliative centre
In 2013, Jimmy Billimoria lost his battle to cancer. Two years after that, Pheroza, his wife, learnt about palliative care and realised that it could have made Jimmy's final days easier and more peaceful.
Pheroza Billimoria
Today, she helps bring this knowledge to other families struggling like she once had. She founded Palcare, a palliative centre, in 2015. While it primarily works with cancer patients, they are working to go beyond only-cancer palliative care. "Until we hone our skills in other areas, we don't want to take on patients and do a half-baked job. As of now, we have started taking about 20 per cent non-cancer patients," she says.
The organisation specialises in home care. This includes end-of-life care. Billimoria says that around 86 per cent of their patients opt to spend their final moments at home. "Most of our patients pas away within five to six months; if they feel that they don't want to pass away at the hospital and would be more comfortable at home, we work with both the patient and family to ensure that they are at peace with the decision. Of course, there are a few people who still panic and rush their loved ones to hospital," she adds.
Jerry Pinto, who wrote a book on palliative care, says planning for sickness and death is as human as we can get
Jerry Pinto, author of A Good Life: The Power of Palliative Care, comes from a place of dealing with his own humanity and what his mother went through in her final days. "I think my mother would have benefited from a variety of therapies and pills on offer now. I think we (he and his sister) would have benefited from some form of palliation too as caregivers," he says.
Jerry Pinto
We have often heard many say that it is apshagun (bad luck) to plan for the worst-case scenario, but Pinto's book talks about the importance of dignity of life. "We have many beliefs about death, most of which are designed to help us avoid thinking about its inevitability. Yudhishthira was right. We see death, but live as if we are immortal. This [measures like a living will] is as human as having a bucket list - an acknowledgement that we cannot live forever and must thus plan to maximise our time here," he adds.
Dr Smriti Khanna, Palliative Medicine consultant at the Living Will Clinic, PD Hinduja Hospital & Medical Research Centre, explains who it's meant for
"A living will is basically a way to record your medical preferences for a time when you are not able to communicate," says Dr Smriti Khanna.
The best time to do this is when you are hale and hearty. "In effect, you are planning for your medical future. There are three categories of people who can make a living will. The first is someone who is fit with minimal or no illnesses, who just wants to plan for the future. This includes planning for accidents or injuries that may leave them in a permanent vegetative state," she says.
Dr Smriti Khanna, Dr Ashutosh Joshi and Bhavika Hotchandani
The second example is "people diagnosed with a chronic illness. They may be okay at present, but they know that a few years down the line, the disease might make them dependent on a lot of medical support," she says.
"Of course, the last scenario is when you have a devastating diagnosis, a terminal disease with, say, a year to live," she adds. The clinic helps you tie up with your GP, so a copy is with the doctor, your family, and the family lawyer.
One has to be 18 and above to draft this document.
To contact the Living Will Clinic, call: 022 67668181/ 022 45108181
In 2025, the city got its sole living will clinic. Sarita Bahl is one among 100 who signed one
For many of us, handing over the power to make choices about our body is a sombre thought. But if there ever comes a day when you're in the hospital and unable to speak for yourself, a "living will" can empower you to lay down advance directives for what measures you would like doctors to take or avoid.
Sarita Bahl has signed a âliving will' that has been approved, effective from 2025. PIC/SAYYED SAMEER ABEDI
The Supreme Court first recognised the document in 2018, and it was eventually simplified in 2023 after a number of procedural complications were flagged. This is not just a document for life and death, but for any medical situation in which you are incapacitated.
The empowerment and dignity this ensures resonated with Sarita Bahl, a 62-year-old who took matters into her own hand and signed a living will early this year. She did this with the help of P D Hinduja Hospital & Medical Research Centre, which runs the only living will clinic in the city, if not the country. "When I turned 60 in 2024, I threw a huge bash to celebrate the beginning of my life. Then it was like, âokay, what's next?' So my first step was to make a living will, and the second step was to start a trust for my son," says Bahl. The intention, she tells us, was to ease the burden of choice for her family: "I didn't want my son to bear the burden of taking the call when the time comes," she adds.
"I really had no problem in deciding what to do. I was very clear," she says when asked what her directive entails. "There are the medical conditions outlined and approved by the Supreme Court and health authorities. They have to be followed. Once the doctor says there is no cure, no hope, that's it. There is no need to debate the ventilator, resuscitation, or wait for another line of treatment to come in," she says.
We are slightly envious of the Bahls' clarity. How have her family and friends reacted, we ask. "Very funnily, two kinds of reactions came in," she says. Some agreed with her choice. Her son, though, "when he saw the will, it hit him; he said, âI would want to hope. I don't want to give up.' That's when I told him that it has to be done, and he agreed to respect my wish," she says.
