Bridging the Gap of Patients’ Caregiver Challenges in a Government Tertiary Care Hospital of Maharashtra

Sir, Patients’ caregiver is defined as “a family member, friend, or neighbor who offers care to a patient with an acute or chronic ailment and requires support to manage various tasks like helping with bathing and dressing the patient, administering oral medications, tube feeding, and ventilator care for the patient”. The role of a patient’s caregiver is often overlooked in healthcare delivery, despite being integral to patient recovery. They give essential support such as administering medicines, assisting with feeding and hygiene and offering emotional comfort. In doing so, they are sometimes referred to as “secondary patients” as their health and wellbeing are also at risk during prolonged hospital stays.[1] In a tertiary care government hospital in Maharashtra, we interacted with caregivers of in-patients across various departments. Their experiences highlighted pressing concerns that mirror the wider challenges in public hospitals. The issues they raised may be grouped under three broad themes: Inadequate Facilities:Caregivers often lack access to basic amenities such as clean toilets, drinking water, and affordable food. Several reported being evicted from hospital corridors for resting, despite the absence of designated waiting areas. Overcrowded wards, unhygienic bathrooms, and lack of parking or seating arrangements compound their difficulties.Inefficient Processes:Caregivers described long waiting times for registration and investigations and confusion due to poor signage within the hospital premises. Many were unfamiliar with medical procedures and expressed dissatisfaction with limited communication from healthcare providers about the patient’s condition. The absence of structured guidance left them stressed and disoriented.Perceptions of Healthcare Providers:Interviews with postgraduate trainees revealed frustrations about overcrowding, repeated queries from multiple caregivers, and lapses in caregivers’ adherence to instructions on medication and hygiene. They also observed that caregivers sometimes ignored available washroom facilities, leading to sanitation concerns around hospital premises.Beyond these specific findings, broader consequences of neglecting caregivers’ needs must be acknowledged. The absence of supportive spaces increases caregiver stress and anxiety, which may in turn compromise their physical health. Poor rest, irregular meals, and emotional exhaustion adversely affect their ability to care for the patient. This may contribute indirectly to delayed recovery as patient wellbeing is closely tied to the presence and comfort of their caregivers. The lack of adequate facilities also increases the burden on healthcare staff, who must compensate for caregivers’ limitations. Additionally, many caregivers come from distant rural areas and they face financial hardships, incurring costs for food, travel, or accommodation when hospital infrastructure is insufficient. Prolonged separation from their social support systems can also result in isolation and psychological distress.[2] Recommendations: A more caregiver-inclusive approach in hospital management is urgently required. Key measures may include: Provision of basic amenities: Clean toilets, safe drinking water, canteens, waiting areas, and designated rest spaces should be considered essential in government hospitals. Streamlined processes: Multiple registration counters, digital health records, and clear signboards for OPDs, IPDs, and laboratories can reduce delays and confusion. Reception counters with dedicated personnel for guidance should be strengthened. Dedicated caregiver spaces: Affordable lodging facilities, ‘dharmashalas,’ or tie-ups with nearby hostels and ‘sarais’ can offer caregivers a safe place to rest. Capacity building and awareness: Regular orientation of caregivers regarding infection control, medication administration, and hygiene practices can reduce medical errors and improve outcomes. Support services: Counseling and respite care options should be explored to address the mental health needs of caregivers. CONCLUSION Caregivers are critical stakeholders in the care continuum. By acknowledging their needs and integrating them into hospital planning, government hospitals can create a more humane and efficient healthcare environment. A shift toward a physician–patient–caregiver-centered model will not only improve caregiver wellbeing but also enhance patient recovery and overall healthcare outcomes. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.