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The increasing prevalence of chronic diseases has shifted medical focus toward the psychological experiences of older adults with multimorbidity. Recent studies indicate that these individuals often navigate a complex landscape of self-conscious emotions, including guilt and shame. These feelings frequently arise because patients perceive themselves as a burden to their families or healthcare systems. Consequently, understanding these emotional barriers is crucial for clinicians in India. This is especially true since family-centric care remains a cornerstone of the local health system. Furthermore, addressing these emotions can improve patient outcomes significantly.
Current research highlights that the severity and number of comorbidities directly influence the intensity of guilt and shame. For instance, physical limitations often exacerbate the feeling of being a "burden." Consequently, patients may experience reduced help-seeking behavior or poor adherence to self-management plans. Moreover, gender plays a significant role as a determinant factor for these emotions. Furthermore, identifying these feelings early allows for more tailored interventions. Therefore, integrating psychological screenings into routine geriatric care is essential. In addition, practitioners should focus on reducing the stigma associated with chronic illness.
Guilt often causes patients to minimize their symptoms to avoid worrying their family. Consequently, this can lead to delayed diagnosis and poor management of chronic conditions. Doctors should foster an environment where patients feel comfortable sharing their emotional struggles.
Key factors include the total number of long-term conditions and the severity of physical impairment. Additionally, social factors such as economic dependence and lack of family support significantly increase these feelings. However, proactive communication can help mitigate these perceptions.
Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.
References
Daher-Nashif S et al. Guilt, Shame and Self-Perceived Burden among Older Adults with Multiple Long-Term Conditions: A Scoping Review. J Health Psychol. 2026 Mar 06. doi: 10.1177/13591053261425329. PMID: 41792890.
International Institute for Population Sciences (IIPS). Longitudinal Ageing Study in India (LASI) Wave 1, 2017-18, India Report. Mumbai: IIPS, 2020.
World Health Organization. Ageing and Health. Geneva: WHO, 2022.

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