The best gift for your ageing parent is the gift of your time

A colleague is scrolling distractedly through images on her phone as we wait for a meeting to start.

“What do you get a mother in her 70s?”, she whispers.

Leaning over, I examine cardigans, scarves and purses by the dozens, holding back on commenting that they all look the same.

“The problem is they all look the same”, she sighs.

The meeting starts, and I never ask her what she got, but I think of her dilemma a few months later as I wonder what birthday gift to get my father.

He is a man of letters, a retired Indian academic. His favourite pastimes are to read and write, especially in retirement when he sits at the dining table for hours on end, crafting deep essays and sublime poetry. I have bought him writing pads and elegant pens but there are only so many of those a writer needs and lately, knowing my penchant for pens, he has been giving them back to me to “use in the meantime”.

His computer is ageing – you could comfortably make a cup of tea and drink half by the time it stirs. Recently, some hackers cunningly singled out all his Indian contacts to be notified that he had an urgent illness that required a financial bailout. Their consternation was nothing compared to my dad’s. It turned out that his backup system for five years of writing had been his brain. My husband and a shop managed to retrieve the data but my faith in his computer was forever lost.

I’ll get him a laptop, I think, pleased with myself.

“Let me buy you a new laptop for your birthday”, I say.

He frowns. “Why? My old one is fine.”

Worried that a new laptop might just upset his writing pattern, I relent.

The next week, the birthday a bit closer, I offer to replace his smartphone, which could really be a great deal smarter, but he is not convinced: “My phone makes calls, sends texts, and fetches mail. What more would a new one do?” I can’t say.

Leaving me contemplating the infinite possibilities, my children do what they can. They bake him their favourite chocolate chip cookies. Since they steal away some of the raw ingredients, they manage only ten finished products, which turn out just right – large, golden and chewy. One cookie mysteriously crumbles, and they keep one each for their brilliant effort. This leaves six cookies hastily placed in a used plastic bag and placed into their grandfather’s hands. He is gratified and thrilled beyond words. For the next few days, he savours his grandchildren’s cookies bit by bit, ignoring his daughter’s protestations about sugar hits for breakfast.

Which still leaves me short of a present – and now, competing with my own children!

I go to work hoping to find inspiration. Every pre-Christmas clinic brings up a similar set of anxieties for a different set of people. Is it OK to have a break at Christmas? If I skip a dose, will my cancer grow faster? Can we give Dad a glass of wine at lunch? Could this be Mum’s last Christmas?

I try to answer each question with honesty and consideration, regarding the disease in the context of the person. The majority of patients are reassured to hear that skipping a treatment will not jeopardise their wellbeing and in fact, a convivial family gathering may be the most therapeutic intervention of all. I witness people’s expression turn to joy at the thought of a Christmas unfettered by the toxicities of treatment – and as I sign the orders, I secretly can’t help feeling a tiny bit like a magician.

But no closer to finding the perfect gift.

Later that day, I meet an elderly man who has resolutely denied my interpretations of his illness, insisting that he feels fine. Worried at the fatal toxicities that chemotherapy can impose, I hope that Christmas will tempt him to take a break. But to my surprise, he wants to know why we close for a public holiday. Sensing my frustration, he reluctantly offers an explanation,

“If I stop treatment, I may not see my son. He drives me to chemotherapy and takes me home – it’s our time together. It’s the nicest thing about having treatment.”

Then he sits back and looks out of the window as I let his simple and devastating reason wash over me.

Did he really see toxic chemotherapy as the price to pay for seeing his son? Had it taken a terminal illness for father and son to talk regularly? I don’t know for sure, but I can see that he believes it and that’s what matters.

“Tell me about your son”, I say, so that my chaotic thoughts might settle.

When he has finished, I realise that he has told me nothing about who his son is or what he does, only the times they have spent together that mean so much. They are mundane too – trips in the car, buying groceries, picking up a grandchild, going to the carwash.

He knows everyone is busy but still, he can’t deny that his son’s company is his greatest consolation and his nicest reward. So, if that means having some extra chemotherapy, so be it. I listen to him, moved and humbled, and a little lost for words.

I find myself thinking of a friend who gave his mother 60 walks for her 60th birthday. Each week’s walk was a great commitment but far more meaningful than any wrapped present. And another friend who visited her mother every single week for the years she spent in residential care, dementia chipping away at her core. In the end, there was no gift to give her save that of a familiar presence that could expect no return. It must have been a heart-wrenching gift to give, but at the same time, priceless.

And it dawns on me that in searching for that elusive gift for an ageing parent, we are neglecting the one that is most obvious, the gift of our time. In an age where we live and work in far-flung corners of the world, spending time together isn’t always easy or practical but we deceive ourselves by thinking that it doesn’t matter. The antidote to an epidemic of loneliness doesn’t lie in sending a bigger gift but in exercising our imagination. If the stories of my patients are anything to go by, our imagination would tell us to show up a little more, to call a little more and to simply be more attentive. A sorrow shared is a sorrow divided. No medical advance, and no wrapped gift, could ever compete with this.

I tell my patient that I will talk to his son and we will figure something out. He says thank you for not judging him. Then I stop looking for a gift for my dad and call him to say I will pick him up and we will go for a drive. I’ll be ready, he says.

• Ranjana Srivastava is is an oncologist and Guardian Australia columnist