Death and assisted dying

Death is all around me at the moment. It is in our daily readings in the Offices. It is in the tears of the recently bereaved who read them with me. It is in the watching and waiting as a beloved mother dies. It is in the memories of those who find this time of year difficult because of an anniversary or the first Christmas without them. It is in the oil to anoint a chilled brow. It is in the bleak chill of the cemetary that I can’t reach. Death is all around.

This morning I have been thinking about how to achieve a happy death. We can’t all choose that we will have a happy death. And if we were just to spend some time thinking about how that might be, what would you want? At the end of a good and satisfying life, in peaceful surroundings, with no pain? That is an ideal that not many can achieve. But when it does we can give thanks.

Reading James Woodward’s blog this morning has made me think about my mum’s death. It was not a happy death. It was in a hospice which should have meant that all was done to make it a ‘good death’. That didn’t happen. On her first visit (to get medication sorted) a nurse was impatient with her when she needed the toilet. To mum she seemed brusque and impatient and made her wait for a long time in desperation. She was rude and she shouted at mum. Of course we don’t know what was going on elsewhere in the ward at that time, and why that particular nurse seemed uncaring. Nor would they know that when my mum needed ‘to go’ there was no hanging about. But somehow this episode became a huge issue for mum. It may be that it became the focus for all her fears about dying, but nobody ever took time to listen to her to find out. She couldn’t wait to get home.

She did get home after a few days to stay with my sister. There she was cared for day and night by C with visiting health care workers coming in daily who got to know her well and who listened. She wanted to die there. She was adamant that she didn’t want to go back to that hospice. But then she collapsed and my sister couldn’t get her up off the floor. For that, and other reasons, the decision was made that she should go into the hospice. I was part of that decision and we all felt it was for the best. I went in the ambulance with mum and it was then that she turned her face to the wall. She didn’t want to go and made it clear that she was unhappy. So unhappy, in fact, that she didn’t speak again for a week until she died. We visited daily and tried to chivvy her along but she remained facing the wall (literally, as her bed was against a wall). The doctors said she was suffering from depression and they would give her medication for that but that it would take time to work. Time she didn’t have.

For weeks before she had been asking to die. She begged doctors and health visitors to give her something to speed the process. She wasn’t in pain but she knew that it was only a matter of time and she didn’t want to prolong it, for her sake and ours. She knew that daily visiting and caring was taking its toll on us all. (We didn’t mind, of course, but we knew she did. She never wanted to be a burden.) In the hospice we knew she only had days to live and when she wouldn’t speak to us, we were told that the only thing she said to doctors was that she wanted to die. There was nothing they could do. She has signed a Living Will but in these circumstances it wasn’t much good.

Nearly five years later I can still remember that last week clearly. It was not a happy death. It was a smelly, silent, and prolonged death. The hospice didn’t burden us with the information that her wound was infected and that she probably had MRSA or some other infection. We only knew when the ward was closed after her death and her belongings destroyed.

And we are left with the knowledge that it needn’t have been like that. I believe mum could have had a happy death. She could have had a happy death at home if the correct care was in place to help people care for their relatives there. And this appears to be a postcode lottery as I hear and have seen Macmillan nurses doing all they can to create such an atmosphere, but they are not available everywhere. She could have had a happy death if a nurse had been more sympathetic over something as basic as bringing a commode sooner. She could have had a happy death if a doctor had been willing to give her something which would have allowed her to bring her death forward by a few days.

I’ve heard speakers from the Church resist assisted dying. I don’t understand it. We know and believe they are going to a better place. I visited someone two days ago who was allowed home from hospital to die. It was peaceful, quiet, spiritual, warm and, in the end, a happy death. It is something that I pray for without fail – that we should all have such a happy death.

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12 thoughts on “Death and assisted dying

  1. Thanks for that Ruth.It was very moving. I would have tended to agree with you except having worked in Social Work for too long now I’m afraid I’ve come across too many relatives with ulterior motives to be entirely comfortable with the safeguards we are told would be part of anyAssisted Dying Bill.
    Best Wishes
    Steven

  2. I can remember when my Grandmother was in her (blessed short) terminal illness, the thing that scared her most was the indignity she felt due to the side-effects of the large doses of morphine she was receiving as palliative care.

    Being allowed home, rather than receiving ongoing care, isn’t, I don’t think, “assisted dying”. It is withdrawal or replacement of treatment. As such, the latter already exists, under the control of the medical establishment, as the Liverpool Care Pathway.

  3. This is very moving. You must have lost your mother at almost the same time as I did. Certainly this week is that in which my mum died, and I shall always be grateful for the care of the nursing home where she had lived for almost a year after a stroke. It was very peaceful and we were helped enormously by the understanding of all the staff we met – even though I had initially felt incredibly guilty about her going there to live.
    Must be the time of year, as I woke yesterday with thoughts of death and loneliness which took much of the day to leave me. Thanks for sharing this.

  4. wow – what a timely and powerful post. Having just ‘survived’ impending death through a life saving operation in September this is a theme very close to my heart. I am so passionate about assisted dying. In a case like mine I would be so glad to know it is there as an option. I am sure God won’t mind and will understand if I call time on a difficult situation. I find that those who are opposed are often people who have not suffered physical difficulty or suffering. If they had- I think they would see the point much more clearly.
    I hear the concern about relatives with ulterior motives, but if the case is signed off by two doctors and the patient is of sound mind I can’t see the problem really. That should act as sufficient safeguard.
    I think we all have the right to a peaceful and dignified death, rather than facing the prospect of sneaking off to Switzerland and worrying about family being arrested on return ‘for assisting’.
    With the right level of palliative care it shouldn’t be necessary perhaps but I know for a fact from experience that this care is patchy and not everyone (including me) wants it anyway. Enough is enough!

  5. Thanks Ruth,
    Jo- I sure you mean well but I work every day with older people in their last days and their families and have also had the experience, like many , in my own family. Ant yet I am still very very wary of Assisted Dying as the point I was making is that although many have experience of the suffering of a loved one very very few of us are involved in Adult Protection processes where the abuse of vulnerable ill people is far more common that most would believe.
    Steven

  6. One thing I have tried hard to make part of my way of life, my spiritual discipline if you like – is the willingness to be a burden to others and to do it gracefully. for me it has become part of the Christian life, and I hope and pray that if I ever need it for a long time, then it will have become part of me, and I will be able for it.

  7. Yes, and yes – to the desire for a ‘good’ death. Seeing others at their deaths, comforting their families, hoping for each one that there would be a kindly end.
    My mother had been in a Home, small,with a Christian matron, and my dread was that – living in Scotland – I [only child] would not get to her in time. But there are true miracles. After a week looking after her in her own home, I went back to the Borders, and we came on a rare impulse to London for an exhibition we’d lacked time to see while in the south. The train was on time, we stepped off it onto a tube, came to the Nat Gall, and spent a wonderful 2 hours. Emerging, we rang the Home: out of the blue, “come at once”.
    There was a riot in Trafalgar Square all exits barricaded, but we slipped through the crowds, unscathed. Our younger daughter – amazingly for once not away – met us at Victoria and drove at a hair-raising speed to the Home. We arrived… what do you do at a death bed? so we said the Lord’s Prayer together- my mother said Amen: the last word she spoke.
    It was the most beautiful answer to anguished prayer, that I, and her grandchildren, could be with her at her dying.

  8. bene3’s comment prompts me to reflect that one of the things that can make a death a ‘good death’ is that the dying person can be empowered, and can empower others. I’ve known relationships healed by the bedside, and surviving family members and friends to be changed into people of greater wisdom and compassion, who can face death, their own and a loved one’s, without being in denial, as so many of our contemporaries seem to be.

  9. Pingback: RIP Liverpool Care Pathway | RevRuth's Rantings

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