Death is nothing at all… That’s a line from a popular choice of readings at many of the funeral services that I have attended. The thing is, death is a big thing. It’s that elephant in the room, the thing we all know is coming, and yet we try our best not to acknowledge. We ignore it, we try not to even speak it’s name, we say someone has passed on gone to meet their maker, become an angel. Very rarely do we say someone is dead, it’s euphemisms all the way.
The thing is, we need to deal with Death. We need to accept it, after all, as a friend of mine says, good health is just the slowest possible way to die! It’s an unfortunate truth. No matter how much we don’t like it, it is one thing we can guarantee.
I have recently been faced with Death and the dying fairly frequently. I’ve been working on the ambulances and have seen a lot of ill people. Most of these are old people, people who have lived full and varied lives, and are proud, strong and fascinating human beings. All too many of them have been reduced to the remnants of the people that they once were. Some may be unsteady on their feet, and so have fallen and injured themselves, or just don’t have the strength to get up. Others may just be weak with age or exhausted from breathing or heart conditions, many have dementia.
But it’s not all elderly people who die. My 7 year old son came home today with news of a school friend who died at the weekend. Younger people die too, no matter how much we want to ignore it. And it’s heart wrenching and horribly sad, and doesn’t bear thinking about, but think about it we should.
In my mind, death shouldn’t be taboo. It should be a subject that we talk about, without dread, we plan so many things in our lives, but very few people plan for their deaths. We leave this most important part of life to our family and friends, people who, with the best will in the world are the least likely to be in the frame of mind to make rational, life or death decisions.
My Nana was probably the person who I have been closest to that has died. I loved my Nana fiercely, and she loved us all fiercely back. None of us would ever want her to be in pain or distressed. She was very ill, she had been fairly I’ll for a long time. She had COPD and was on oxygen constantly, but she was still firing on all cylinders and bossy as hell!
Then one day, she got a chest infection, and was admitted to hospital. Despite treatment, she didn’t improve. The Dr’s wanted to withdraw treatment and in that moment, I would have done anything to save her. Even in the poor health that she was in, I wasn’t ready to let her die. It wasn’t about her. I was selfishly thinking of myself, i didn’t think that my Nana was suffering and would hate to be like this. I just felt that I could not let her go. Luckily I was able to cry it out, talk to my friends and family and ultimately, it wasn’t up to me to let her go. Probably a good job, as I don’t think I would have had the strength. I’d want them to keep her alive, not for her but for me. My Nana slipped away quietly in her sleep early one morning soon after.
The funny thing is that after she died I felt relief. Not that she was dead, but that she was gone without suffering: she never lost her mind to dementia, or her independence. She died after a short illness and was peaceful. It took my mum and aunt a lot to allow them to withdraw treatment but ultimately it was the right thing to do. Nana would have hated to be a burden and if she had survived she wouldn’t have had the life she was used to.
And that’s why it is important that we face that elephant in the room, that we talk about death and dying, and give our loved ones an idea of what we want or don’t want to be done to keep us alive. It’s not fair to leave a grieving loved one to make decisions on your life or death completely in the dark. It’s not fair on them, and it’s certainly not fair on you. As humans we are ultimately selfish. We don’t like pain, and the pain of losing someone we think we can’t live without is too much. Some people can’t put that aside and think of the other person. And that says nothing about them, and more about being human.
So we should all make our feelings clear. Talk about them, write them down. Be unequivocal. Speak about death, and life, and the conditions in which we would choose death over life. How much should we be prepared to let Dr’s intervene to prolong our life? If we lose our ability to choose the best for us, who do we trust to choose it instead. What do we want done with our bodies when we die, are we leaving them to medical science? Being buried, cremated? How do we feel about organ donation? All of us, none of us, or only some parts? All of these things are important, they mean that we know what will happen to us, and it takes the guilt and pain and decision making away from a loved one who is in an impossible situation.
So I’ll start it now: if I get dementia, or have a stroke or any other condition that means I have no mental capacity and no hope for recovery, I would like treatment to be withdrawn. I would like my family with me and I’d like to die. If I am able to, I would like any of my organs to be donated. I don’t mind if I’m buried or cremated but I’d like a grave that people can visit if they want to. And most of all, I want my family to know that it is my choice and not theirs. There is no guilt, it’s what I would want.
kate, I went through a very similar thing with my nan. She went into hospital with an asthma attack, she seemed to brighten up. Then one night about 2am we received a call to say she had another attack, flatlined and was resuscitated. We couldn’t get up to North London so mum was asked what she would like if it happened again. Mums reply was let her go.the vicar had read her last rights and we were expecting to go that morning to collect her belongings. Next morning we got a call to say she was sitting up with her breakfast. She was never fully functional after that and one day I will tell you the stories she got up to in a not so correct state of mind. However, a few months later I told her I was getting married.. Her words were ‘ he’s not the one for you’…. She was right !!!!
She asked me if she was allowed to come to the wedding or was she not with it enough to come? I told her if she wasn’t there, then neither would I be….. She died 3 days before, and yes I went ahead…. You see, she had been admitted into hospital with an infection and wasn’t eating…. They put drips in her to keep her going and some how she pulled them out…. Again mum was asked what she wanted to do… ‘If she doesn’t want them in, then don’t put them back’ was mums reply. It had all taken it’s toll on my mum and I was aware she couldn’t cope with it all….
My marriage lasted 18months and yep…. Nan new it…. I have always said she did it to stop me getting married to the wrong person…. She may not have been in her right state of mind, but she did know what she was doing.
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Precisely the reason I find palliative care such a rewarding and challenging field. We should be upfront about our wishes: it makes the grieving process MUCH easier and the feeling of guilt is negated.
Of course, this all relies on people understanding their own capabilities and resilience in circumstances they could never comprehend.
Incidentally – our funeral director told us not to read that exact poem for that exact reason. Death is a colossal freight train coming at 140mph: collision is inevitable. It is a BIG thing. Instead I read “as we look back” and it seemed to fit my dad perfectly.
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