When death approaches for the old and sick, who decides how far we should go to prolong life?

Peter Kammerer reflects on the difficult decisions that many will have to confront some day, as he had to do with his mother’s recent passing. If death is inevitable, can we at least set the terms of our departure?

PUBLISHED : Monday, 24 September, 2018, 2:30pm
UPDATED : Monday, 24 September, 2018, 5:53pm

We would wish our loved ones to be with us forever. But age brings physical and sometimes mental frailty and a time will come when we have to let go. My mother’s passing in Australia on the final day of August was understandably difficult for me and my family, but, on reflection, for the best. Importantly, I believe she set the terms of her departure.

My mother died almost a month shy of her 88th birthday. Her life had been long and eventful, but in the last five years, marked by an ever-growing list of medical conditions. There was always high blood pressure and a heart murmur, but then came a diagnosis of osteoporosis, a fall that broke her pelvis, fractured bones in her back, diabetes and, in the final months, dementia. Pneumonia was the final straw; it put her back in hospital for the last time and it is there she passed away on a Friday afternoon.

The Mid-Autumn Festival is a time to share meals and gifts with parents. But we also have to think of their health and be prepared for taking care of them in their old age. For that, we will require knowledge, both to cope with the ailments that will arise and to discuss and, if necessary, negotiate or even confront medical professionals. Those we love who may not have the faculties to make their opinions clearly known will rely on us for that help.

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I had been prepared for my mother’s passing. Her body had been quickly deteriorating and I knew when I got that call from the emergency room that I had to get on a plane fast. On arrival, I was told that she had perhaps hours to live. But she clung on for five more days, drifting in and out of consciousness, with occasional windows of alertness that made it appear that there was nothing seriously wrong, her eyes being wide and bright and her voice strong.

Those windows were only too familiar, though; there had been good and bad days for two years, the bad becoming increasingly the norm. Her refusal to leave the home built by my father and lived in for six decades was a challenge to accept and, eventually, with insufficient home help, she had to be tricked into leaving. A prolonged hospital stay was engineered while a nursing home was found and it became her home for the final few months.

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Efforts for better home help, getting her to hospital when things didn’t seem right and searching for a good nursing home were the reflex actions of a son who loves his mother. With hindsight, they were also about prolonging life for as long as possible. It was why I got angry when confronted by a doctor on what turned out to be my mother’s last day of life, with the statement that food and water were no longer necessities for her, nor should there be monitoring of things like blood pressure and sugar levels. What right did this person have to play God with the life of the woman in a deep sleep before her?

The reason given was that my mother was dying and ensuring she was comfortable should be the priority. I had already signed a form ruling out intensive care, understanding that going to extremes to keep organs functioning would be cruel to so frail a body and would probably induce shock and a traumatic death. But the idea that my mother, in a state of delirium, should be the one to decide if she needed food or drink, and that the monitoring of her vital signs should end, seemed inhumane. The doctor was stared down, and backed off.

My mother never awoke. Perhaps she had been subconsciously listening to the conversation taking place across her bed and her spirit made up its mind then and there that enough was enough. She passed away as we would all wish, peacefully. Now joined with my father and sister, I know she is in a better place.

Peter Kammerer is a senior writer at the Post