Saturday, June 26, 2010

The quality of the end of life

Two weeks ago, a young family member survived her second heart attack. While we hope and believe she will live many years longer, she is arranging an enduring power of attorney, and exploring living wills and advance directives for doctors.

I discussed the latter two options with my son. He says (as a GP), the EPOA is crucial, but frank discussions with close family about various death-bed scenarios are worth far more than any written instructions. When healthy, we cannot predict which of 1,000 situations will be ours at the end of life. He said, just think about which faculties are indispensible, and which ones you could bear to live without.

My own attitudes have changed over time. I've gone from the "Put me down! I don't want to be a burden!" to realising that this request would itself be an unbearable burden for my children. That what seems unbearable to a 20-year-old may be tolerable to a 90-year-old.

Above all, I'd like my children's wishes to play a major part in making end-of-life decisions.

When my mother-in-law was young, she repeatedly said that death would be better than losing her mind. But when she lost her mind, she appeared to be as happy as Larry. Always a sweet-natured woman, she stayed that way.

If by bad luck someone must decide when to "pull the plug" on my life, I hope I will be completely unaware of the fact. If I'm aware, I hope that includes a certainty that my children must do what is right for them. They'll have my blessing.

Talk of "what Mum would have wanted" is ultimately sheer speculation, living will or no living will. I expect to adjust my opinion frequently, at times every day or every hour. I trust my children's empathy and communal common sense. And they don't have to be perfect! Nothing can negate our past happiness and shared experiences.

This morning, these thoughts came back into my mind, because dementia and Alzheimers were the topic of a moving documentary on Radio New Zealand.

A living will

When do I want to die?
When my body tells me to.

If I lose my words,
feed me music and birdsong.

If I lose my balance,
feed me videos of dancing.

If I lose my self,
show me children and the sea.

Feed me life until
I lose my appetite.

When do I want to die?
Let me go

before my crippled life
begins to cripple yours.

I have lived in joy.
Let me leave this life

before I lose
the memory of joy.