“I’m tough, aren’t I?” It was almost the first wholly intelligible thing she’d said for about a week, and there was really only one possible answer. “Yes, Mum, you are.”
At the start of that week I’d had the kindly professional chat from the senior consultant. The one about “last days care”. Now it seemed those last days had got longer.
The antibiotics intended to ease the pain of her passing had apparently forestalled it. Against all odds, the sepsis everyone had expected to take her had been cured.
It was not entirely a matter for rejoicing. It was certainly not what she wanted.
The day after she went into hospital she spoke to me at length, and in detail, about what I would have to do after she died. She had thought about it, and we had talked about it, a great deal over a number of years. Now she approached it cheerfully.
Her attitude had always been logical, and consistent. As long as she was able to enjoy life, and to contribute something to others, she was glad to be alive. Once that was no longer the case, she wanted a quick and easy exit.
Which of us, in our right minds, would not want that?
We all need to face death eventually. It would do us all good – individually and as a society – if we faced it more openly before our final curtain falls. And with more of the calm, rational approach my mother showed.
She was not alone in that. A study carried out by researchers at Cambridge University shows what anyone who has spent much time among the very old already knew – that most people in their nineties are not afraid of death.
Indeed, while they might care a great deal about the manner of their dying, the idea of being dead is something many positively look forward to. And not necessarily because life has ceased to be worth living.
Until the last few unwanted, unexpected weeks, my mother generally had a good life. Yet at 94 she still looked forward to its end.
Dr Jane Fleming, who led the Cambridge study, said: “Despite the dramatic rise in the number of people living into very old age, there is far too little discussion about what the oldest old feel about the end of their lives.
“Death is clearly a part of life for people who have lived to such an old age, so the older people we interviewed were usually willing to discuss dying, a topic often avoided.”
Nearly half of all deaths in the UK are of people 85 or older – up from one in five only 25 years ago. The number of people topping 90 has tripled in 30 years. The Cambridge interviewees were all 95 or older.
One told her son, after visiting a friend with dementia: “Gordon, if I ever get like that, for goodness sake put a pillow over my head, will you?”
Which is exactly what our laws and common morals won’t let us do. Yet would the abuses really outnumber and outweigh the benefits?
I'm not sure. And I know some elderly folk who definitely think being allowed – even assisted – to die when they want would be infinitely preferable to being kept alive against their will.
Another of the Cambridge interviewees remembered her parents’ deaths. “They were alive, then they were dead, but it all went off as usual,” she said. “Nothing really dramatic or anything. Why should it be any different for me?”
One 97-year-old said: “I just say I’m the lady-in-waiting, waiting to go.”
Nearly all said that if faced with a life-threatening illness they would rather be made comfortable than simply kept alive. And most said they would rather not go into hospital. In both those respects, my mother was typical.
“Now so many more people have reached a great age before they die, it’s important we know about their views and their concerns, particularly in relation to end-of-life care,” said the study’s other author, Dr Morag Farquhar. “Having these conversations before it is too late can help ensure that an individual’s wishes, rather than going unspoken, can be heard.”
Time, perhaps, to have that conversation now. To let your doctor know the outcome. And, perhaps, to put your wishes clearly in writing, signed by independent witnesses, as my mother very sensibly did a few years ago.
Though she recovered from sepsis, she had a stroke while in hospital. It took away most of her ability to form intelligible words, though she went on trying. It also severely affected her ability to understand what was said to her. As far as one could tell, it did not impair her ability to think. She died at home eight weeks later, quite comfortable and clearly aware who was around her to very nearly the last.