My wife wanted her choice of a peaceful death to be shared. This is our story.
Personal Stories | June 8, 2018 | Don Ayre
Winnipeg’s Jean Ayre believed passionately in a more loving and caring world, and throughout her 86 years of life, she did everything in her power to make that belief a reality. It’s no surprise, then, that on her final day — the day she said “yes” to a medically assisted death — Jean was surrounded by unconditional love and care in the form of her husband, their family, and 15 of their closest friends.
In this special blog post, Jean’s husband, Don, shares the powerful story of their love, while recounting their final months together and the peace Jean felt when she made her final choice.
My beloved wife, Jean, and I were made aware of life’s precariousness more than two decades ago when we discovered that a seemingly inconsequential heart murmur was in fact due to a small defect in Jean’s heart — a hole remaining from birth — that had caused her heart to work harder and become enlarged. At the time, the surgery to repair the hole was extensive and risky, but one surgeon offered to do the surgery, saying, “If you let me do the operation, I can give you five more years of life.” Jean had done a quick read of her own body’s readiness and refused the operation. That was 25 years ago.
Jean insisted that it was her body after all — her life to decide. We were referred to another doctor who agreed to monitor her heart’s progress and advise her on an ongoing basis. She got 20 more years, not five as the surgeon had predicted. Jean often talked about this. We considered her heart to be special, doing what it could in its own way. Her heart defect was something that Jean would just have to live with, and it made us very aware of how precious life is.
Jean and Don when they were married in Winnipeg on December 28, 1966.
Then we were confronted by the darker side of life a second time. Five years ago, I was diagnosed with bladder cancer. I was fortunate enough to be operated on successfully. Nonetheless, while I was still recovering from the follow up treatment, Jean and I decided to move out of our home of 46 years to a retirement community.
As it happened, I was struggling in the garden one October afternoon and Jean was in the sunroom in the back of the house, watching, unable to help. I went in and said, “I don’t think I can keep up with the garden much longer.” Jean just smiled knowingly and went into the house. She returned with the phone numbers for three retirement communities. Jean was always a step or two ahead of me.
We eventually moved to a two-bedroom, two-bathroom apartment within the Portsmouth Retirement Community in Winnipeg. It was the right place for us. Jean was elected president of the Resident Advisory Committee, and I was able to write and take up art. We even wrote a poem together as we moved into this next phase of our spiritual growth and development. It became a sort of mantra for us:
Look for beauty in all things,
Expect love at all times,
Give from the heart,
Be grateful for life itself.
We enjoyed the sense of community and participated to the point of being very happy and content with life there, except that Jean’s visits to doctors and stays in hospitals became more frequent.
Ramon, Anthony, Don and Jean arrive in Winnipeg in the summer of 1972. Ramon cheekily calls this photo “1972 Bad Hair Day.”
It was during one of Jean’s hospitalizations for heart failure when two doctors at Victoria Hospital said to her, “You are in the process of dying. We can’t treat the failing heart, but there are things we can do. You can keep going in and out of doctors’ offices and hospital emergency wards. Obviously, that’s not working. You can go into comfort care here. You could have palliative care in your home. Or you could explore medical assistance in dying.”
Jean and I were so relieved. Finally, someone in the medical field was talking our language. Although we live today in an amazing world of medical capability, there comes a time in life when death is the only option. As individuals, family, and friends, we may not want that to be the case, but it has to be accepted. It takes faith.
The doctors then admitted Jean into comfort care in the hospital, while we explored the option of medical assistance in dying (MAID). I was able to get a private room for most of the three weeks that Jean stayed there. Her room was always crowded with visitors and flowers. I had to be there from nine in the morning to seven in the evening to make sure that she wasn’t moved from her private room and to schedule the many visitors so she wouldn’t get tired. She loved visitors and would never say “no.”
From 5 p.m. to 7 p.m., Jean and I kept to ourselves. We shared her dinner and sat on the edge of her bed looking out of her window at the wintry outdoors. We kidded to one another that it was like being on a cruise ship. At one of the doctor’s suggestions, I brought in a CD player so we could play music during dinner.
Don and Jean with their two sons, Ramon and Anthony, at Jean’s retirement party.
We were both interviewed by two different teams of three specialists: a medical doctor, a nurse, and a social worker. They asked us questions about our readiness for MAID — physically, intellectually, emotionally, and even spiritually. Jean and I wanted our two boys, Ramon and Anthony, to be present at the second interview to have some input into the decision we were making. The Winnipeg Regional Health Authority’s MAID team was very open to having our sons participate.
It turned out to be a very wise request as our sons had yet to accept that their mother was in the process of dying and in so much pain. They came to the second meeting prepared to argue for their mother’s life and showed great love and concern. Gradually, they were able to accept what they had already suspected and became fully supportive of their mother initiating contact with the MAID team. It put us on the same page as a family and it was a great relief to Jean to have their acceptance.
Then, two friends agreed to witness her application, as required by the law. It took the two teams less than a week to consider the information they had put together before they called a third meeting to tell the family that Jean qualified for medical assistance in dying and could exercise that option whenever she wanted. It was up to her.
Jean celebrating her and Don’s 25th anniversary.
Jean was later released from the hospital into palliative care at home, knowing she had the option of an assisted death in her back pocket. She was forever positive about life and a fighter, but she regarded her having qualified for MAID as her “ace-in-the-hole.” It gave her control over her life and filled her with a sense of fulfillment.
And so we both knew and talked openly about that fact that she had this option open to her — when she was ready. It was a matter of her feeling self-fulfilled and at peace with her destiny, she would explain. I had told her many times that I was more than willing to take care of her forever. But we both knew better.
While in palliative care, Jean wrote her own obituary and planned her own Celebration of Life. She was like a project team leader, discussing with all of us what she wanted in her obituary and Celebration of Life, and then assigning us various tasks to help her with the writing and organization. In this way, our two boys and their wives had a very active part in what happened and she was very proud of their involvement.
Palliative care, we also discovered, is no longer a place where a patient who is terminally ill goes for the last days of their lives. It is a process that can be implemented at home. The philosophy of palliative care is “to keep a patient as comfortable as possible for as long as possible.” We had visits from a nurse every second day to monitor and assist Jean’s progress, and on three separate occasions, we had doctors visit and make adjustments to her medications. Palliative care ordered all of the appropriate drugs and equipment and, in effect, we were like a hospital room connected to the hospital through computers and a 24/7 phone number. The medical care was exceptional — very caring and professional. Our expenses for medications were covered and even the cost of our oxygen was reimbursed. Jean required oxygen even while she slept.
Jean and Don celebrating their 50th wedding anniversary on December 28, 2016.
We had been told that due to the progression of her heart failure coupled with an inoperable hip that was now “bone on bone” and other sources of pain that were difficult to identify, best estimates were two months. Thanks to the exceptional care we received from the palliative care staff, we had nine months at home together.
After those nine months, though, Jean’s heart began to fail rapidly. She felt, then, that she had no choice. On Monday, December 19, 2017, several doctors and a nurse met with us. They wanted to try a new regime of drugs but when Jean asked them about her heart, they said that it was worsening. It was up to Jean. We discussed the situation after they left as we had so many times before. The next morning Jean phoned the MAID team, led by Dr. Kim Wiebe. They agreed to meet with us the next day.
We knew Dr. Wiebe well having met with her three times before, and we both held great respect for her, not only as a compassionate and highly skilled professional but also as a close friend. As always, Jean had managed to establish a relationship with her that was lighthearted and positive. Not surprisingly, Dr. Wiebe started out by saying: “I’m surprised — and pleased — that we didn’t hear from you before this.” We told Dr. Wiebe that we, too, were grateful that we had made out so well in palliative care. “But it’s time,” Jean added without hesitating.
Since we wanted to have Jean’s medically assisted death performed at home and not in a hospital setting, it was fairly easy to schedule the date. The morning of Saturday, December 23, 2017, was set as the day.
Jean visiting with her youngest great-granddaughter, Everlee Joy, in October 2017.
On December 23, 2017, the MAID team arrived at 10:30 a.m. and set Jean up for the procedure while I waited with the visitors in a room provided by the Portsmouth staff. Of course, Jean was the consummate hostess for the medical team and everyone else in attendance — our two boys with their wives and our five granddaughters, and 15 of our closest friends. Jean had had one of her close friends bring her several new dresses to try on for the occasion. She chose a red, long-sleeved top with black pants and red earrings to match her top. She wanted the long sleeves to cover the IV tubing taped to her arm for the three injections.
Jean had the MAID team position her in her favourite armchair and we gathered around her. I sat beside her and held her hand. The doctor and our sons were on her other side. Jean presided over the event, calling each person forward to spend a few private moments with her.
Then she spoke to the room, assuring everyone with humour and strength of heart that she was at peace. She had fulfilled her life – indeed, her destiny – with their help. There were tears, of course, but also much laughter and happiness, just as Jean had wanted. She wanted it to be a celebration of her life. It was her way. We called it “love’s connectivity.”
Several weeks earlier, Jean had asked one of our older granddaughters, Jessica, who is a professional singer, to sing her favourite song, Steven Tyler’s “Smile.” Two days before the procedure, Jean asked her again if she would sing the song, and again, Jessica said “yes.” But she added teasingly, “You want me to sing it twice?” Jean was quick to fire back: “Of course. I won’t hear it the second time.” Jessica sang the song beautifully.
Finally, it was my turn to spend a few private moments with Jean. We had already spent the few days leading up to the day preparing one another. We leaned toward each other to touch foreheads. Jean began the mantra that we had repeated together nightly:
“Look for beauty in all things,” Jean said.
“Expect love at all times” I replied.
“Give from the heart,” she continued.
“And be grateful for life itself.” I said.
Then we both smiled and said: “And SMILE.”
Dr. Wiebe asked Jean again if she still wanted an assisted death, as she is required to do under the law. Jean said “yes” quietly but firmly. Then we said our last words. At that point, Dr. Wiebe began the injections. There are three injections: a sedative, an anesthetic and a muscle relaxant. The person goes to sleep, then into a coma, and then, the heart stops. Jean was among the first 100 people to choose a peaceful death in Manitoba.
Before her death, Jean informed all of us what she hoped her Celebration of Life would be like. She wanted something that truly reflected her joy of living and her gratefulness for 86 wonderful years of life. “Sure, there were ups and downs,” she would say. “But Don, we shouldn’t be greedy. We’ve been so fortunate in life. We’ve seen our boys become successful; we’ve seen their children grow up; we’ve even seen their children’s children growing up. We’ve got a lot to be proud of.” Jean truly felt grateful for one generation to the next and she wanted her Celebration of Life to reflect that. She also wanted it to be a happy event where her friends would be encouraged to share their memories.
Jean and I often talked about our somehow being part and parcel of a vast and unfathomable sea of energy that sustained our humanity, a love’s connectivity that flowed from one person to another and from one generation to the next. We tried to understand it, but we decided instead to simply try to live it. It was us. It still is.
Jean and Don in their apartment at Portsmouth in December 2017.
Nearly 250 family and friends packed the First Unitarian Universalist Church of Winnipeg for Jean’s Celebration of Life. Jean chose two songs: “Gather the Spirit” and “All is Well with My Soul.” All of the family spoke, and Jessica, of course, closed the event by singing “Smile.” The crowd stayed afterwards for nearly two hours, telling stories about their friendship with Jean, laughing and crying as one. We received many cards from people that day — always written inside was the joy of knowing her and the gratefulness for the happiness that she had brought to people.
Jean left so many encouraging and loving words that we as a family decided to take on a project suggested by a fellow resident in our retirement community — a book about Jean and her belief in the power of love’s connectivity. We wanted to make it a love story and tribute to her but we also wanted to fulfil Jean’s wish to make medical assistance in dying more known and more supported.
As a family, we co-authored the book, which is based on our mutual experience and love. We invite everyone who thinks positively about life and death as part of a loving and caring process to read and enjoy it.
Dying With Dignity Canada thanks Don and his family for sharing the power of their love’s connectivity with their beloved Jean. You can purchase their book, which is both a love story and a case study on medical assistance in dying, here. You can also read Jean’s obituary, which she wrote herself, here.