Yvonne’s story, Part 2: My mother’s forced transfer and struggle to access MAID

Part 2 of Yvonne’s story details what her mother went through during her last few months of life (you can read Part 1 here). It describes her ordeal with her decision to stay in the hospital in her Northern Ontario city so she could be visited by her friends. It also describes her medical assistance in dying (MAID) experience where she was forced to move because the only hospital in her city happened to be a Catholic hospital.

On New Year’s Eve, my mother’s health took an unexpected turn.  She began vomiting and her scheduled hospital transfer to receive medical assistance in dying was still four days away. One afternoon I came in and she had black vomit down her pajama bottoms and over the side of her bed. She told me it had happened in the morning and asked if I could please bring her for a shower. I informed the nurse that she was going for a shower and asked if they could also wipe down her bed. When I saw her the next day, she had the chills and she was still vomiting. Her pain was bad, and she could not keep her oral morphine tablets down. I asked my mom if she wanted to switch to morphine injections, and she said yes. I talked to a nurse and they made the switch. She was now more comfortable, but still doing a lot of deep belly breathing to control the pain. She was afraid to be too medicated to be able to consent on the day of the procedure, so she was keeping her morphine at a low dosage.

The morning of January 4^th, I was about to step out of the house at 7:30 am to help prepare my mom for her 8:30 am transport when my phone rang. It was the local hospital; the highway was closed near the remote hospital due to freezing rain. I headed over to the hospital to be with my mom. I spoke with the transfer coordinator explaining that my mother was scheduled for a procedure that very afternoon. I also texted the remote physician explaining our predicament. She came back with a plan. If we could be on the road by 2 pm, she could do the procedure that day, otherwise, they would admit my mom overnight and proceed with the procedure in the morning.

The ambulance attendants arrived around noon. My mother had been given her morphine injection, her motion sickness injection, she hadn’t eaten in 4 days, yet she got out of that hospital bed on her own and used her walker to get to the gurney in the hallway. They transferred the extra foam padding from her bed to the gurney to make the two-hour trip more comfortable. The ambulance was off and my husband and I followed it in our car. At the remote hospital, they had set up a room for the procedure. My mother and I got to spend some time alone. She did not want me to stay until the very end and I did not want that to be my last memory of her either. She had not wanted to talk to my brother or sister the last couple of days. I think she could not bring herself to say goodbye and she did not want anyone crying over her. I passed along some messages from my brother and sister. We started talking about some songs from the sixties and I played them for her on my phone. The doctor came in and introduced herself. She went over the procedure in detail and then needed some time alone with my mom to fill out the consent form. I was then allowed back in the room and just before they started the procedure my mom told me it was time for me to go. She hugged me and said, “thanks.” That is a good last memory of my mom. I was escorted to a lounge to wait. The doctor came in and told me everything went as planned. I thanked her. There are no tears today. I had been crying often these past few months and now I realized it was from having to watch someone you love suffer through their hospital stay, their loss of independence and their pain, that was so emotionally excruciating.

Though I had started cremation plans with a funeral home in my mom’s city, I switched to use a funeral home near the public hospital in the other city. My husband and I stayed in a hotel for three nights while we made final arrangements. Not knowing if the funeral home would be supportive of medical assistance in dying, I did not mention it at first. When they showed me a proof of the memorial card, it had my mom’s birthday and the city she was born in. It also had the day she died and the city she died in. She had only been in that city for a few hours and I did not want to have to explain to everyone why it wasn’t the city where she lived in and where she spent most of her hospital stay. I asked the funeral director to remove both cities from the card. I explained about my mother’s medical assistance in dying decision and the funeral director said that occasionally it can cause some issues when you want a religious funeral service. My mother only wanted a cremation and for me to scatter her ashes in the city she was born in.

I am Catholic. My mother is Catholic, and she appreciated the priest stopping by on Fridays to anoint her with oil while she was in the hospital. Everyone that I did confide in, regardless of religion, was personally supportive of medical assistance in dying. If I had gone home before winter hit like she told me to, my mother would have had to suffer to the very end. It is very difficult for a sick person to navigate the MAID paperwork, arrange witnesses, and hold medical video conferences without the support of the hospital staff and equipment. It is too easy for hospital staff to ignore a patient’s verbal request and not offer any direction. One possible solution would be to have the Catholic hospital staff direct such requests to a designated person who works in a nearby medical clinic. That support person could assist with the MAID process and the actual medical procedure could be done by a MAID visiting physician or nurse practitioner in the clinic after hours. This solution would have greatly assisted my mother and avoided a lot of undue stress.

Editor’s note: Dying With Dignity Canada believes the most practical and human-rights focused approach to end-of-life rights access would be for all publicly funded facilities to allow on-site requests, assessments, and procedures. There should also be a clear system in place to ensure that those in private religious facilities are being seen in a timely manner by MAID assessors, if they request it.