Sharon Wolfe, a volunteer with our GTA Chapter, had some candid conversations with her closest friends about death, dying and Advance Care Planning. She shares them with us in a blog post in recognition of National Advance Care Planning Day, April 16, 2021.
It’s always amazing to learn new things about friends, especially when you’ve known them for ages. There is one topic which, more often than not, leads us into uncomfortable territory. At least it did for me when I recently told friends that I had become a volunteer for the GTA Chapter of Dying with Dignity Canada.
Perhaps a bit of background is necessary. My friends range in age from early 70s to mid-80s. They are bright, with-it people who keep up to date on all manner of happenings, be they political, social and most currently with COVID raging, scientific.
So, I was very surprised that so few had heard of Dying with Dignity Canada or Advance Care Planning. Even those who thought the name sounded familiar initially had no interested in finding out what the organization was about. Two friends dismissed it outright.
One said; “Dying with Dignity, you can’t be serious? The only way we’ll die with dignity is if our heads are working and we have a heart attack. That’s dignity. Otherwise, we need to make an arrangement with someone we can trust and knows what they’re doing, which I already did.”
The comments of the others were not as blunt, but few showed interest. Since I wanted to know why these usually curious people appeared so disinterested, I asked if they ever think about dying. Most admitted that they do…sometimes. Not so for one vibrant woman of 88 who said, “I never think about death. I plan to live to 100 and when that time comes, I plan to give away all my jewelry.” Another commented, “What’s the point? When something happens, there will be time enough to think about it then.”
I decided to find out what, if any, plans they had put in place. None of the many people I spoke with were religious. Most had no qualms about ending their life if living became unbearable. Many had made provisions by having their lawyer draw up a document giving someone, usually a partner or child, power of attorney. One woman said she hadn’t “felt complete” until she had done that.
With reference to the legal provisions they made, when asked if their document specified the circumstances under which they no longer wished to live, or if instead it simply left that up to their designated person to decide, some couldn’t remember, stating they had simply signed whatever it was that their lawyer had prepared. Others said they had stipulated they wouldn’t want to be on life support if an accident or stroke offered little hope of recovery. Although one did correct herself immediately, by adding, “Well maybe I would want to be put on for a little bit just to see if something turned around.”
No one I spoke with had seen or heard of the immeasurably helpful Advance Care Planning Kit that Dying with Dignity Canada has produced. Once they heard about the questions and details it elicited their interest in the organization was piqued considerably.
COVID appears to have been the impetus for many people to think about things they hadn’t before. Fear they might find themselves in hospital without their partner or care provider present has resulted in many a conversation about the use of experimental treatments and ventilators in particular. Reluctant partners are being urged to be more forthcoming, to express what they would or would not tolerate should they find themselves incapacitated and alone in an ICU.
One wise friend said she called her unmarried son in another city to ask him what his final wishes might be should he develop COVID. A difficult conversation but a necessary one. As the mother said, “It’s one thing to prepare for one’s own demise, not the same when it comes to visualizing the death of a child.”
Many of my friends didn’t know Canada has a medical assistance in dying (MAID) law and the ones that did know were unaware of the restrictions currently in place or the recent amendments to the bill. The main concern for those who “choose not to go there” - signing up for MAID - is what will happen if they change their mind. One woman spoke of her sister who always said she wouldn’t want to live if there was a chance she’d be permanently incapacitated. When the time came for her to undergo a highly risky surgery, the doctor asked if she stood by her previously made resuscitation directive. “No,” she answered, “give me everything.”
Once the discussion about the benefits of having a comprehensive plan along with the understanding that it could be changed at any time, attitudes relaxed. Many of the same people who showed little interest in anything beyond their immediate circumstances seemed more open learning more about MAID.
What is most apparent is that there are two camps: those who prefer to go about their lives focusing on the now and those who have come to terms with the fact that since their lives will end eventually, they might as well make the ending as full as their living. I enjoyed hearing about women who have faced the inevitable and made preparations beyond the legal and practical things they may require, using creativity to have their demise more in keeping with how they lived, while making it easier on those they leave behind.
Most important to many was the need to take care of unfinished business before they died or before a friend or relative passed away. It was deemed important to mend fences, to say whatever it was that needed to be said, so one’s life would end free of anger, resentment and regrets.
One woman said in making her final preparations she chose a photo of herself looking her youngish-best and gave a laminated copy to each child to ensure that picture would accompany her obituary. Another person spoke of a recently deceased friend who not only chose the photo she wanted, she also wrote her own obituary and one for her husband who is still very much alive.
Interesting were the stories about the people who, knowing their death was imminent, organized parties or gatherings to say good-bye to friends. One woman made her way around the room telling each person how much they had meant to her. Another, a lover of crazy hats, gave each friend one of her hats to wear at her party, with the request they take them home and wear them again at her funeral.
We discussed ways friends and families can make a loved one’s last months special. One woman was often heard bemoaning the fact that it was a shame people couldn’t be alive to hear the wonderful things people said about them at their funerals. Her daughter picked up on the idea and wrote all her mother’s friends and relatives asking them to write a letter to her mother explaining how much she has meant to them over the years. When the letters arrived, the daughter put them all in a book.
In essence, more and more people have discovered that planning ahead for their inevitable demise has offered more comfort and less distress for their families as well as for themselves.