End of Life Musings

It was November. Buddy’s birthday was approaching. I was midway through my pregnancy with Sissy and the big gender reveal ultrasound was scheduled for the next day. I wasn’t feeling too good. In addition to being pregnant I had some sort of respiratory infection. And I got a call about my maternal grandmother. She wasn’t doing too well. She would need surgery and there was a good chance she wouldn’t survive.

It wasn’t a big shock. She’s in her 80s. She’s been on a downward spiral for a long time. Dementia, strokes, and now a fall that shocked her weakened body. Besides, I’d been lucky to get into my 30s with all four grandparents alive. I told myself this was bound to happen eventually.

I took a day off work and drove up to the hospital. When I walked in my grandma was vibrant. “I’m so sorry I’m not going to live to see Buddy’s birthday.” She said.

I stumbled over my words. How do you respond to that?

“Maggie, you’re not going to die!” my grandpa snapped, obviously more distressed than my grandmother. She was at peace.

I sat on the couch and watched as my grandma made her goodbyes. As luck would have it, one of my aunts and cousins from out of state happened to be visiting at that time. Grandma was saying goodbye to everyone, and basking in the glow of their attention. The thought of her dying was obviously more distressing to my grandfather and my aunts than it was to her. She was ready.

I thought about the things she would miss if she died that night. She would never know if her third great-grandchild was a boy or a girl. She wouldn’t even get to meet her!

They wheeled my grandma out to surgery. I went with my folks and my grandparents’ minister to the waiting area. The minister was actually liberal and pretty cool and soon the more liberal members of my family were critiquing Fox news while the conservative members shook their heads. The mood was strangely buoyant, but I was aware it could easily change.

We got the news that grandma had survived surgery. Relieved, we went home.

Grandma was not relieved to have survived though. If anything, she was as mad as hell about it. The months that followed were horrible. She was mad, stated over and over again that she was ready to die. She was now bed bound, and the dementia was worse. Two years later and she’s still here. And yet she’s not.

That night at the hospital when she apologized for not being able to make it to Buddy’s birthday party was the last time I spoke to her and she knew who I was. For years my grandfather was in denial about her mental deterioration, but it’s at the point where even he admits it now. She’s aware of her great-grandchildren, but she’ll talk to me about them as if I’m not their mother and have no idea who they are. She used to be very independent, but now she’s completely dependent on my grandfather. She uses a wheelchair.

It’s not a life I would like.

I watch her and read discussions about end of life planning. I value the quality of life greatly. I know that if I were in a similar situation to Brittany Maynard I would definitely end my life. But dementia is so tricky. The loss of the person is so slow, and a person’s ability to consent is constantly challenged by nature of their medical impairment. My gradmother’s descent into dementia has taken nearly twenty years. At the start she was still sharp, knew who I was, and I could have a conversation with her. That’s not the case anymore.

I hope she’s found meaning in these years. Yet watching her, and knowing I share her genetic vulnerabilities, makes me think about what I should do if I ever start showing symptoms of dementia.

If my grandmother had died that November she would have missed the arrival of two new great-grandchildren. Whether or not this makes up for all her suffering is not for me to answer. If she had died five years earlier she would have missed the arrival of her first great-grandchildren and several weddings and college graduations among her grandchildren. If she would have ended her life when she started showing symptoms she would have missed my high school graduation.

Everyone bows out at some point and misses the arrival of new family members and weddings, etc. And I can’t help but think about how tranquil and at peace she was with her impending demise that November, and how it contrasts with the indignities and the anger she feels over being alive now.

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