During my year so far, I have been struck by the advanced discourse here in the US about compassionate deaths. In the US, there is a major initiative to have “the conversation.” This is a discussion with family members before it is too late, to discuss your wishes and help ensure everyone understands your wishes. I have personally experienced the “end” with both of my grandmothers; one went out exactly as she wished, one suffered more than any member of my family could cope with. I have often wondered how it may have been different had we spoken earlier, as a family, about the plan for the end.

My Nian died of advanced dementia after a long hospital stay. It was clear once she was admitted that she would never be discharged home. I think her final hospital admission was 25 days. During that time she was trying to “escape” nearly every day. Some days she would make it to the garden, other days she made it further afield; one day she managed to hitchhike all the way home. Her behaviour was viewed as aggressive, violent, and she was a flight risk so her drugs become more and more potent. When her physical body finally gave up, relief was the only sentiment I felt. Her suffering, anxiety, fear and confusion were finally over.

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