Excerpt from “One Woman’s Choice” (c) 2005

“I guess I’ve known I was coming to the end of my life, but I was avoiding it. I don’t want to struggle anymore.” My mother was speaking from her heart and I was listening.

It was just an ordinary day when my mother and I had the most important conversation of our lives. She was chronically but not terminally ill at the time, we did not speak about advance directives, and she was not asking for physician-assisted suicide. Yet to my profound awe, 10 days later, she died at home.

The following days were a mix of emotions and more, entering the most profound process of her life on her terms.

It took a team to support her wishes.

It took her courageous knowing and choice to call us all to what was needed most

When I last saw her, she had a smile on her face

My mother was supported to let go and die a natural death, but she had to ask for it-and so will many of us, but we don’t know it.

In her courageous choice to align her heart and mind and actions, my mother chose not to struggle any more, but hadn’t known what her options might be. Supported by our conversation, my personal and professional experience of healthcare realities and options, partnering with compassionate and humane healthcare professionals, and my family’s faith, love, and trusting that she knew what was best for her, we were all able to support her last acts of living through her dying. How?

First, with our conversation that honored her truth, her fears, and her options. Whenever the time came, she knew she had full support and permission to die, to ’stop struggling’, to not fight anymore. “I guess I’ve known I was coming to the end of my life, but I was avoiding it,” Mom told me. Haven’t we all.

Once not avoiding the conversation and coming to a deep peace about her own beliefs and wishes for her death, we talked about what she could focus on that she wanted to complete before she died. A newly focused ‘to do’ list so to speak, with a profoundly honoring purpose.

Not long after this amazing conversation though, her “one good knee” collapsed beneath her, she took a bad fall and was rushed to the emergency room. She and our entire family knew of her beliefs and wishes, and were then able to weigh every medical treatment option and their outcomes with her wishes. She chose to not accept new treatment that would only prolong her life and increase her pain and struggle. And then, with full support, she was told the truth that medications she’d been on for years were not cures to her chronic illness, but the ‘best medicine could offer’. As they couldn’t cure her, it was her option to take them, or not. Again, with full medical partnership and support, she chose to stop taking any medication that were only prolonging her life-not improving her health, with compassionate care to support her.

Pain management, hospice care and coordinated communication between my family and a healthcare team ensured my mother’s wishes were met. It was not the result of one conversation or a signed consent form. It was an emotional, spiritual, logistical, and communication process over the course of days.

If my mother had chosen to continue to struggle and fight the effects of chronic but not terminal illness, we would have supported her completely. Yet she didn’t want to continue on, and we all knew it. As a daughter, I cannot express how much I miss her. Yet, her last and most courageous wishes were met, without additional painful and costly medical interventions, months, or even years of bedridden, nursing home care that she didn’t want. She chose what she wanted, and when it was time, we were all ready to stand behind and support her.

As a daughter, there is nothing more comforting than to know we supported her last days of living on her terms.

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