I have written about all the cycles of aging but the last: dying. I recently heard a palliative specialist say that most people in our culture are terrified of dying because the people around them are going to go on living, to carry on without them and are going to forget about them. I think there are many reasons to be afraid of dying: a life wasted, wrongs uncorrected, uncertainty about after death, lack of faith, fear of the process of dying, and perhaps a few more.

My mother died on June 5 of this year at the age of 95. She knew she was dying and she was both afraid and unafraid in the last weeks of her life. I think she was afraid of being alone and afraid of dying in pain. She did not believe in a life after death and knew our memories of her would be her after-life existence. She had long been wondering why she had lived so long. In the last years of her life she was a warm and wonderfully generous woman. When I asked her if she had anything else she wanted to say, her response was: “You have been a good daughter, and have taken good care of me.” She told my sister the same thing.

She had a heart attack on January 31 and spent five weeks in the hospital. In the first weeks of her hospital stay, it was necessary for us to spend 24/7 with her so that she would get all the care she needed and to oversee the level of medical intervention. Last month I spoke about advocacy and at that time, advocacy for her was important. In addition to a “do not resuscitate” order, there were many other decisions to be made. We would often send away the blood and ECG technicians when these tests had just been done hours before. And when she was eventually moved from the critical care unit to less acute “holding bed” in the hospital, we had to advocate for a nursing home placement.

After five weeks, she was moved into a Daily Assisted Living bed in a privately run assisted living facility. There she lived for less than three months, before experiencing a fall. Following the fall we were able to prevent her from going to the hospital and asked for palliative services. The facility agreed to keep her. This was the very first time they had kept a dying patient. Thus we were able, in relative comfort, to remain with her all the time. We bought a new futon for us to sleep on and we brought in her and our favourite foods. In the four days from the fall, to her death, each day represented a decline in physical functions – eating, walking, bladder and bowels. Really, she slept her way out, and in her few wakeful moments we would talk to her and assure her we would be with her. And that we would never forget her.

At the very last moment, my niece was with her. Ironic, because my niece was the least prepared for that moment of death. Appropriate, because even in death my mother was doing some teaching about how to live a really fulfilling and good life. And she taught us how to die gracefully with dignity. So it should be for all of us.