Frailty of Old Age

In the lottery that is 'cause of death' this has to be one of the less unwelcome ones. No cancer, debilitating rheumatoid arthritis or stroke, lung disease, cancer, sepsis, MND, MS, years of inexorable dementia... 

It does rather gloss over the gradual but insidious loss of muscle strength and mobility, the failure of the heart to supply adequately the whole body, and the decline in mental agility, cognition and attention spam, the occasional delusional episode, the steady loss of hearing and sight loss etc etc. Actually it's a really raw deal, especially if you felt ready to go years ago.

Once she passed about 90, Mum would say "I think the Lord's forgotten about me!". More recently it was "Why's He making me stay?". She had prepared a "Do Not Attempt Cardiopulmonary Resuscitation" declaration years ago.

We knew in early April that Mum was in an 'end-of-life-care' situation. Paramedics had been called due to overall weakness and laboured breathing and "did we want them to take her to hospital?". Everyone agreed that she would be better off in her own room, surrounded by familiar faces, if there was no specific treatment they could give her in hospital. The next day she was up for breakfast!

From then I was able to visit without booking a slot, as long as I rang through first and (of course) took a lateral flow test. Mum rallied for while and we had some conversations - mostly lasting just a few minutes before she'd fall asleep. 

Eventually she spent more and more time asleep and her medications were withdrawn because she had difficulty swallowing them; then she lost the capacity to swallow and moved into a permanent unconscious or semi-conscious state. The GP was called to prescribe morphine in case of her showing signs of distress. 

If you want to know what it's like to sit with a loved one in this state, watch Together, the recent TV drama. Dennis Kelly, the writer, and Sharon Horgan delivering his words, just about nail it. (In fact Horgan and McAvoy are excellent in this, so watch it anyway.)

The care Mum received could not be faulted. She died after I'd gone home for tea, but when we later visited to empty her room, the carer I'd been seeing over the final few days told me she'd been with her when she died. I have no reason to believe she was in pain or distress at any point.

On my list of tasks now is to look at setting up an Advanced Healthcare Directive and also a Health and Welfare Lasting Power of Attorney.