Thankful for my nan's good death

Did you have a good Christmas? One parent in the playground to another; just a normal January greeting. How to respond? Did I just give the ‘It was OK’ look or describe how gut-wrenchingly painful it had been, writes Amanda Nash.

Trying to fit the death of a loved one in between school concerts and work hadn’t been the relaxing family occasion we all dream of. It’s only when I look back, with time putting a bit of space between then and now, that I realise how difficult it was.

We don’t talk about death much. We talk about people having died, especially with icons Bowie, Wogan and Rickman having passed away in January. But despite the work of the hospice movement, dying itself is still somehow hidden away behind closed doors; more often than not, hospital doors.

I’m a parent myself and losing my beloved Nan was my first adult experience of helping someone I love as they die. I’d seen people die and washed dead people as a student, working as a nursing auxiliary. But it’s different to have to watch, indeed to help, your own loved one as they fade away. To watch, as they become weaker every day; to see the strong matriarch who once boasted “I’m 65 and could jump over your lots’ heads” gradually become less and less able to tell you what she wants.

It’s sad to help them inch up the stairs they once bounded up two steps at a time; to have to cook just soft mash for the person who has made you the best cakes of your life, because you know their ability to chew and swallow is diminishing by the day.

Nan had a full 95 years

And yet, for all the sadness and grief, my beloved Nan was very fortunate. She enjoyed a long life, well lived. Born at a time when the milk was delivered by horse and cart, she spent the war years working in a munitions factory, welcomed my Grampy back from fighting in 1947 and, when she was widowed, travel round Europe with her family. She never moved more than a street away from where she was born but she had a full 95 years. She lived to see her cherished granddaughters grow up and nurture their own families, just as she had nurtured us. All her little tips and touches, the kind that only grandparents have, live on in us. My own boys, aged six and nine, were lucky enough to know her and will take their memories of Grandma on into their own lives.

In her 90s, Nan was still racing, literally, back and forth to the shops running errands for neighbours, many of whom were older than her. Up until a few months before she died, she was doing all her own gardening and painting fences. None of us could see old age getting Nan. She was just too indomitable. But cancer did. But something has to get us all, in the end.

Just as Nan had experienced a good life, so too she had a good death – if there is such a thing. I’d like to think, with some forethought and more investment in end of life care, more of us could have something similar.

She distracted medics with stories of her dancing days

Nan's death wasn’t without pain or worry. I don’t suppose any death can be. But Nan died in her own home, in her own bed, in the bed sheets she had instructed me to get out – because they were the best ones, with the flowery valance. Nan was from a generation where appearances were everything. That sounds sweet but was sometimes a problem. Whenever any health professional visited in those last two weeks, Nan would tell them resolutely that she was ‘Fine, no, not in any pain, eating well’ and distract them with stories of her dancing days.

It was left to us, her daughter and granddaughters, to fill in the blanks, explaining this wasn’t really her at all, to be sat in a chair all day, sleeping for most of it.

We wanted Nan to pass away quickly. Watching her sat in that chair, barely able to muster the energy to stay awake through Mary Berry’s Christmas special, was heartbreaking. To have to watch her, always the great hostess, ask others to make her a cup of tea and then barely sip at it. It was hard, for us and no doubt for Nan, although she rarely complained.

Nan didn’t complain exactly when last September she began to feel tired. She thought she might be anaemic or even diabetic. The cancer diagnosis took her by surprise. But then, thankfully, her demise was quick. She received her prognosis on 17 December. The young surgeon used his kindest bedside manner. But even he didn’t know what to say in the face of pretty imminent death. Instead he wished us “A Merry Christmas” and offered us, in true British style, a cup of tea.

“You only get offered a cup of tea if you’re on the way out,” Nan remarked, temporarily stemming our tears.

We knew Nan wanted to die at home

We knew, instinctively, that Nan wanted to die at home. The NHS is fantastic but who of us would choose to die in hospital? We asked for palliative care to be involved and Louise, the specialist nurse from the local hospice team, was serenity and jolliness wrapped in a pink uniform.

Of course, she didn’t see much of Nan. Nan wasn’t one for medical intervention. She hadn’t been in hospital since she was 19 with a burst appendix and in her last days she would barely take paracetamol for the pain. But when, the day before her death, the time did finally come for stronger pain relief, Louise was on hand to administer it. God bless the Louises of this world.

Nan had spent the two weeks between prognosis and death fading away in her own home, surrounded by her own pictures, smells, memories and the sound of her familiar clock ticking away on the wall. One of us, her daughter, granddaughters or brother, was with her all the time. Her last breath, my mum tells me, was expired peacefully.

It’s hard, especially in the middle of grief, to accept that there’s such a thing as a good death. But I think there is. I think Nan had it. Her stoicism and stubborn desire to stay at home and keep the medical professionals away for as long as possible ensured that.

This is how people use to die, in the days when my Nan was born. At home, cared for by people they loved and who loved them. When my time comes, I think I’d like that too.

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