Last Part of To Die With Dignity

"I said, 'My daughter and granddaughter are trying to take me to Switzerland for an assisted suicide and I don't want to go.'"
I sat down hard. "What? Why would you do that?"
"I don't see how this is possible. If we go and I get rejected, which I know I will, they'll retaliate against me."
"Who will retaliate?"
"The manager here. Then they'll treat me even worse."
"Mom, they don't treat you badly, they're just doing their jobs," I said through gritted teeth. "What did the manager say?"
"She was very concerned."
I'll bet. "Did she ask if you wanted an assisted suicide?"
"Yes. I told her I did, but don't believe it will happen. I won't be able to hear the Swiss doctor when he asks me questions. Then you'll abandon me there."
"Mom, that makes no sense." I leaned my back against the living room wall and slid down to a seated position on the floor. "What possible reason would I have to abandon you? If anything goes wrong, or if you change your mind at the last minuteâ€"you can always do thatâ€"we'll just fly back and that's the end of it."
She sniffled into the phone. "I want to go, but now I'm afraid I messed everything up."
"Don't worry. I'll see what I can do. Okay?"
"Okay. They want to speak to you."
"Assisted living?"
"Yes. And they called the police."
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A few days later, one week before my daughter and I were due to leave, the AL manager and a social worker phoned me.
"We understand that you're planning to take your mother for an assisted suicide," she said.
"Yes, that's correct."
"Are you aware she told us she didn't want to go?"
I kept my voice even and friendly. "I believe she said she did want to go but is having some anxiety about the logistics of travel."
The social worker spoke up. "That's what she told us, but maybe subconsciously she doesn't want it and that's why she's making excuses."
That thought had occurred to me as well, but I'd witnessed her increasing anxiety at her loss of independence and declining health. Her latest reaction seemed to be a manifestation of the same. Besides, how could I deny her my assistance for PAS based on an unsubstantiated guess that deep down she may have reservations?
The AL manager continued. "We can't release her from the facility unless she agrees. We need to meet with you when you arrive here to pick her up. And we filed a routine police report, so an officer may contact you."
"I understand," I said and signed off. I did understand. If a person is being coerced into PAS by someone who stands to benefit from their death, it becomes a police matter. In our case, there was no coercion, but my daughter and I were my mother's inheritors. Surely it was common for a relative to assist and accompany a loved one, and likely they would be named in that person's will. But would the police view it that way?
My daughter called. "Are we still going to Switzerland next week?" I'd been keeping her in the loop about her grandmother's imagined concerns and the latest issue with the AL manager.
"I keep trying to reason with grandma. She's worried she won't hear the doctor's questions, so I told her we can bring a small whiteboard to write on. And she thinks she has nothing to wear, so I reminded her you took her shopping and we'd help her pack." I paced the kitchen floor. "Oh, and now she's afraid assisted living won't let her leave even though I said they can't hold her there if she says she wants to go." I huffed in frustration. "It's like she's not hearing me."
"That's the problem. You keep trying to reason with her logically. I found a video you should watch. It's a TEDx talk on how to speak to an elderly person who's being irrational."
After Kirsten sent me the link, I watched the talk, Validation, Communication Through Empathy, by Naomi Fell. Naomi, a social worker employed in a senior's home, presented a compelling way to relate to elderly people. She discussed how we commonly treat older people who are in distress with sympathy ('I know how you feel. Have some tea.'), or redirection ('Don't cry. Everything's fine.') or lying ('You're asking for your mother [deceased]? She'll be here soon.') Naomi said never to argue or negate what they say. Even if it seems illogical, there are likely deeper unresolved emotions. She encouraged the audience to instead validate the person's feelings and gain their trust with empathy. To rephrase what they say, matching their tone and inflections, and to ask questions, allowing them space to express themselves. What seems like delusional behavior is often the manifestation of unresolved feelings from the past, so it's important they be allowed to grieve and cry.
My daughter was right. My habitual way of dealing with my mother was a combination of all of the 'don'ts' in the video. But how I interacted with her was deeply ingrained. Kirsten changed her flight and arrived a few days sooner to be with her grandmother in the way the video described.
I arrived in New Jersey on January third. The next morning, I drove through slushy roads, my wipers clearing wet snow from my windshield. I parked at the AL facility and headed for my mother's room. I hastened my steps as I passed the AL manager's office. The manager would question my mother about her desire to go to Switzerland before we could leave the facility. Would a police officer be there? What would my mother say? Had Kirsten been able to ease her paranoia, or would she still refuse to leave despite constant affirmation that her greatest desire was to go?
I put a smile on my face and opened my mother's door. Kirsten sat beside her, holding her hand, a packed suitcase lying open on the floor. "... and then what happened after you got sunburned on your honeymoon?" she asked.
My mother looked up. "Ah, you're here," she said to me and then smiled at Kirsten. "My lovely granddaughter has been coming every day." Her eyes glistened and she wiped at her cheek. "She's been helping me pack. Too bad nothing fits."
I set my coat and purse down on her bed and gave her a hug. "What are you talking about? Kirsten had you try everything on. It's all right there," I said, gesturing to the suitcase.
Kirsten leveled a warning look my way. "Grandma, why don't you tell me more about when you and grandpa were first married?"
I grabbed my purse. "I'll just wait in the common area. See you soon, Mom," I kissed her cheek and went to the door.
I sat on the overstuffed, floral couch across from the communal TV. I leaned back and breathed, letting the past ten months of stress drain from my shoulders. I loved my mother and had done the best I could for her. Either we would leave for Switzerland that afternoon or we wouldn't. It was as simple as that.
A couple of hours later we were ready to go. My mother seemed relaxed. There was a knock on the door. The AL manager and another staff woman, evidently the social worker, entered. No police.
The manager addressed my mother. "I have to ask youâ€"do you know where your daughter is taking you and do you want to go?"
I held my breath.
My mother sat up straight in her chair and spoke directly to the AL manager. "My daughter and granddaughter are taking me to Switzerland for an assisted suicide. Yes, I want to go."
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We arrived in Zurich after an eight-hour red-eye flight, rented a car and drove to our Airbnb. It took us over an hour to find the lodgings. Not because we were tired, which we were, and not because the street signs were in Swiss-German (the local dialect) which they were, but because the exterior looked like an abandoned commercial building. We parked in a crowded lot flanked by a gas station, and a liquor store and I helped my mother up the crumbling cement steps. The listing had stated the third-floor apartment had an elevator. They didn't say it was working.
I struggled with my mother up dimly lit stairs, holding onto the metal handrail. The three-bedroom apartment shared a wall with a dance studio and bore little resemblance to the on-line photos. There was no oven in the narrow space that passed for a kitchen and the toilet seat was broken. The beds were harder than the floors. But we'd gotten this far.
Kirsten grabbed a European adapter and plugged in her iPad. "At least we have powâ€"" she said as the lights went out.
By the next morning, we'd all gotten a few hours of sleep and the power was back on. The Swiss physician assigned to our case arrived at the apartment. He introduced himself and sat in a chair opposite my mother. He opened his briefcase and took out a piece of paper. "Can you tell me why you're here?" he asked her, reading from the paper.
"For an assisted suicide," she answered in a clear, unwavering voice.
"Are you here of your own volition or have you been coerced in any way?"
"No, I haven't been coerced."
"Do you understand that you will have to drink a glass of sodium pentobarbital which will cause your heart to stop, bringing about death?"
She nodded. "Yes."
"And are you sure you want the procedure?"
"Yes."
The physician returned the papers to his briefcase and snapped it shut. "Okay, that's all I need. I will be back in two days and ask you the same questions to make sure you still want the procedure."
"That's it?" she asked him.
He smiled. "Yes, that's it. I'll see you Thursday," he said and left the apartment.
We made the best of the substandard Airbnb for the next two days. I bought groceries at a small market and made my mother's favorite dishes, glad to see her enjoying them. Kirsten and I talked with her for hours, the familiar stories of her youth rendered fresh by the context that we were hearing them for the last time. Of the three of us, she slept the best.
The physician returned, repeated his questions, and my mother gave the same answers. The following day, we drove to Dignitas' rooms for the accompaniment. Upon confirmation from Dignitas, I'd brought my mother's clothing and medications for donation and proper disposal, respectively.
We arrived and were greeted by two women. They put us at ease, offering tea and Swiss chocolates. The room contained a bed, a recliner, a couch and several chairs around a small table. The bed was only for patients who needed it, and my mother took a comfortable seat in the recliner. The rest of us sat around the table. I showed my passport and filled out some general paperwork.
After a half an hour or so, a young, uncomfortable looking policeman entered the room. Another thing we hadn't expected. Had I done everything right or would there be an issue, literally at the last minute? I wiped my palms on my pants and tried not to think of the potential for police intervention when I returned to the States. His affable manner suggested his presence to be a formality at this stage. He asked some basic questions, similar to the physician's, and left.
It was time.
One of the women handed my mother a cup of liquid and instructed her to drink it as quickly as she could. She drank from the cup without hesitation and with mostly steady hands. Kirsten and I sat on either side of her, each holding her hands, stroking her back and saying we loved her. Gratitude that we could be with her this way made me blink back tears.
When she finished drinking she said, "I don't feel anything."
"That's normal. Just breathe," one of the women said in a hushed voice.
Kirsten and I stroked her arms and we waited for about five minutes more.
My mother smiled and leaned back in the chair. "Here I go."
We gathered our belongings and prepared to leave, and both women hugged us. One of them said, "I've seen many cases over the years. Some people, even in the worst situations, feel one-hundred percent sure they are ready to die, but their bodies fight the medication. I just want you to know your mother went peacefully and without any resistance. She was ready."
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I returned to New Jersey and cleaned out my mother's room, looking over my shoulder for the police. Just before we'd left the accompaniment, we'd been instructed that any U.S. legal concerns should be directed to the Swiss authorities, but I couldn't help being nervous. Thankfully, there were no police, nor any further mention of them. I returned home and began the process of dealing with her affairs, including executing her will with its many charitable contributions. I had no regrets. I'd helped my mother fulfill her last wishâ€"to die on her own terms.
With dignity.