A loved one dying at home is not a small thing. My own culture teaches us that people should die in hospitals (in a study some years ago in America, while 88% responding said they wanted to die at home, 56% actually died in a hospital). Here in India, it’s becoming more the norm too. It takes courage, preparation and faith to insist on handling everything oneself.

That’s what we wanted for Mummy. It’s what she wanted too. And at the age of 100, when you know what you want, you aren’t afraid to say so. She had told me many times in the last few years how ready she was to go. No heroic measures, she said. Nothing invasive. And, she insisted: “I don’t want to be a burden.”

Not wanting to be a burden is at the top of many elderly people’s lists. It’s painful to hear for those who love them. Burden us, we shout: NO PROBLEM!

I added one more thing to the list: No pain while dying.

But India is a difficult country to die in if you want to be comfortable. It is the world’s largest producer of morphine (the drug of choice to manage pain in the dying) but it exports over 90% of it and severely limits its availability here. The law makes it so difficult to obtain that most doctors never even bother to apply for the six licenses which are required to dispense it. Its scarcity means that few doctors know how to administer it; its use is not taught in 80% of the country’s medical schools.

Thank God for The Network. I was able to acquire a small amount from a sympathetic doctor friend – luckily, I know how to give injections – and it made all the difference to our peace of mind. She only needed it at the very end, but knowing it was there if required and that she would not suffer needlessly removed the fear of pain which is almost as bad as pain itself.

Elderly woman asleep in bed; two grown-up grandsons on either sideIn the last month of her life, Mummy took us by the hand and led us gently into the world of the dying. Slowly, she began to withdraw from the daily life of the house. Where before she had always joined us at the table for meals, she now came out less and less frequently – first having breakfast in bed, then dinner and finally even lunch. She was too tired, she said, and it was too cold.  And anyway, she wasn’t interested in food anymore.

As she ate less and less, her energy declined further. Small ailments became major as her resistance decreased and her weakness grew. I took her to the doctor for treatment and the cure for one problem would simply create another. It was like a house of cards, so fragile had her system become.

Then she began to limit fluids. Even the sight of tea or lemonade made her feel queasy; swallowing a sip of water made her retch. As she went into acute renal failure, I tried helplessly to convince her to drink more. “What will happen if my kidneys shut down?” she asked me. “I’ll die?” I nodded. “That’s what I want,” she whispered. “I’m praying for that every day.”

Elderly woman in wheelchair with daughter and granddaughter before a Christmas treeThe family began to gather. From all directions – Bhopal, Mumbai, Gurgaon, London, Chicago, Connecticut, Pune – her loved ones arrived. When Mridula, her older daughter, got here, something crazy happened. Mummy – who had been lying still for hours, not responding, not eating – suddenly sat bolt upright and said: “Let’s go!” I thought that she wanted to go to the bathroom (even though she had not passed urine in 36 hours, she still kept asking to be taken. She had a horror of losing control and creating problems for me.)

I got her up with difficulty (she was so weak) and wheeled her to the bathroom. “Why are we here?” she asked. “Let’s go out!” Her granddaughter Manisha suggested that we take her into the living room and so we did. The Christmas tree was still up and we wheeled her in front of it and took photos. She smiled and laughed, even setting the photos up (“You stand behind me,” she told her granddaughter. “It will look better that way.”)

We were thrilled out of proportion. No one could stop laughing. We took picture after picture, sending them to our whole family, almost begging them to confirm what we thought we were seeing: she was FINE. Those who were making plans to come asked if they should cancel their bookings – maybe the crisis was over? Maybe we had panicked unnecessarily? Maybe she wasn’t dying?

It’s called the “Euphoria of the Dying” and it’s a recognized phenomenon. A sudden burst of energy, an unexpected surge of interest and vitality – it typically takes the family totally by surprise and changes the atmosphere of the home completely. My friend Linda, who is a hospice nurse with years of experience and wisdom learned from the dying, told me she had seen it happen a few times, though not usually as remarkably as what I described. She told us to make the most of it – enjoy it while we could, because such moments were both rare and precious.

Elderly woman playing cards on her death bedA few minutes after the photo shoot, Mummy said she was tired again and wanted to lie down. She sank then into a deep sleep that lasted for several hours. But she woke with another burst of energy – this time she got up and said she would like to play cards.

She had always been a card shark, using the game to amuse herself, teach her students numbers and – I found out only yesterday from a young woman who had stayed with us some years ago – as a means of communicating with guests who couldn’t speak Hindi.

But she was also fiercely competitive. 

It was a game to remember. She was alert and attentive, checking the accuracy of the shuffle and the cut, complaining about the dealer and prodding the others to play quickly, as if she was on the clock. She had eyes only for the game.  When one visitor said goodnight, she waved him away impatiently. Mistaking him for one of the players, she turned to me urgently and said “Can you take his place?”

Her intensity and focus took that game to an entirely different level. Those who were playing kept their wits about them and simply played. Those of us who were watching from the sidelines could only marvel at her passion, delight and excitement. It was a fiesta. Everyone was laughing out loud in wonder and amazement.

Young man feeds an elderly womanAnd then again it was over.

She had a few more moments of lucidity – asking Arayaman to feed her some kheer, smiling in recognition when Anand arrived from London, squeezing Cathleen’s hand in welcome when she arrived from Chicago and finally taking her last breath 90 minutes after Nutan arrived from Connecticut.

But today, looking back at the past six weeks of her dying days, what we all remember are those brief, intense moments of joy and excitement when she seemed to come back to life – more vital, more vivid, more alive than ever.

It was, I believe, her parting gift to us. Yes, there was pain and discomfort and a few lingering anxieties. But the overwhelming memory we all get to keep (and we’ve already told the story dozens of times to friends, relatives and neighbors) is the playful, merry, carefree way she asked to take one last tour of the house, posed for a round of photos, ordered a hand of cards to be dealt, and demanded a bowl of kheer.

Who can cry at her departure when she had so much fun while going?

A family group photo with elderly woman in front in a wheelchair

Showing 15 comments
  • Maneet
    Reply

    This is so touching Jo. It’s so beautifully written, I have no more words to say. One can relate to it so well when we think of our dear grandparents depart from this world. :) There is so much to learn from all the beautiful words you write!

  • Natasha Badhwar
    Reply

    I can cry, Jo…I had to pause twice while reading to control the urge to cry…, but I guess I am not crying at her departure. Just the beauty of a life lived so well and with so much determination is enough to being on tears. Reading about Mummy’s dying makes me think of all the dying that will happen in my life…and hope that we will be blessed with so much love, laughter and light too. Suffering ka kya hai, that one is reconciled to anyway.

    • Jo
      Reply

      Oh, Natasha!

      Thanks so much for this. And yes, of course. We all cried too. But what a life! She was teaching just days before she left us. Amazing woman.

  • Mridvika
    Reply

    Jo – I have followed her in your posts / photos so much that it was painful when I read about her departure. It almost felt like loosing my own grandma one more time. It was strange because i have never met your MIL, i have no specific memory with her to look back to. But yet have felt some unknown, indescribable pain to know that she was no more. This narration of her last mile journey puts a closure to that anxiety. Knowing how well lived even her last few hours were make me repent on how I have missed meeting a legend. Very few people touch and inspire you the way she has…thank you for sharing yourself, your family with everyone. Deeply inspired.

  • Devika garg
    Reply

    Thank you so much, Jo for sharing the story of your amazing mom in law and her remarkable life! Extremely inspiring !! You were lucky to have her and she you all! I had tears in my eyes reading your post and seeing the pics. What a sparkle she has in her eyes! Lovely!

    You are right when you say India is not an easy country to die in comfortably. Buts its also the one place you find a lot of empathy and sympathy for the old. I have a 80 yr old, wheel chair bound father who insists on living alone. Thank god for his 7 member very loyal staff that helps me let him be independent. I see the same spirit and fierceness to live life in him as you describe for you mom and so totally understand how lovely those precious moments of shared conversation and wisdom are.

    All the very best to your family. Her loss must be immeasurable but the beauty and immense joy with which you celebrate her life and share it with the rest of world is deeply appreciated.

    Warm regards,
    Devika

  • PATRICIA VIERA
    Reply

    Jo – This was so absolutely touching! I am so sorry for your loss, but – oh my! what an exit Mummy had, and gave to each of you. What a blessing. Tears for your loss, but also for the most incredibly touching post. God Bless.

  • Rajagopal M R
    Reply

    A good death. A beautiful death. A parting that leaves her loved ones with so many good memories. What a blessed life!
    But a good death does not come by just wishing for it. It has to come out of more than love. One needs determination to fight the whole medical system which would have wanted to incarcerate her in ICU and condemn her to solitary confinement until death.
    And for those who have pain, breathlessness or other discomfort as they approach death, why does our health care system not provide palliative care? Simply because palliative care is low-tech, high-touch and not expensive?

  • Patricia Davis
    Reply

    What an incredible death, Jo! It is so inspiring. Having been present for Allan’s death, I see so many similarities, although he never made it home. He emanated such peace that everyone flocked to him. It is such a privilege to participate in a death like this. She lived an incredible life and it’s only fitting that her death would be the same. Hospitals have limitations and their focus isn’t on getting you a good death. They do the best they can but home is better. Not everyone can do what you did. Thanks so much for sharing.

  • Vishwajeet Ghoshal
    Reply

    Dear Jo
    My deepest tribute and regards to departed and divine soul…Death is inevitable and so life..While reading, I was recollecting all memories of my Grandmother who was on Bed for three continuous years and even compelled to do her natural calls..I was pretty young and witnessing every second how she was coming closer to her last breath…
    It seems that even after 20 years that she is still with us..Living her life through me again and I wondered that how even after two decades, she has not gone from my memory even for a second…
    We all will go through the same process one day and will become one with nature…
    Once again my deepest regards to divine soul
    Vishwajeet Ghoshal

  • Martha McCann Rose
    Reply

    Good night, Mummy.

  • madhu gupta
    Reply

    Joe and Ravi,Iam sorry for the loss.Iam at loss of words as to how to express that My mother also celebrated a wedding before she died.I have also seen two of my close persons die in my hands. life going out of them,Eyes becoming still but peace on there faces.I am reminded by your sharing your expierence.

  • Manjula Bhagi
    Reply

    Thanks a lot dear Joe for walking us through the eloquent journey of parting gift; it felt like being participating in it. Its so heart touching and I have tears of pride and joy, rolling down my cheeks, such a divine soul who always resolved others problems where as counting her own was so insignificant for her, I always watched her, at the end of giving from heart, education, services, helping financially, and giving care, love, valuable advice, inspiration and showing concern were her personality traits.

    Since my childhood, she always gave me love of a mother, I have very rich memories of her to cherish through out my life. Surendra ji too always had praise and respect for her. She lived a life of KARMA-YOGI to the very end. God may give us strength to carry on her great legacy. We are sure her soul is resting in full peace, and with contentment.

  • Ashim Jain
    Reply

    Dear Jo,

    An immensely educational piece for me about the natural process of death and the relationships of love. I’ve read it word by word and will visit this page again a few more times to derive inspiration to better myself in dealing with and preparing for the ultimate.

    With profound respects and love.
    Ashim
    Kandbari, H.P.

  • Vanita. Puri
    Reply

    Beautifully depicted Buaji’s last days of her life. I felt as though I am present there and witnessing all this. Thanks for sharing it with us Bhabhiji. She and her principles will always remain in our hearts. Thanks

  • Malini
    Reply

    Jo, you have captured the strength, intellect, fun and passion of your mother-in-law. How wonderful to be surrounded by so much love. I know her physical absence must be hard but she lives on through your work. I did not know that Karuna Vihar was named after her. Thanks for sharing.

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