Stella Ross lived a fabulous life.  She was born in 1920 and died at 102.  As a child there was no running water in the house, and by the time she was 90 she had been an Air Force bride in WW2, raised two children, got two degrees, had two careers, traveled the world, and was a pro with an iPad.  She also went to the gym 3-4 times a week and volunteered taking seniors out.  She was a no-nonsense whip with a very large social circle.  She was fiercely independent. 

When it came to preparing for her death, she did everything right

 

• • She had two Powers of Attorney: both her children

• • She had a do-not resuscitate order that she carried around with her

• • She subscribed to LifeLine and put her 2 granddaughters as the first points of contact

• • Her will was clear, and had both her children as executors 

• • She prepaid her funeral

• • She had a room in the basement that she rented to students and RCMP officers with the intention of getting full time care when she needed it

• • All her medications were sent to her home 

• • Her doctor even made house calls 

But at around 95, Stella’s brain stopped being forward thinking, and her ability to learn new things began to deteriorate.  She did not tolerate change well.  She began falling with regular trips to the hospital.  There was no medically determinable reason for her frequent falls.  

At 99 Stella got a toe infection and stopped going to the gym.  She knew her schedule, she debated politics, read 4 books at a time, read the paper, worked the crossword, and watched CNN.  Stella knew her limitations and was aware of the risks, until she didn’t.

At 99^1/2, Stella started the death process.  At that time, she was conversationally lucid, but her mind was not aware of reality.  She was certain she would die in her sleep and adamant that she did not need anybody to help her, but she regularly relied on her neighbours, friends and granddaughters (her two children no longer lived in the city).  She was convinced she never asked for help, though she always did.  She was certain she drank 8 cups of water, and ate well, but she was losing weight and her water jug always at the same level. She was certain of her abilities, and stopped calling for help when she fell (twice this caused extended stays at the hospital).  She stopped reading, working the crossword, watching TV and could not work her iPad.  According to Stella, she had just lost interest.  She was proud and did not want to admit that they now confused her.  She swore that the room in the basement was never intended for somebody to move in to help her in the last years.  Stella could no longer care for herself, or her home, but she was incapable of realizing it. 

On the Labour Day weekend in the 99^th year of life, Stella was rushed to the hospital. Her neighbour had popped in and found her in her bed.  There was blood everywhere.  She had fallen, tried to clean up the blood and went back to sleep not realizing that she continued to bleed. 

After 8 weeks of rehab, Stella returned home, certain she did not need help.  Also certain it was not her home.  She could no longer prepare her own meals, would not take her medication unless somebody gave it to her, and worked a puzzle by staring at for long hours.  Stella had lost her lucidity and had to have her rights taken away. She could not keep track of who was coming and going.  Too many people in one day and her cognition would radically decline, so she needed hours and sometimes days between visits.  She was adamant that she wanted to die at home, but did not want to accept help in her home. 

Her Powers of Attorney hired a service and had 5 personal support workers (PSW) cycle through her home.  One granddaughter made sure she had groceries.  

Stella could not keep track of the PSWs, or who would be where and when.  Sometimes they would not show up, and nobody would know until the next door neighbour started keeping track.  The PSWs did not communicate with each other even though they came from the same company.  

Stella could not leave the house for appointments, but needed her hearing aids replaced (she mistook one for food while in the hospital), and her glasses fixed.  She needed hair cuts, and cleaning services, her furnace checked.  The lists were in her head, and her head no longer worked.

There was no coordination, no communication.  Stella’s life was a mess with nobody in charge.  Stella’s Powers of Attorney (PoA) did not live in the city so were incapable of seeing the issues.  One of her granddaughters, Marie-Chantal, could not stand to see her like this, so took over her care.  It was not easy because she did not have PoA, so extra coordination was required with her father who lives in the United States.

One month before she turned 102, she was admitted to an Assisted Living Facility after another fall.  Her death plan was to stay at home and go to the hospital for tweaking until she could not be tweaked any longer.  The hospitals kept her for weeks rather than hours, moved her about and put her in Covid wards (she got covid); every stay at the hospital saw significant physical and cognitive decline.  She HATED hospitals, so did Marie-Chantal. 

The Assisted Living Facility was no better at communicating than if she had been at home. There were no transportation services for her.  The family hired a death doula and one additional PSW to balance her care needs.  She died 2 months after her 102^nd birthday, and her granddaughter was exhausted after just over a year of her grandmother’s extensive care needs.  

Stella’s Story is Only Good for Stella

Stella’s story is one of the better ones.  She had the funds, owned her home, and had a competent, trustworthy person who could take of her care.  She also had a great social network.   But, Stella’s story was not good for her granddaugher.  

Marie-Chantal had no idea what to expect from the death process. There was virtually no information available to inform her, and what was there was confusing and overwhelming.  The services offered by the province were intermittent and insufficient, and Stella worked against help. There were no integrated technologies to help and privacy respecting communications tools to coordinate.  

Waiting for God would like nobody to go through that if possible.  Marie-Chantal lost out on enjoying her grandmother’s time.  All her time was spent on Stella’s care, so she felt resentment and anger and did not want to hear her stories.  Looking back, Marie-Chantal would have really liked somebody to help relieve the burden so that she could enjoy quality time with her grandmother up until the end.