In Australia, fewer than one in three expected deaths takes place outside an institution, but eighty per cent of people say they would rather die at home.
I firmly believe that most people, given the opportunity, would prefer to die in familiar surroundings, amongst treasured possessions, cared for by people they know and love. The fact that it occurs so rarely is, I believe, less to do with the dying, and more to do with the living. The physical and mental strength required to nurse and oversee the deterioration and death of a loved one is incredible.
Katherine Baden’s brother, Don
When Hugh Baden realised he was terminally ill, he took steps to ensure that the months ahead would unfold in accordance with his wishes. He informed his wife Katherine that he wanted no one to come to the house, apart from family. He visited his solicitor and drew up an Advance Care Directive, stipulating the kind of treatment he would accept in various circumstances and clearly stating his intention to be cared for at home until he died.
Flipping through this document during my second interview with Katherine, eighteen months after she had successfully completed a task that pushed her to her absolute physical and emotional limit, I found myself wondering what my mother would have made of it. Faced with these confronting irreversible conditions, would she have chosen life regardless, and ticked yes for the most active of medical interventions to prolong her existence? What if, from the vantage point of full command of her faculties, she could have seen into her future and understood that it was her fate to become permanently mildly demented, unable to remember things or reason clearly; permanently unable to speak meaningfully; totally cared for by others; bedridden, unable to wash, feed, or dress herself?
Would she still have wanted to live? Would she still have expected us to care for her at home?
Hugh Baden’s Advance Care Directive indicated that he wanted no life-sustaining treatments. In a handwritten comment, he noted that he might have chosen differently if he hadn’t known that he would still be facing the lung cancer afterwards.
‘I wonder what my mum would have put,’ I say to Katherine. ‘If she’d been given something like this to fill out.’
I pause, realising just how unlikely it was that Mum would ever have wished to contemplate the possibilities listed on the form.
‘I think she would have felt that any bit of life was better than none,’ I say.
But of course I can’t be sure, because we never discussed it.