Care homes and the right to die

Ursula Fausset, Psycho-spiritual elder

Published in JHH12.2 – Works that reconnect

My life experience has been as a nurse, an artist, a mother, a patient and, since I founded the first London Gestalt Centre 30 years ago, a psychotherapist. Our society denies death. I find that it helps people of all ages when ‘death’ is brought out of the closet. Only then can we avoid useless years of suffering brought about by well-meaning medical interventions: otherwise the physical, emotional and financial costs are needlessly enormous. This year alone, there will be one million more over-70s (in the UK). Yes, we do become a burden and loving openness can mitigate that.

We take a lot of responsibility these days for our bodies with diet, supplements, exercise, and we also have a wonderful choice of health and wellbeing practitioners. But when it comes to our late, more helpless, years we give up that responsibility. Most of us hand over our life, our bodies and souls, to the powers that be. Care homes and hospitals are overflowing with the elderly, many of whom would rather be dead. We are kept alive by the wonders of modern medicine, thus unwillingly putting more strain on those institutions. There is little time for the overworked staff to be really caring.

Thirty years ago I was kept alive when a cancer was removed, and I’m thankful to the doctors as my children still needed me. But now I’m old.

My dear parents’ last years were terrible. Mother went to hospital at my age for investigation. She caught a hospital bug and spent the next two years trapped in a single room with just the necessary attentions for her survival. My father, in his 90s, gave up visiting because he found her groans and smelly catheter too depressing. When I visited, she’d plead like a helpless child, ‘Take me home, Ursula!’ I dearly wished I could. My brothers and I were present at her death. I saw her body in the mortuary and tears of relief flowed.

That left my father alone in an isolated cottage. No one he had known was still alive. He became a pathetic old man, with double incontinence and searing pains of loneliness. He was too deaf for the radio and his eyesight was barely good enough to feed himself. For his last months he lived on chocolate biscuits and cola. I don’t blame anyone. The tragedy is that these kinds of fates still exist for many of us. If you are young and healthy now, your time will come, for I understand that the proportion of helpless old people continues to increase. Be prepared!

For many of us, our last long years will be ones of physical and mental suffering as our bodies and minds fail. We may be in miserable resignation, wishing we were dead: dependent, confined and among strangers, all in various degrees of decrepitude. Nobody seems to ask what we, the elders, think or can do about it. We may have devoted family or others who genuinely choose, from love not duty, to care for us at home. Yet this may not be what we old ones want; what seems like compassion can sometimes be clinging or guilt and the old end up living a half life. If we have savings or our own home, all this can be eaten up by treatments, care, or nursing to keep our pumps ticking. If we have children, they face inheriting nothing or worse, just at a time when money is most needed for them and their children and, sadly, we may not have enough grasp of our minds that we can even recognise family and visitors.

Demographically, in the west old age is growing increasingly burdensome for all concerned. A greater proportion of the population will be old and resources of the state, health and welfare services and, importantly, the planet, wasted.

I am an 85-year-old woman and have four loving daughters. I still have a rich life and feel well blessed. Suffering has sometimes taught me, or it has just been hell on earth. In any case I’ve had abundant joys and a full share of life.

A common way of looking at the world is noticing tendencies of regression, towards blame, greed and selfishness. Alternatively we can realise powers of awakening to respect and compassion for all living things, great and small, starting with ourselves. Our survival on this earth depends on that universal kindness. It isn’t ‘they’ that need to change, it is you and I. Every word and gesture we offer can add to the work of ‘the good gods’ and to survival, not of the fittest – this is the 21st century! – but of those who know their essential loving nature and, from that place, are willing to take responsibility for their lives. And if we are to be responsible for our life, then we also need to take what responsibility we can for our death.

I am grateful for my life. I like to remember that my days are numbered. It helps me to appreciate the gifts of small things. When the time comes I believe I will be equally grateful for my death.

Death is not a failure. We can rarely call the time of our dying ‘natural’. But whose job is it to decide when it’s time for me to die? The law doesn’t own my life. The medical profession (of which I was once part) definitely doesn’t own my body. I don’t want a doctor to make the burdensome decision about when I’m to die. If I, as an individual, feel my time has come, am I to submit to the cultural norms and become what, to me, would be a victim of the status quo – institutionalised with the rest? I wouldn’t treat a dog that way. If human beings survive I believe that our present system will, in some future, seem barbaric.

Someone who is close to me works in care homes. She says the worst cruelty is not the lack of care. People cry out ‘Help me!’ for years. Their real need is to be helped to die. Society’s attitude would have to change. Surely it is a human right, to die. The commonly heard ‘I wish I was dead’ is sadly ignored in the current culture.

Suicide? The word suggests constrained despair and a burden of helpless guilt for those left. Euthanasia? In Greek that meant ‘good death’. Now it means getting legal permission to die, or an onerous journey to a foreign clinic. Yet the mantra of ‘too many old people’ is constantly in our ears.

Words are so important: we need a new word for a do-it-yourself exit strategy. My hope is to act when I hear my familiar still small voice guiding me. We are not just bodies. We don’t need religion to recognise the power of love.

Even if thousands of people in this country feel like I do, it would still be illegal for a doctor to give me a prescription to end it all when I hear that calling. In some conditions informed fasting can be a gentle way to go, or a reliable dose of appropriate drugs.

Yes, I believe I will know when my time has come. I have discussed it all with my family and they are totally with me in my decision to die when I feel it is right. I am very aware that this also involves them and many others. It is important that I feel at peace with my dear ones, that all is forgiven and there will be no regrets when I am gone. Hearing the call, knowing that the time has come, and having the trust that it’s true and the courage to say goodbye, requires fundamental faith. Ideally I’d have a party the week before! Realistically, I probably won’t be in a fit state.

I am fortunate in having friends who would risk the law and sit with my dying body; a gift of love.

Why, when we are old, are we reluctant to say goodbye? Sometimes we hope that life will improve. Generally it doesn’t, it gets worse! Sometimes it is simply a fear of no longer existing; the unknown. I don’t minimise death’s finality: it is the ultimate letting-go. Although, obviously, having no experience of dying or of reincarnation, I am satisfied with my own conclusions. They may not be ‘right’. I just sense their truth for me and, most importantly, my answers neutralise any fear of annihilation and enable me to live in gratitude.

And after death? As the body becomes part of the earth so the soul becomes, as it always has been, part of a universal consciousness. My individual soul lives on in those I have influenced. The suffering I have caused, whether conscious or unconscious, is now for the living to understand and heal (‘the sins of the fathers…’). Where my influence has been of love and wisdom, that lives on in the hearts of those I leave behind, especially near and dear ones. If I have been essentially kind, I add a jot more consciousness to the evolution of life on earth.

The transition into life at birth does not happen in one moment. It’s part of a process. It is the nature of change, including from life to death. Nor does the spirit leave the body at the moment the heart-pump stops, which is one reason why I have asked for a vigil – at least three days with my body at home in an open coffin. During this time, when faced with my corpse, death cannot be denied. I believe, through ceremonies of the living, my spirit can be helped to go free, and those whose hearts weep can mourn together.

These ideas are obviously not for everyone. In the end, I know how little control we really have. But, for me, I am freer from fear of the death-cheating power of our present system. May we all die in love and peace.

Ursula Fausset founded the first Gestalt Training in the UK in the seventies. Since then she has been a dedicated student of ‘inner work’, influenced by numerous approaches and teachers. She now does half-hour telephone sessions with those who are home-bound. Her autobiography Much Ado About Me is an acclaimed good read.

For sessions telephone 01803 868625, or for the book, email: