"I knew I didn’t have to save my energy anymore. I could give it my “all” because I knew that I would be dying on that day. I felt so relieved."
Choosing when and where you would like to have an assisted death may or may not be difficult for you. It might be that you have had a place and date in mind for a long time, and have already discussed this with family and friends, perhaps even before you applied for MAiD.
You may find choosing the day and place difficult. You might be unsure of what you want. You may decide to hold off on setting the date and wait to see how things go. You may be feeling so unwell it is hard to muster the energy to decide.
If you are struggling with making these decisions, talk to someone you trust and who can support you. Many people make these decisions with family and the people who are closest to them. Others decide on their own.
You can have MAiD at home, at someone else’s home, or in some health facilities such as a hospital, long-term care home, or a hospice. MAiD can also be provided at an alternate location agreed to by the MAiD provider.
As much as possible, the location where MAiD takes place is your decision, but the location may depend on factors such as the MAiD provider’s availability, and the fact that some health facilities do not allow MAiD. If you are in one of these facilities, you will need to be transferred. This will be done at no cost to you or your family.
If you would like to have an assisted death at home, you might be wondering if this will be “too hard” on your family and friends, especially those who will continue to live in your home. It will be hard on them when you die, no matter how or where.
Try to have an open conversation with those who might be most affected by this. Most would prefer that you die where you want to, in familiar surroundings for them as well as for you. Others may worry how it will be for them to continue to live in the place you died.
While it is neither right nor wrong to want to die at home, and is a personal choice, it can be helpful to know that there is no evidence that dying in a shared home is more difficult on those who will be grieving.
You may want to have MAiD as soon as possible. If your death is not reasonably foreseeable, you may feel frustrated that you cannot choose a date before the 90-day assessment period.
Choosing the day and time is a personal decision, but it can be helpful to talk about it with those closest to you and let them know what you are thinking and feeling. The date must be when the MAiD provider is available. They may not be available on the weekend or in the evening.
Your choice is affected by how you are feeling physically and emotionally. People have talked about a “line in the sand” in their quality of life which, when crossed, is when they know they would want to set the date. This is different for everyone. You may be ready to pick a date, for example when:
- You are no longer able to get out of bed.
- You can’t communicate with family.
- You can’t go outside.
- You can’t engage in activities that are meaningful to you.
- You are dependent on others for intimate care.
- You are no longer able to live at home.
You might also consider:
- Avoiding birthdays or other dates that have special meaning to your family and close friends.
- Tending to unfinished business and ensuring your “affairs are in order”.
- Having the time to say goodbye and have meaningful conversations with family and friends
- Giving people from out of town who are important to you time to visit.
Many people have said they “just knew” when the time came. If you are struggling, talk to someone you trust and who can support you, or ask your health care provider or the MAiD team to arrange for you to talk with a counsellor.
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- You may feel relief that you have the independence to schedule the date of your assisted death
- The idea of “picking a date” on which to die may feel very surreal.
- You may also feel reassured that you can change or cancel the date at any time.
- You may feel anxiety or pressure that you will inconvenience the medical team if you change your mind. Be reassured that this is not an inconvenience - the team is there to support you.
- You may feel anger, sadness and fear that your medical condition is taking you from your family and friends too soon. You may feel afraid of what death will be like.
If you can, try to give yourself and family and friends time to adjust. Some people find it easier to manage their energy knowing the date instead of living with the uncertainty of not knowing when they will die. For others, this is not so. Neither is right or wrong.
If you have been asked to tell the MAiD office the chosen date, you are obviously someone this person trusts. Making the actual call can bring up all sorts of feelings and can make the “abstract” of talking about something very real.
Remember that you are the messenger. Allow yourself to feel whatever it is you are feeling – there are no “right” feelings. You might find it helpful to have support available before and after you make the call.
“I realized after her death that I’d actually done much of my grieving before she died, because I knew when it was coming. Somehow that seemed to help with my grief afterward.”
"It was so surreal – I kept looking at the calendar – it was like a “countdown” to the day she died……"
You may experience a mix of feelings once the date is set. You might be grateful and relieved that you know the suffering of the person you care about will end. At the same time, you are probably feeling very sad about losing them. Depending on your relationship, you may be anxious about how their death will affect your life, and you may wonder how you will be able to go on without them. You may be experiencing anticipatory grief.
You may have accepted that the person is dying, but knowing the date and time can feel different:
- It can be a very surreal feeling knowing when they will die.
- You may feel anxiety now that you know exactly when the death will happen. You may feel that the person’s dying has become more ‘real’ or that time is speeding up.
- If you have been distressed by the person’s suffering, you may feel some relief in knowing it will soon end. You may feel reassured that you were able to support their wishes for an assisted death.
- You may find that knowing how much time is left can help you to know how to use your energy and pace yourself.
- You might begin thinking about what the time left with the person might look like.
You can begin to think about what you most want to say or do before the person dies, especially if you’ve been avoiding this up to now or having your own conflicted feelings.
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Resources
- Grief and Medical Assistance in Dying (MAiD) - MyGrief.ca learning module
If a date hasn’t been scheduled but the person’s condition is worsening, you may wonder if you should bring MAiD up with them or how to talk to them about it. If you know that they wanted information about MAiD or are eligible for MAiD but have not yet picked a date, you may feel comfortable raising this subject.
You might start a conversation like this:
“I am wondering if you are still thinking about MAiD, but it’s been on my mind, and I’m wondering if it’s something you would like to talk about.”
“I noticed that you seem to be getting worse. I’m here to support you, whenever you decide to set a date or with whatever decision you make.”
If you are not comfortable to raise the subject of choosing a date for MAiD with the person, you can ask their health care providers, or perhaps other family members if they would be able to talk to the person about it.
Even though a date has been chosen, you may decide not to proceed, to ask for MAiD sooner, or to postpone the date. This can be done by calling the MAiD office. They will reschedule or provide other options that may help with your suffering. Control over this choice is an important part of the MAiD process. It can be a huge comfort to know that these options exist.
Sometimes people feel anxiety or pressure that they will inconvenience the MAiD team if they change their mind. This is not a problem - the MAiD team is there to support you in whatever you choose.
It can sometimes be difficult to be prepared for a date and time and have plans shift. You may feel like you are swimming in many different directions. This emotional roller coaster is normal. It can be helpful to find someone to talk to – a trusted family member, friend, faith leader, your health care provider, or a counsellor.
Sometimes, a person will die from their illness or an unexpected event before the date they planned to have MAiD. This can feel like yet another unexpected turn. You may feel that there were things unsaid or their death was not what you or they had hoped it would look like. You may also feel the person didn’t “get their wish”. You might feel relieved they died “naturally” as you were not sure how you felt about a medically assisted death.
It can be helpful to remember that ultimately the person was ready to die. It can also help to talk about your thoughts and feelings with someone who you trust and who can support you.
Resources
- Grief and Medical Assistance in Dying (MAiD) - MyGrief.ca learning module