Should you discuss with an ageing parent the subject of mortality, of death? If yes, what is a good way to do it? And when?
Illustration/Uday Mohite
How do you discuss with an ageing parent the subject of mortality, of death? Or the possibility of being in a medical situation where the doctor insists on an aggressive treatment that the patient does not want? Or if the patient prefers a certain mode of treatment, but the adult children disagree?
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Should you discuss it? If yes, what is a good way to do it? And when? I don’t think there’s one answer that fits all. But I can share my experiences with our remarkable parents, Papa and Amma, S Rammohan and Indu Shedde.
Years ago, Papa, when hale and hearty, informed us that whenever he passed away, he wanted his body donated to medical science. He gave us a filled-up body donation form, registered with JJ Hospital. Amma and I also signed the body donation forms; I thought it awesome that I could still be of use to someone, even after I was gone. We filed the papers somewhere and forgot all about them. Papa passed away much later—one moment, he was having tea, and the next moment, he was gone. I was at the Toronto International Film Festival, TIFF, in 2012, when I got the news; I collapsed, then scrambled to book the first flight back. My sister Akku, Sarayu Kamat, called to say Papa would not be there when I got home to Bombay: as he wanted his body donated to medical science, the body had to be sent within a few hours of death. Amma and she were doing OK, she added. I was to moderate TIFF’s Asian Film Summit discussion the next day, with Mira Nair, Guneet Monga, et al. There was only one way to decide: what would Papa have wanted me to do? He would have been outraged if I abandoned my assignment. So, with a split brain, I calmly moderated the discussion, and then broke down completely on the flight home.
As Amma is 98, it was wise not to postpone the discussion on the medical treatment she preferred, in case it became necessary.
Amma is quite independent and feisty. Still, when broaching the subject, I first reminded her of my favourite sculpture in Ajanta Caves, Cave No 26, of the Reclining Buddha, who has passed away and entered Parinirvana. There’s a row of followers below him, mourning, and a row of people above, welcoming him in grand celebration—how differently various people perceive the same event.
Then we recalled our relatives who have passed away, whom Amma was fond of—they’re all partying on the other side, I told her. Together, we compile a list, including Papa, Kanna Pachchi (Amma’s sister Kamala Divgi), Aai (Amma’s mother), Vatsalakka (Amma’s beloved aunt); Usha, another aunt; Padmini, a second cousin, and many others.
Then we discussed what kinds of medical treatment she’s okay with, if it becomes necessary. Amma said she’s OK with regular treatment in a hospital, eg, saline, medicines, etc. But in case of a serious, prolonged medical condition, she said she would not want aggressive medical treatments like chemotherapy, electric shocks to revive the heart, etc, that artificially prolong life. It is important to sign a “living will,” as it is called—best drafted by a lawyer and vetted by a doctor—specifying which kinds of treatment are acceptable and which are not, when you’re in control of your mind and body, in case a time comes, when you’re not in control.
The living will must respect the patient’s wishes above all; it must be countersigned by two “surrogate decision makers” and two witnesses. From most accounts, the medical system is geared to prolonging life—sometimes at any cost—which can be torture for the patient. Doctors sometimes also refer to a “DNR” or “do not resuscitate” order, not to perform cardiopulmonary resuscitation (CPR) if a patient’s heart or breathing stops. For body donation after death, you need to fill up a body donation form issued by a hospital that accepts body donations, ideally relatively near you—such as JJ Hospital in Mumbai or MGM Hospital, Kamothe, but there must be many others. The form, signed by the body donor and two witnesses, must receive a registration number from the hospital.
A few days after the papers were signed, I asked Amma, if she had any bad thoughts or worries or nightmares? “Not at all, I forgot all about it,” said our darling Amma, who is content, and has learnt to live lightly, and in the moment.
Meenakshi Shedde is India and South Asia Delegate to the Berlin International Film Festival, National Award-winning critic, curator to festivals worldwide and journalist.
Reach her at meenakshi.shedde@mid-day.com
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