Many, many years before my mother began to suffer from the effects of Alzheimer’s disease, we had some very frank and open discussions about end-of-life issues. She was nurse who had cared for the elderly for 20 years, and she knew the realities that death’s door can bring.

We discussed her desire to donate her body to medical science after her death, a desire that I heartily endorsed. She wanted to continue to contribute to the medical profession even in death. Over the next several weeks, she had to get the signatures of all of her children endorsing her decision, or the Medical University of South Carolina would not accept her donation.

In a way that only we could lighten the weight of the decision, I teased Mama about how delighted those medical students would be to have such a beautiful specimen. We laughed and laughed, and in the midst of that laughter, we embraced the seriousness of her decision, realizing that in our belief she would no longer be in that body, but at home with the Lord.

In addition to this decision, Mama signed power of attorney papers and durable health care power of attorney papers, giving me the responsibility of caring for her affairs should she become diminished in her capacity. She gave me the responsibility to refuse medical treatment that would simply prolong the existence of a body after she was no longer mentally or emotionally present.

It is my firm belief that Mama suspected that she would endure the same disease her own mother suffered from for 10 years. She began making her preparations long before it was necessary.

Today, how thankful I am for her insight and foresight. Her decisions and the expression of her desires, along with the very frank discussions we had, gave me the strength to carry out her wishes. Though painful, letting her go when the time came was her wish. She died with dignity and peace in the presence of a nurse. That’s the way she would have wanted it.

Recently, a CNN Web site article discussed end-of-life issues, describing private dramas that reverberate in hospitals, homes and nursing facilities every day. Medical science has progressed to the point that it can keep a body going long after the person is functional. Technology plays a great role in this development, but it is up to families to stay ahead of technology and discuss, regardless how uncomfortable, the deep issues that surround these types of situations.

Along with my mother, my aunt’s family made the decision with her permission, to disconnect life support equipment. She died four days later. In addition, my husband’s brother-in-law repeatedly had catheters, breathing and feeding tubes reinserted after critical brain surgery. He had pulled them all out several times, but finally one day he pulled them all out and communicated to the nurses that they were not to reinsert them. He died in a hospice hospital a little over a week later.

Faith played a large role in my mother’s decisions. Believing that her soul would ascend to heaven after death, she was not afraid. Believing with her, I knew when it was time to let her go from this earth, but certainly not from my heart.

The CNN article quotes Dr. Christina Puchalski as saying, “I don’t think we do death very well.”

Only about 15 percent of people sign advance directives, such as living wills and durable health care powers of attorney.

My mother was one of those 15 percent, and it gave her and me as well as my brothers great peace of mind. My husband and I have ours.

We are all going to die. We need to make sure our families know when it is time to let us go.

Harris Murray is director of library services at Orangeburg-Calhoun Technical College. She can be reached by e-mail at writeharris55@yahoo.com. Discuss this and other stories online at TheTandD.com.

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