Nancy Russell was a 90-year-old woman living in aged care in Toronto. She was doing well for her age, and her daughter described her as having an active lifestyle. But over the lockdown period, her mental health and happiness severely declined. As coronavirus cases in Canadian aged care started to increase again, Nancy made a decision.
“Being mobile was everything to my mom,” her daughter, Tory, told Canadian news website CTV News.
“My mother was extremely curious, and she was very interested in every person she met and every idea that she came across so she was constantly reading, going to different shows and talks. [She] was frequently talking about people she met and their life stories, very curious, open minded. So for 90, she was exceptional.”
As is the case in many countries, aged care in Canada was hit hard by coronavirus. In Nancy’s facility, they were placed on a two-week isolation period, confined to their rooms. For Nancy, who would regularly walk to the library, do her own shopping, and was a spry and social woman, this was difficult to deal with. As lockdowns continued to stretch over the months that followed, she felt herself decline.
“She was just drooping,” Tory said.
“It was contact with people that was like food to her, it was like oxygen. She would be just tired all the time because she was under-stimulated.”
Faced with a second round of lockdowns and isolation, Nancy made the decision to go to her doctors and seek out a medically assisted death.
According to Health Canada, the eligibility requirements for medical assistance in dying, also known as MAID, includes “experienc[ing] unbearable physical or mental suffering from your illness, disease, disability or state of decline that cannot be relieved under conditions that you consider acceptable”.
As Nancy Russell was already a supporter of medically assisted deaths in Canada, and had already planned on electing this, the decision for her just made sense.
“I do want to underscore the fact that she wanted medical assistance in dying at some point,” said Tory.
“And she had told her family doctor that, but the application was hastened by the impact of the lockdown measures.
“She just truly did not believe that she wanted to try another one of those two-week confinements into her room.”
After being refused by a first doctor, who told her she had “too much to live for”, Nancy Russell began preparing for winter. But facing more lockdown restrictions, more strict isolation rules, and Canada’s long winter, her condition worsened.
The second time she applied, her daughter said she had developed “more concrete medical health” issues, and her application was approved.
“When you stick someone alone and deprive them of the usual things that bring them interest in joy, that can be an incredibly isolating, lonely, depressing experience,” Dr Samir Sinha, a geriatric specialist at Mount Sinai Hospital told CTV News.
“And frankly, when you can’t look forward to getting out of your room, to having meals or doing activities with others, to even seeing your own families and loved ones, you can imagine for a person in the last few years of their life where these are the basic things that actually bring them joy and really defined what they would call their own quality of life, when you actually deprive a human being of these things, you can imagine that that can have significant psychological consequences that can really give people no real will to live anymore.”
Nancy is not alone in making this decision. According to CTV News, researchers have found that during lockdowns in aged care facilities, the rates of loneliness and feelings of hopelessness has increased among older people, causing what they call ‘confinement syndrome’.
This has caused more older people to inquire about medically assisted death during this time. Those in the field have reported that the lockdowns have sped up the timelines for those who were already considering a medically assisted death.
“I would say it is an accelerator, not a cause for people’s MAID requests,” Dr Susan Woolhouse, a member of the Canadian Association of MAID Assessors and Providers, told CTV News.
“They met the criteria and wanted MAID prior to lockdown, but are choosing to die sooner than they would otherwise because the LTC and retirement lockdowns, particularly visitor restrictions, are so miserable.”
In the days leading up to Nancy Russell’s death, she left her care home, and moved in with one of her children. For eight days, she was visited by family and friends, they were able to spend their last precious week together, telling stories and playing games.
“Her facility was in full lockdown at that time,” Tory said.
“We would not have been able to visit her in her facility. She had to leave. And for a week, with all proper COVID [precautions], we visited.”
On October 20th, 2020, Nancy Russell laid in bed, surrounded by family and friends. As they stood together, holding her hands and singing the song she had chosen for her departure, a doctor eased her through her medically assisted death.
As she died, she spent her last minutes totally different from how the previous months of her life had been. She wasn’t alone anymore. She was with her nearest and dearest, and met death on her terms.
“She was able to direct a peaceful, pain-free death on her own time and avoid a great fear of hers, which was to endure winter and lockdowns,” said Tory.
In her obituary, Nancy’s memory was celebrated, as was her decision to die on her own terms.
“Ever adventurous, Nancy departed this world with her wits intact and her expansive curiosity tempered only by a willingness to let the mystery be.”
If you or anyone you know needs help:
Lifeline on 13 11 14
MensLine Australia on 1300 789 978
Suicide Call Back Service on 1300 659 467
Beyond Blue on 1300 22 46 36
Headspace on 1800 650 890
Image source: iStock licence, this image does not portray real people