In their final moments, Ron and Irene lay together in a single bed, soft smiles on their faces. They wore special shirts picked out for the occasion; his a cranky cockatoo print, and hers the same white and floral print blouse she wore to their 70th wedding anniversary a few months previously.
The only sign of what was to come were the twin cannulas, one in each of their intertwined hands, with long thin tubes winding back behind the beds and out of sight.
It had felt like an eternity to get here – the reality closer to three weeks – with countless possible pitfalls. But it was about to happen. Ronald and Irene were about to get their final wish; to die peacefully together.
My grandparents met in South Hurstville in the 1950s. Irene defied her father’s wishes and married at just 19. As the youngest of seven, she was expected to remain in the family home and care for her sickly mother. Ron, whose parents and older siblings migrated from London in the early 1930s, met her through a friend, and was smitten from first sight.
The courtship was fast, but the love endured. They had four children in Sydney before moving the family unit to Port Macquarie in the 1960s. My mum speaks so warmly about her childhood, growing up on the banks of the Hastings River, days of sandy feet and salty hair. Streets where they knew the names of every neighbour, and afternoons spent prying oysters off river rocks to slurp down.
In the decades between my mother’s childhood and my own, my grandparents travelled Australia in a caravan, with long stints in Perth, Katherine and wherever else took their fancy. In the 1990s, they bought a small hobby farm in Unumgar, inland dairy country on the Queensland-New South Wales border. By this point, they had five grandchildren and set about turning the property into a kids’ paradise. Ultimately they moved back to Port Macquarie, to spend their twilight years with the wider family.
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I can’t remember the first time my grandparents told me that they wanted to end their lives together. I felt like I’d always known, and to my surprise so did many others. In the lead up to them accessing voluntary assisted dying, we learned that they’d said it early and often to many people.
Fiercely proud, Irene had nursed all her siblings through their final stages, seeing first-hand how painful the end of our lives can be. It was at least 10 years ago that she told me, vehemently, that when it was her time, she wanted to go her own way.
Fate took away her sight first, with glaucoma making her almost totally blind, and then saddled her with a hideously cruel degenerative spinal condition. She’d lose dexterity and feeling in her hands and feet first, as her nerves were slowly crushed by the crumbling spinal discs, eventually leading to paralysis. She was tougher than an old boot, and barely let any of us see her pain – wrestling with my toddler even at the age of 90.
In April, when the nerve damage turned into dysphagia and she could no longer eat, she decided it was time.
“I’m done,” she said. “I’ve done everything I wanted to. I am ready to go.”
NSW was the last state to legalise voluntary assisted dying, coming into effect in 2023. Each state has slightly different requirements, and it remains illegal in both the Northern Territory and Australian Capital Territory. Eligibility is strict; in NSW, a person must make three requests (two verbal, one written), be assessed by two separate physicians and a board, and, crucially, suffer from a terminal illness that is expected to cause death within six months. In the first seven months oflegalised VAD in NSW, 1,141 people initiated a first request to access VAD and 398 patients died via the service.
Irene’s first assessment was tense. It was unclear whether the spinal condition would qualify as a terminal illness. Ron, overcome by the situation and his own myriad health problems, had a severe panic attack. These attacks were frequent, incapacitating him mentally and physically. One of the medical staff commented that he’d likely qualify easier than my Nan – and the room stood still.
It felt like an obvious choice. A period of wonderment – would they really get their wish? Ron was crystal clear and adamant. He did not want to live without his love. They were ready to write the final chapter of a love story spanning seven decades.
The next few weeks were incredibly stressful. They each had three stages to pass, in quick succession, with their primary physician walking a thin line in balancing medications to keep them comfortable without ever impairing their ability to make a clear choice. Any perceived impairment or loss of mental ability could disqualify them. For people in their 90s, that could be triggered by something as simple as a fever.
My grandparents took it in their stride, instituting a daily happy hour – longtime friends and family could drop by from 4pm, for a last glass of “bubbles”. Miraculously, Irene’s dysphagia seemed to not include Australian sparkling wine.
It was like a farewell tour, as they laughed and cried, treating nearly every visitor to their own rendition of Willie Nelson’sOn the Road Again, which they’d sing together with a smile, anticipating their final adventure together. My aunt made a last-minute, multi-leg journey from Western Australia to hold her parents’ hands one last time.
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Some people struggled. It had only been a few months earler that we’d celebrated their 70th anniversary in the rec room, with balloons and a giant slab cake. A volunteer played the guitar, and my grandfather crooned Too Young by Nat King Cole over the microphone. Despite this, they were unwavering and emphatic in their decision. They had a wonderful life, they had done everything they had ever wanted, and it was time to go.
Once the NSW Voluntary Assisted Dying Board passed that final approval, the date was set. Arrangements were made. Final meals were requested; honey king prawns for him, spring rolls for her, from one of Port Macquarie’s many Chinese-Australian restaurants.
I have no idea how my mother, their primary carer and an absolute saint, managed the process of orchestrating not only the death of both her parents, but also wrangling all five of us grandkids together from across Australia. Even with the approvals in place, there were still hurdles to jump. There were last-minute psychological evaluations. Anecdotally, we’d been told only half of VAD cases actually go through with it – data from the states puts the number closer to 30-35%. What if one of them changed their mind at the last minute?
The night before the final day, we all gathered in my parent’s Port Macquarie house, sitting around the table with our Nan and Pop for one last meal. A blur of tears and laughter. Holding my Nan’s soft wrinkled hand, and her convincing me that this is what they wanted. I felt like a little girl, crying and being comforted by my grandmother one last time.
In a way, I felt as though I had pre-grieved, particularly when I took my husband and two boys to say farewell two weeks earlier. My three-year-old climbed up on my Pop’s lap to share his plastic insect collection, and they talked at length about grasshoppers versus praying mantises. My Nan toggled her head around until she found the one pinpoint in her vision that still worked, fixed it on my husband, and told him to look after me. I could tell that day that they were so sure, so strong in their decision. They would never go back, not knowing it was what the other one wanted. They told me my boys were special, and destined for great things, and in that moment I broke.
Maybe that’s why on the day I could be strong. The “event”, as we called it, was scheduled for 10.30, and we started assembling in their room from 9.30am. My dad opened bottles of champagne, and we all had our final bubbles together. The kitchen staff of their assisted living facility wheeled in a trolley laden with finger sandwiches, caramel slices and tea and coffee provision. Willie Nelson played. It felt like a party. It was a party.
Both my grandparents chose to die via medical assistance, rather than self-administer, requiring four medical personnel in the room. The two doctors shepherded us through the process with an endless amount of patience, empathy and care. They gently told us it was time, and Irene laid down next to Ron on the bed. The cannulas went in, the cords winding back and away, so the doctors could step back and allow us to be by their sides.
Ron and Irene held hands. The music changed to a soft version of You Are My Sunshine.
I sat next to my Pop and held his other hand, while my Mum, brother and cousins surrounded my Nan on the other side. I whispered the first line of a favourite childhood story, and he smiled, picking up and taking over, telling it to me one last time.
My Nan made a highly inappropriate joke – terrifying us that it would be her last words – before chuckling, and saying: “Here I go – love you all.”
And then it happened. Calmly, quickly, with dignity. In a room full of love, with smiles on their faces and without any pain.
We’d been told that hearing was the last sense to go, so we repeated I love you, I love you, I love you, until we were sure that they’d finally slipped away.