For those of you who know me personally, the sorrowful news of my husband David’s death won’t be news to you. However, those of you who read my posts sporadically or who have fallen on this post accidentally may not know this.

Whatever the case, this post is about David’s death and its aftermath. Writing it has been an important step in my grieving process.

There is a detailed background to this story. If you want to read it, you can go to my previous post where I talk about David and me navigating his Alzheimer’s. Or you can just read the short version below.

The condensed backstory

David and I met in 1998 when we were both in our very late 40s, moved in together in 2000, married in 2010 and both retired in 2012. David was diagnosed with Alzheimer’s in 2018. Over the years since then, his cognition gradually deteriorated, starting with, as expected, his short-term memory. That affected his ability to engage in conversations, eventually meaning he wasn’t able to form full sentences or even remember common words – or my name. His ability to undertake even simple tasks, like making coffee in the mornings or bathing himself, fell away.

At first David certainly noticed these losses and was very frustrated by them. Later he got to the point where he didn’t know what he didn’t know, so to speak; interestingly, that turned out to be a happier place for him.

Also happily, David’s temperament remained wonderfully joyful and upbeat, as it had always been throughout his life. In addition, because of his athletic past, he remained physically fit with good mobility. That meant we could continue to do many things together like going cycling, doing household tasks, taking long walks and even going on trips to the cottage.

But in 2023, David started having what I’d call a variety of types of anxiety attacks along with depression. This caused great stress for him and me. We struggled to manage. There was also a very disturbing wandering incident. His wonderful smile became less and less frequent and he began resisting attempts by his caretakers and myself to manage his daily care. As a result, I became a 24/7 caregiver.

That’s when I made the difficult decision to move David to a cognitive care residence here in Montreal. He moved in on November 5, 2024. Happily, after a few weeks there, the routine and a change in his medications led to David settling in relatively well. He engaged with the activities they provided (the staff, like everyone else, said he was adorable!) and he could come out for local walks and coffees with me. His sweet smile became more frequent again. For me it was a relief and for David as he seemed happier.

One day things changed dramatically …

On Sunday evening, May 25, 2025, about 7 months after David moved to the residence, I was at home when I got a call from the doctor at the residence. He told me that they had had to send David by ambulance to the emergency room because he needed treatment for an infection that they weren’t able to manage.

I arrived very quickly at the ER (at the CHUM hospital – Le Centre hospitalier de l’Université de Montréal) to see that David had already been assigned to a private negative pressure room in the ER. Tubes were coming in and out of him – antibiotics and fluids I later learned – with multiple monitors bleeping away. David showed signs of distress which shocked me because I’d just seen him two days earlier when, although tired, he seemed fine. But now he seemed to be unconscious with no indication that he knew what was going on around him. He certainly wasn’t aware of me in any visible way.

I spent the night in the room with David while doctors and nurses continually came and went, wheeling him in and out for tests. Very disturbingly, David also twice vomited what resembled coffee grounds. I learned that it’s actually coagulated blood which is a symptom of upper gastrointestinal bleeding – a very, very bad sign. I was stunned and horrified.

In the early hours of Monday morning, the internal medicine doctor who’d been called in to manage the situation told me that she was “very worried”. I asked her, with great trepidation and tears welling, if that meant she felt David was going to die. She nodded her head in the affirmative. “I’m thinking 24 hours”, she said.

They moved David to the “Salle de Choc”, which David had taught me was called “The Crash Room” in the English hospitals. It’s for the most serious cases in the ER where there were additional staff with the possibility of multiple interventions.

The outcome, the doctor said, depended on the root cause of the infection which they still hadn’t established. Long story short, more tests eventually led to a diagnosis of septic shock, meaning an overwhelming infection. But what had caused it?

More tests led to the discovery that the infection was a result of a kidney stone that was partially blocking David’s urethra. At the same time, he had a urinary tract infection. A deadly combination, I later learned. That is because the kidney can’t perform its usual function of filtering blood and removing waste and extra fluid from the body.

Isn’t there anything that can be done?, I asked. The doctor said that David could be transferred to an ICU (intensive care unit) where, well, intensive measures could be undertaken. Along with that, he would require a surgical procedure to remove the kidney stone. The doctor added that, if even David was able to survive those actions, there was virtually no chance of him returning to even what had been his status quo.

“Or you could choose palliative care”, she said.

I knew what that meant: David would die.

Decision time

What should I do?, I thought, as my heart pounded. Many years ago David and I had written a “Living Will” as it’s called. We gave each other power of attorney which included a “Protective Mandate given in anticipation of incapacity”. That’s where we both said that we were “opposed to all heroic diagnostic and therapeutic measures”. That’s easy to say when you’re young and fit. But it’s also very general and doesn’t always help in specific situations – like this one.

The classic “DNR: Do Not Resuscitate” order which we often hear about wasn’t applicable in David’s case as his breathing at this time was relatively normal.

I had, however, years earlier, as David’s Alzheimer’s had progressed, spoken with his doctor about what “no heroic measures” would specifically mean in his situation. He informed me that Quebec has a form called “Advance Medical Directives in Case of Incapacity to Give Consent to Care” and we looked at what the form called the different “Levels of Care”. As the mandator, he showed me the options I could chose when David was confronted with a “serious and incurable medical condition” like he was in now.

After much discussion, I had picked Goal C with the doctor’s more specific added notes of “No central line, No ICU admission; OK to IV fluids and OK to IV medications”.

I had to feel that my decision would have been in line with what “no heroic measures” meant and was what David would have wanted. In discussing it with the internal medicine doctor, she confirmed that palliative care was a perfectly legitimate decision to take according to the mandate I had.

I wanted to share the decision-making

Although I could have made this decision on my own, I knew that I would have to live with this decision for the rest of my life so I wanted to get more input and support on this. Therefore, I phoned David’s sister, Jane, who used to be a family doctor and is fully knowledgeable about situations like this. She had been both a practical and an emotional support throughout our Alzheimer’s journey. Luckily I reached her at the same time as the internal medicine specialist was in the “Crash Room” and could put them on the line together. They talked for about 5 minutes.

The doctor passed the phone back to me and Jane confirmed it was right time to let David go. She told me a very helpful story to back up her thought. Their father had also lived with Alzheimer’s and had also resided in a long term care home having lived with Alzheimer’s for about the same time as David had. At one point, the father had, during his stay in the care home, experienced a lung infection that could have led to his death but the family had decided to have it cured with IV medications.

Two years later, their father got another infection but this time she told me that they had decided, as a family, including David, to “let him go”. Jane said that David’s stage of Alzheimer’s now was at about the same stage as their father’s Alzheimer’s had been back then. Therefore, she suggested, David would agree to having the same thing happen to him.

After a walk outside, I returned to the ER and spoke to David, even though he was still virtually unconscious. I wanted to tell him what I had decided to do and said I hoped he’d be ok with it. And that I loved him.

And then I said these words to the doctor: “Yes, please move David to palliative care”.

In Palliative Care

With that decision behind me, we waited for about 8 hours for a room to become available. During that time, they removed all the IV’s and David lay peacefully with only the oxygen tube. If he became agitated, they said that he would receive a sedative.

David’s niece, Martha, and a friend of ours, Mark, who both live in Montreal, had arrived shortly before to be with David and me at this time. I had their love and support as we eventually moved with David to a lovely large private room with excellent facilities. This hospital was only a few years old so it was the best.

As I had spent 36 hours in the ER and David was now in a calmer condition in a lovely quiet room, I headed home for some overnight sleep.

Terminal Lucidity

It was now Tuesday May 27 and I arrived early to find my friend, Mark, already by David’s bedside. My sister, Barb, and her partner, Vaughn, who had driven many hours to be with us, were also there. And guess what – David had his eyes open and even managed a big grin when I came in the room alternating with peaceful sleeping.

I couldn’t believe it. What a change from yesterday. I was both delighted and worried. Had I made the wrong decision? Should he have gone to the ICU? Was he recovering?

I later learned that this alert stage wasn’t uncommon with people in palliative care heading towards death. Even though the underlying disease is still progressing, patients get a kind of revival for some time with heightened alertness and more energy. It’s called “terminal lucidity” and, although its cause isn’t known exactly, it does happen. As well, the huge injection of antibiotics over the previous hours had helped give David back some life, I was told.

These episodes offered us a final opportunity for connection and closure.

• A very similar situation had occurred with my stepfather. After a heart attack, he had been unconscious for a full day but, in hospital, he gradually became alert and, over a period of about 24 hours, he was able to say goodbye to all his children and grandchildren who had arrived in town to see him. He died early the next morning.

On Wednesday 28th, David’s other sister, Cathy, arrived along with her two daughters, Martha and Julia, and grandson, Lachlan, which was great because they were all able to have some connection, eye contact and smiles with David. We all took shifts coming and going from David’s room making sure that he was never left alone but also that he was given peace and quiet too.

During that day, David continued to show some alertness and lucidity and he even attempted to get out of bed. More friends (Kevin, Ross, Harold and Jon) visited and I was happy that they could have a last visit with David.

However, I noticed that David was beginning to fade, along with showing more signs of anxiety. The doctors suggested an injection to reduce that anxiety and I agreed although I knew it signalled, again, the beginning of the end. It turned out that this was the last day of David showing signs that he recognized us.

The final days

I arrived back on the morning of Thursday 29th with my overnight bag packed. David was lying still with a blank stare. It was a very disturbing change from the last two days but I continued to remind myself that we had those good days which was more than I had expected – especially when that doctor had told me on Monday that she thought that David had just 24 hours to live.

This was the first day that David began receiving some morphine-like medications by IV which calmed David but took him further away from us. We met several different palliative care doctors and nurses all of whom were so kind and thoughtful, always taking time to answer our questions and calm us. What a variety of skills you need to have to be a palliative care doctor.

That scenario continued Friday, Saturday and Sunday and each day I was expecting David to die as his breathing got more hesitant and his distant look looked more distant during the few times his eyes were even open. The doctors said that probably it was David’s physical strength, obtained from his long history of athleticism, that was keeping him going. But it did allow more visitors to see David and for me to have more time with him.

I slept for three nights on a couch that flattened into a full comfortable bed which I very much appreciated. At times, I would get into bed with David and have a cuddle.

At one point early on the Monday morning, I woke up. This time, though, I couldn’t hear David breathing.

David had died

Heart-broken, I lay with David holding him tightly absorbing his lingering warmth. I knew that I would have to go out into the corridor and tell the nurse that David had passed away. I eventually did that and she sympathetically gave me a wonderful hug which I needed as I broke down in tears.

Almost immediately, a doctor came into the room to confirm the death and take note of the time – 2.15 am on Monday, June 2, 2025. Age 75.

After he left, the nurse said to take my time with David, pack up my things and when I was ready to leave, let her know.

I spent about twenty more minutes with David, holding his hand and hugging him for the final time. I said goodbye and left the room sobbing. Outside there was a gurney waiting to take David to the morgue – a further sign of the reality of his death.

The nurse accompanied me down to the ground floor, surprisingly, to “Admissions” where I was given forms and information about the next steps from a very kind administrator. These tasks helped to calm me. I then left the building and took a taxi home. David’s sister was staying with me and when she saw me at home she knew David had died. We fell into each other’s arms crying.

The aftermath

While I had been sitting by David’s bedside hour after hour over his final week, I found myself dealing with my sadness by starting to think how best to celebrate David’s life given that it was now coming to an end. There were so many decisions to make.

Starting to write an obituary for him by his bedside had given me some peace – and tears – remembering the life he’d so fully led. After that was published a few days later, I was beautifully drenched by a deluge of love, condolences and support from far and wide that lasted weeks.

I loved hearing stories people told me about their memories of David, especially from friends and family. But I also heard stories from people who had worked with David in the Montreal Children’s Hospital years earlier or had run marathons with him in the 80s and 90s or had even figure skated with him at the Olympics in 1968 and beyond. They all told me stories about how much David had meant to them and, in many cases, how he had made a difference in their lives. It meant so much to me to hear these memories. Here are some examples.

• David was such a fine, beautiful man. He chose you to complete him, which you did brilliantly. He did the same for you. But what a terrible loss. My deepest condolences.
• Accomplished doesn’t begin to describe David. His warmth, brilliance, big-hearted and unassuming spirit – and, of course, his deep love for you – will be what I will always remember.
• One of the things I find so meaningful about medical education is the longitudinal impact of a great teacher.  As a medical resident in the 1990s, I particularly remember David’s way of pausing when I had screwed up and gently re-directing with that grin of his. All these years later, he continues to make me a better physician.
• Within seconds of meeting David, he looks at you straight in the eyes and a gentle smile follows. Right away, you feel safe, not judged or analysed. You feel included in his aura of kindness.
• May he be landing in heaven all the triple axels he ever dreamed of!

Here is a link to that obituary. There you will also find a link to a recording of the memorial service ceremony we held for David on June 28th. People told me that the event was an exceptionally warm and beautiful celebration of David’s life at the same time as it allowed us all to mourn our loss.

Here is the link to another obituary; this one written by a journalist, Susan Schwartz, for our local Montreal Gazette newspaper. To my surprise, it appeared on page 2. What an honour.

Eight months later

Working sporadically, it has taken me many months to write this post, including taking weeks away from it. Writing it brings back the sadness, the grief and the reminder that I’m alone now. Not lonely (as I am lucky to have a strong network of friends and family), but on my own in a way that I haven’t felt in the 27 years that David and I had been together. I had become so used to doing things as a couple. My tongue continues to trip when I have to remind myself to say “I” or “my” rather than “we” or “our”.

What also helps is constantly reminding myself that losing a partner is hardly unique. Widows and widowers are everywhere and I gain strength from sharing stories with them. If you have any stories or suggestions to share, I’d be happy to read them in the Comments section below.

For me, as I have said, writing this post and sharing it here has been an important part of my own grieving process – another step towards slowly transitioning to a different life without David. However, keeping David in my heart will always be part of whatever long or short life I still have ahead of me. As I said at the memorial:

“In David’s honour, I plan to live the rest of my life to the fullest extent possible.”