Cathy Calisi

Cathy shared her story in August of 2024.

There was nothing typical about my mother. A survivor of a traumatic childhood, Mom healed herself through self-care. She became a yoga teacher and later, in her 50s, an ordained minister and spiritual peacemaker after attending graduate school for her Master of Divinity degree. Every day as an 80-something, my mom walked the shore road in her tiny Massachusetts village.  

Given that Mom was always finding opportunities to teach someone, I should not have been surprised that she wanted to use her own end-of-life journey to help inform other people about their options. She would challenge those in her presence as a teaching-learning process and opportunity to make the world better — one person at a time! Not always cooperative, she often questioned current prevailing ideas, asking why something could not be done differently. 

In July 2023, we went on a family vacation with my mom, who hung back more than usual, citing some hip pain. By August, she needed a walker to get around due to the pain. Then swelling began in her ankles and rose to her knees and eventually her stomach. Over the next few months her mobility declined, and in December Mom was accepted into hospice care due to malnutrition. She started developing wounds on her ankles and shins as the swelling shifted, and between the swelling, the pain and the constant maintenance required for the wound dressings, she struggled to get around her own house. She had no formal diagnosis for the hip pain or the fluid accumulation because she did not participate in the “less than effective” healthcare system. 

In February 2024, I took a leave from work to help care for Mom. For some time now, she had been telling us that she was ready to “get off the planet.” Eventually she mentioned voluntarily stopping eating and drinking (VSED). I had never heard of it, but apparently she had known about VSED for several years thanks to materials she received from Compassion & Choices. She was considering stopping eating and drinking herself and had reviewed a handbook on it. 

Mom started talking seriously about choosing VSED with me and my two brothers. It was a bit of a shock initially. I learned how few people, including myself and many other healthcare providers, knew about VSED as a legal option. Yet we were in support of her wishes. I knew that the way Mom had coped with trauma and hardship for so many decades of her life had been through exercise and moving her body, and now she could no longer do that. At 83, she was ready to move on. 

By May, Mom was struggling to reconcile her desire for privacy with her increasing need for help at home. One Sunday when I was there, I asked her, “Have you decided yet when you might want to start VSED?” My brothers and I wanted to plan ahead so that we could be there for her. 

“I’m not in a big rush,” she said. I thought, “Okay.” We had some time to prepare. 

Next thing I know, she’s texting me on Tuesday: “I think I’m going to start tomorrow.” And she did. 

Nana Dunn on the phone with Compassion & Choices staff while undertaking VSED

When I arrived that Saturday, day four of the VSED process, Mom was doing better than I expected. The next day she continued to feel good, proclaiming that she felt better than ever. Day six was the same. As a nurse practitioner, I was surprised. I had expected her to be much more groggy and dizzy, the kinds of things that happen when someone grows dehydrated. My brother and I kept asking her, “Are you sure you’re not taking in any fluids?”

We finally learned what was going on when the hospice nurse came by and suggested that Mom’s severe edema, what’s known as 4+ edema, was “feeding” her body fluids. Her body was reabsorbing water from her swelling, slowing the progression of symptoms. 

Meanwhile, Mom was journaling a lot, reading and contemplating. She enjoyed foot massages and getting ice baths on her hands. She used a nonmedicated nasal spray called Natural Aid, with saline and aloe, to keep things moist, and Hyalogic dry mouth tablets to create saliva in her mouth. My brothers and I took shifts staying with her. The biggest challenges just came with making sure everything was done her way, from cleaning her glasses to going to the bathroom. 

On day seven, Mom spoke with someone from Compassion & Choices by phone about her decision and how VSED was going. It was very important to her to increase public awareness about the option of VSED. Even among medical professionals there’s a real lack of information about it, as I can personally attest. Virtually everyone who came to visit Mom in her last few weeks had never heard of VSED. And so, true to form, Mom’s last act would be sharing knowledge. 

Mom did a lot more sleeping in the last three or four days as she had finally started taking morphine. Every time she would wake up after sleeping 12 or 16 hours, she was so happy to see us. It was like she was elated to find her daughter and grandchildren and sons with her. 

On day 10, the night before she died, I was with Mom. She got in bed holding a little sign that read, “Be calm and go to the beach.” And she went off to sleep and slept all day until 6:00 the next evening. That night, my brother was holding Mom’s hand on one side, one of her caregivers holding the other and my sister-in-law working on setting up the instrumental music my mom liked, when all of a sudden my mother woke up and said, “I’m so grateful.” And then she lay back and died. It was June 1, 11 days since she had begun VSED. 

I’m sharing Mom’s story now because I know how important it was to her that people be informed about all of their options for end-of-life care. I also know how peaceful her end of life was for her and for all of her loved ones. At Mom’s celebration of life, my nine-year-old niece read the following poem she had written perfectly summing up who my mother was and how she concluded her journey on this earth:  

Peace from Nana

Like a warm daisy staring up at the sun
A solemn warrior pose
A stretch into downward dog
A family gathering full of love
A walk on a quiet beach
A listening ear from up above
Peace for all both in heaven and on earth