### Navigating the Emotional Nuances of End-of-Life Care: A Daughter’s Insight on Love and Grief

End-of-life care represents one of the most emotionally intricate pathways families encounter. My personal narrative, steeped in a rich familial legacy, illustrates the challenges of harmonizing love, responsibility, and the quest for tranquility for an elderly parent. My parents, united by the same birth date six years apart, influenced my life through their deep devotion to one another and to family values. Their existence imparted the significance of care, while their passing unveiled the intricate layers of love and advocacy at life’s end.

#### The Paradox of Seeking Tranquility
When my father departed on Christmas Eve in 2016 at 92 years old, it was both shocking and curiously appropriate. Dad, who embodied the essence of the holiday and spent over thirty years joyously portraying Santa Claus, chose the most meaningful day of his existence to leave us. Every season thereafter, while tending to my elderly mother, I silently contemplated whether she would soon follow him. Was it wrong for me to wish for that? This thought persisted in my mind throughout the subsequent seven years.

Desiring death may appear distressing or even taboo. However, for families witnessing the prolonged and painful deterioration of a loved one, this wish can signify compassion rather than hopelessness. I recognized that my mother, a quintessential nurturer and dedicated caregiver, would have despised the erosion of her independence and dignity as she grew weaker. Observing her decline—from assisted living to skilled nursing care—was not only painful but also profoundly at odds with the strong, capable individual I had always known.

This paradox—wanting her to survive, yet hoping for her suffering to cease—was the emotional terrain I navigated for years.

#### The Reality of Aging and Deterioration
My mother’s aging journey brought significant challenges for her and for us. Similar to many seniors, her independence waned with every fall, injury, and medical setback. After fracturing her shoulder two years post-Dad’s passing, she reluctantly transitioned to assisted living. Although she initially adjusted, her world contracted during the COVID-19 pandemic, which restricted her social interactions and attendance at daily Masses that provided her comfort. A stroke further diminished her quality of life, requiring more intensive care and ultimately a transition to a nursing home.

My sisters and I stepped in as her advocates, overseeing her care from afar and in various roles. Despite being well-educated—two physicians and two educators—even we found the nuances of long-term care systems formidable. From coordinating physical therapies to addressing medication errors and fulfilling basic needs like haircuts and toenail care, it was non-stop work. And yet, despite our efforts and the emotional toll it exacted, we understood one critical truth: our mother’s living situation was not a life she would have selected for herself.

#### When Prayer Transforms into Advocacy
One of the most difficult realizations during my mother’s decline was that our best intentions were often inadequate. Nursing homes, marketed as nurturing environments, frequently fall short of expectations. Staff at her “award-winning” facility were overwhelmed. Call buttons often went unanswered, and even fundamental tasks like assisting a patient with eating or repositioning were delayed. Without continuous family involvement, my mother would have faced neglect. It was undeniably exhausting, but as her daughters, we felt morally obligated to fill the voids.

There came a time when I had to question: What is the boundary between advocacy and accepting the unavoidability of decline? When she could no longer express her needs, when meals and care shifted from sources of nourishment to fear and distress, I prayed even more fervently for her passing. My prayers stemmed not from selfishness but from love and the acknowledgment that her agony surpassed her fleeting moments of happiness. However, those prayers also prompted ethical dilemmas: Was I hastening her natural journey or seeking to honor who she had been? Was it wrong to wish for her death?

#### An Ailing System in Need of Change
My mother’s experience—and our family’s—exposes the severe shortcomings of the eldercare system in America. Even in facilities lauded for their care, the actual experience can be quite different. Nurses burdened with heavy caseloads, temporary staff unfamiliar with patients, and transient care directors make achieving consistent, quality care a challenging endeavor. Without a family willing to advocate daily, how many of our elderly loved ones slip through the cracks into neglect?

This compels us to consider: How are families without medical knowledge or the luxury of time meant to navigate such an overwhelming system? The emotional labor does not conclude at caregiving; families become de facto health care coordinators and advocates amid systemic indifference. When we cannot offer compassionate care for those who dedicated everything for us, what does that reveal about our society?

#### Discovering Tranquility in Release
Ultimately