The call from the district nurse came out of the blue, and not at a good time. Rushing from the busy office, I parked myself on a sterile stairwell and made a series of life and death decisions about my mum, 76, who has advanced Alzheimer’s. Should carers intervene if she chokes? What would I want if she acquires an infection? Would mum wish to be resuscitated if her heart stopped?

I wonder how she’d react if she could see herself now

As we talked, colleagues passed by on the stairs: I smiled inanely while continuing my conversation. Did I understand, asked the nurse, the trauma of CPR – the broken ribs, the awful and probably unexplainable pain, the risk of oxygen starvation to the brain reducing her capacity still further? I hadn’t, I admitted – had barely given it a thought, so wrapped up by mum’s current condition, which is not good; unable to eat without constant monitoring, to perform even the most “basic bodily functions,” as the euphemism has it, without support.

Sometimes, when I sit with mum in the care home she lives in, as I did yesterday, I wonder how she’d react if she could see herself now. Not in a mirror – each time she catches her own reflection she becomes hysterical – but  the old (younger) mum, that intelligent, hilarious, artistic woman who left a brutal background at sixteen and made a new life for herself – several new lives. What if, ten years ago, or perhaps longer, before the first signs (memory muddles, confusion, panic attack) became apparent, she’d caught a glimpse of her current state?

I have little doubt that mum would have said: kill me. Don’t let me live like this, among these old people, staring at sixties pop videos on a loop on the hovering TV, being spoon-fed lunch, hallucinating about dead parents and dead babies. Kill me, she would beg: we all say it. My dad said it too, when we went to see his mum towards the end, fading away like my mum, though admittedly 20 years older. Shoot me if I get like that, dad joked as we drove away from the home. But we never did: because you don’t just change overnight, the process is slow, imperceptible to others, let alone yourself. And a good thing too: because now he stays home, baffled by crosswords that once would have been easy, his memory almost gone, but at least with some semblance of a happy life: aided by alcohol and a caring wife.

For my mum, there are few such pleasures. She long ago forgot that she smoked (joyously, whole-heartedly); takes no pleasure, now, in a glass or three of wine; can barely recognise her three grandchildren or me, her son of 57 years. In a sense, her life is over: we’re simply waiting for the braincells that control her breathing, swallowing and other basic bodily functions to shut down, the electrical impulses to short and fade.

Incredibly, it’s still uncertain whether any changes to the law on assisted dying would be relevant to the one million or so families in the UK alone afflicted by Alzheimer’s. Yet Alzheimer’s and other dementia-related conditions are precisely what many of us fear most, and the fate we most wish to avoid. Who, granted a choice between years in a home, memories fading, faces undergoing a process of sudden and shocking defamiliarization, and a swift, painless exit, would choose the former?

Except of course this is where reality sets in: even as reality loses its grip. My mum was diagnosed with Alzheimer’s in 2019, around the same time her doctor convinced me to secure Power of Attorney. Though the diagnosis was agonizing for us all, especially mum – who threatened to jump in the canal – I do not believe there was a moment when she would seriously have chosen death: by the time all the impacts of Alzheimer’s had become clear, mum no longer recognised them, had lost autonomy.

That’s the scary part: I have no idea what I would do if given the choice

Fast forward five years: having secured Power of Attorney, mum’s life is already in my hands. Should the law change, and I had power to decide, what would I do? Could I honestly sit with her, holding her hand, as she slipped away, oblivious, into oblivion? I’m not sure I could (am certain in fact I could not). Currently mum’s world is a scary strange place, but it has its pleasures, its comforts: hot chocolate, hugs, music (she still dances round the room to “Sinnerman” by Nina Simone). Who am I to put a stop to all that?

That’s the scary part: unlike so many in this debate, each side possessing such conviction, such certainty, I have no idea what I would do if given the choice. When a pet grows old and unwell, we have them put to sleep because they are our responsibility; we kill them because we love them. So what about parents, partners, our loved ones? Is it possible to make an objective, rational decision about someone else’s life and the leaving of it? Or would we be blinded – by our love, our resentments, finances, convenience?

In my case, at least, money is barely a consideration: mum owned no property at the end, her savings depleted by care home costs, and I’m not in her Will. But what if I was? What if, each week, I watched as thousands of pounds was taken from mum’s account, money that would no longer be coming my way? Can anyone say that such a situation would not impact on their final decision?

Grappling with my mother’s decline, I already feel I have too much control over her affairs – and yet in other ways, her sad, inevitable decline, not nearly enough. Nothing, and nobody, can alter the fact my mum is dying. The question is: what am I going to do about it? I don’t know the answer, can hardly bear to frame the question; all I do know is, there are no easy answers. So let us at least be honest, here, about what we are suggesting.