One Last Thing: How to live with the end in mind

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If anything, Mitchell has turned into a bit of a daredevil as her condition has intensified. Last year, she went wing walking. A month ago, she walked the Infinity Bridge, a highwire suspended 1,000ft above sea level, strung across the Honister Slate Mine in Cumbria. “It was the hardest thing I’ve ever done,” she says proudly and with a smile. Later this year, she’s set to abseil down London’s 225m-tall “Cheesegrater” Leadenhall Building. Ultimately this is going to continue to be a long road of political debate and not something that is likely to be available in the very near future. It raises powerful emotions from those on both sides of the argument of assisted death. It doesn’t take a poet laureate to realise that these mismatched stripes of grass are a powerful metaphor in Mitchell’s increasingly foggy world. “If you accept that the lines won’t be straight then it relaxes the effort of doing things,” she says. “It doesn’t matter any more. It doesn’t matter if they’re wiggly.” Perhaps this has been Mitchell’s biggest mission since she was diagnosed nine years ago: to show us all what she – and the more than 850,000 people who also have dementia in the UK – can do in spite of the odds.

You have interviewed and met such a wide range of people for this book. What was the conversation that most took you by surprise or the most enlightening? Wendy of course raises the topic of assisted death and its unavailability as an option in the UK presently. Furthermore she also explores the impact of dementia on the decision making process involved in assisted death. Having dementia puts an added barrier in the way as it becomes questionable as to whether that person has the ability to make the decision to end their life. Wendy takes this discussion to another level arguing the right to make the decision to end her life before she “goes over the edge”. The right to die as your “preferred self” could apply to anyone with a terminal or life changing disease or illness. I have this struggle every time I look at what is left of my own mother who is in end stages Parkinsons. This is not how she would like to end her days. Before Mitchell was diagnosed, she was afraid of so much. “Now, when I lie in the dark, there isn’t any worry whatsoever. And that’s because I think, ‘Crikey, if I can face dementia, why should I worry about anything else?’” If the last nine years have taught her anything, it’s the importance of time and how not to take it for granted. “The only certainty we have in life is this moment. No one knows what’s round the corner. People always say, when I retire I’ll do this, or next year I’ll do that. And I say to them, ‘Why not now?’ Because, if it’s that important, don’t wait for the future, because it might not come.” As I read this book, I am reminded of the conversations we each need to have (and some of us avoid) about choices. Yes, many of us have wills and make provisions for funeral arrangements and for dependents, some of us have advance care directives (or are thinking about it). Those of us avoiding these issues and discussions assume that we will have time and will have the ability to make such decisions. But ability to make such decisions cannot be taken for granted: a brain injury, mental incapacity or advanced dementia might intervene.We talk so often about prolonging life, but we are actually prolonging death by not discussing the suffering part of it.’

That might sound daunting and morbid, but the alternative doesn’t bear thinking about. “To have no autonomy, no independence, to be totally reliant on others for when and how I do things, is not the life today’s Wendy wants for future Wendy,” Mitchell says firmly. She adds that she doesn’t want sympathy: fair enough. But I hope, instead, she will accept the gratitude of everyone who reads this urgent, humane manifesto on how to care for and about those edging towards the finality of death. In talking about these issues, which are uncomfortable for many of us, Wendy challenges the unfairness of being denied choice. Wendy’s concern is for her own future: Well it felt like the natural way forward… what better subject to choose for my final book than planning for the future, assisted dying and death? You can’t get more final! Throughout writing this book I’ve realised that death is treated like dementia - it’s a taboo subject for many, but it doesn’t make any sense to me. The one thing that is guaranteed to happen to 100% of the world’s population is given so little value. What other thing affects the entire world’s population?Like so many things in Mitchell’s life, gardening – a pastime she’s always taken great pride in – has shape-shifted into a more complex endeavour since her diagnosis, in July 2014, of young-onset vascular dementia and Alzheimer’s disease: a degeneration of the brain that currently affects more than 70,000 people in the UK. She was 58 years old. What I want this book to do is open up everyone’s minds on the importance of talking,” Mitchell explains as we discuss the many discourses in her book, each one centring on death, dying and living well – however long you might have left. In a country where two-thirds of UK adults haven’t written a will, Mitchell is intent on probing all angles of death: how we can prepare for it, how we should talk about it with our loved ones and why making our own choices – about how and when we die – should be a right, not a crime. Rather than make her feel vulnerable, these conversations have only strengthened her. “It could even be as simple as: cremation or burial? I’ve realised since writing, many people don’t even know that about the closest person to them, because they’re uncomfortable having that conversation.” In One Last Thing, Wendy embarks on a journey to explore all angles of death: how we can prepare for it, how we talk about it with our loved ones and how we can be empowered to make our own choices. With conversations on the topic of assisted dying, from those who are fighting to make it legal to those vehemently opposed to its practice, Wendy reminds us that to get on with the business of living, we need to talk about death. You have inspired and moved us all with your first book Somebody I Used to Know about your diagnosis with early onset dementia, illuminated and demystified a disease many fear, but little understand with What I Wish People Knew About Dementia. Why did you decide to write One Last Thing?