The Duchess has suffered periodically from extended bouts of ill health particularly sinced with her miscarriage in 1977. Rumours of marital probelms didn't help. She has also has concerns over her son's Nicholas' well-being in recent years. It was with the Queen's permission she ceased performing public duties and generally does not use the HRH style. She does however attend some family cleebrations such as the funeral of Princess Alice. She takes great comfort from her catholicism. I think she looks relatively good for a 71 year old grandmother.
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