On the first weekend in November, Queen Elizabeth II flew north to Sandringham House for a private retreat. The British monarch, who has been advised by her doctor to rest, was spotted being driven around the estate, which holds special memories for her. Last winter, she and her late husband, Prince Philip, spent time there during lockdown. It is also the property where both her beloved father and grandfather passed away.

By Nov. 9, Elizabeth, 95, was back in her Windsor Castle office engaged in light, desk-based duties. The queen insists she will get past the health crisis that put her in the hospital on Oct. 20, but time and age have begun to catch up with her. “She has brittle bones, and her immune system is weak. She has come to the realization that the clock is ticking,” says an insider.

Elizabeth has followed her doctor’s recommendation by giving up her daily martini and horseback riding, but after 69 years on the throne, she’d been stubbornly refusing to curtail her royal duties. “It’s in her nature to be on the go,” explains the insider. “She was listening to her mind over what her body was signaling, which isn’t good considering her frailty. Even after spending the night in hospital, she hoped to get back to normal. It took a lot of nagging from those around her to get her to see reason and take a step back.”

In truth, Elizabeth has found it harder to carry on since the death of Prince Philip last spring. The couple were wed for nearly 74 years, and she is profoundly aware of his absence. “She hasn’t been feeling herself since his passing,” admits the insider. “They had become even closer after they isolated together last winter, so it’s only natural that she’s struggling.”

Her children and grandchildren have tried to fill the void by calling, visiting and sharing their favorite family memories with her. “Elizabeth was homeschooled, so she never formed any solid friendships outside the royal family. Her children have devised a routine where someone is always available, so she never feels alone,” says the insider, who adds that Elizabeth also has an inner circle of staff who look out for her.

Queen Elizabeth Health Crisis

In this difficult time, her greatest joy has come from her family. “She’s closest with Charles,” says the insider. “Followed by William, her daughter Anne and Kate Middleton. Kate has been baking cakes with the children and sending them to Elizabeth. The kids also made her sparkly get well cards.”

Charles and his brother Andrew have always looked to their mother as a pillar of strength; the recent downturn in Elizabeth’s health has left them shaken. “Out of all her children, Elizabeth has always had a real soft spot for Andrew, and he can’t imagine what his life will be like without her,” says the insider. “Prince Charles is also more sensitive than anyone knows, and the thought of Elizabeth’s passing is hard for him to fathom.”

As tradition dictates, Charles will be declared king immediately upon his mother’s passing, even as the royal family enters a 12-day period of mourning. “She’ll have a state funeral 10 days after her death and has also requested an intimate, private, family memorial,” confides the insider

It’s likely that Charles’ public coronation, in which he will swear an oath and be crowned by the Archbishop of Canterbury at Westminster Abbey, would take place approximately a year after Elizabeth’s death. “Prince Charles’ coronation will likely be smaller than Elizabeth’s,” says the insider. “But it could cost up to $50 million if you take into account the immense security fees.”

When she thinks of dying, Elizabeth fears more for the well-being of the royal family than she does for herself. “She worries about her family keeping the monarchy strong,” says the insider. “Death doesn’t scare her in the slightest. Elizabeth is a good Christian and believes in an afterlife and that she’ll be reunited with Prince Philip in heaven.”

When that time comes, Elizabeth will pass from this life with few regrets. “She has told family members that she has lived a good life and her death should be a celebration of it, not something to get depressed about,” says the insider.

In that same spirit, Elizabeth continues to look forward. Christmas is coming, her favorite time of year, and she hopes to be well enough to welcome her extended family to Sandringham, as she has in the past. “It will be a smaller, more intimate occasion, but that doesn’t mean it won’t be special,” says the insider. “Prince Harry and his wife, Meghan, are hoping to be there, too. Harry feels guilty about not saying goodbye to Prince Philip in person and would never forgive himself if the same thing happened with his beloved grandmother.”

Elizabeth is also determined to be strong enough for next summer’s Platinum Jubilee, a national celebration that will mark her 70 years as queen. “Elizabeth knows she won’t live forever, but she doesn’t believe she is dying right now,” says the insider. “She is an optimist and continues to plan for the future.”