Singapore Minister of Health Ong Ye Kung attended the 8th Singapore Palliative Care Conference on Saturday (1 July), where he shared a story about his grandmother who passed away, wishing that she had passed away at home because it would have been what she wanted.
He was speaking about the importance of palliative care to improve the quality of life of patients with terminal illnesses.
Snippets of Ong Ye Kung’s speech
Information about our health is always confidential and personal. As our life journey ends, how we wish to leave this world is even more personal. So much so that many of us keep it to ourselves and do not talk about it, not even to the people closest to us.
In my lifetime, I have lost three people very close to me in my lifetime – both my parents, and my maternal grandmother who looked after me when I was a kid. All of them passed on in hospitals. Looking back, I wish my family had done things differently and that the way they passed away could have been different or better.Â
Grandmother’s death
Today, let me share just one story – the passing of my grandmother.
She was born in Swatow, China, but escaped from her hometown and came to Singapore during the Second World War. She was kind, gentle, but led a hard life which made her very feisty and resilient.
She had such a high threshold for pain, that she carried on her usual chores even though she had started to feel a sharp pain in her chest. Eventually we persuaded her and she decided to see a doctor, who diagnosed her with end stage lung cancer. She was 80 then.
After the diagnosis, she was going in and out of hospital. Each time I visited her at the hospital she would tell me she wanted to go home. She said that staying at the hospital for one night felt like a month.
During one of her several admissions, her condition deteriorated. By then I was living abroad and could only speak to her on the phone moments before her passing. Fortunately, she was surrounded by loved ones gathered around her hospital bed when she left.
I had no doubt she would have wanted to go home, even if it was to pass on. She was a devout Buddhist. She had her affairs settled and even her photo for the wake taken. She surely had prepared herself for the inevitable.
Talking about death no longer taboo
But none of us knew about palliative care then. No one had spoken to her about how she would like to leave and understood her last wishes. In fact, for my parents, uncles, and aunties, it was taboo, inauspicious, or in Malay ‘pantang’, to talk about death.
The reason could be that this was a generation of survivors. Life was hard. My parents and grandmothers lived through the Second World War, racial riots – uncertainties that were matters of life and death. To be alive was a blessing, and they did not like talking about death.
The new generation does not have those memories. Our life is not about survival. It is about progress, fulfilling our aspirations and enjoying life. It is also a generation that experienced significant advancements in medical science, knowing that very intrusive interventions and painful surgeries can prolong life, even without quality. Many of us would not want that.
While I think talking about death is still sensitive today, it is no longer as taboo a subject as before. Seniors today are much more prepared to express how they wish to leave the world. Surveys done by the Lien Foundation show that three in four seniors prefer to pass on at home. Doctors have told me that in their conversations with patients it was more like nine in 10. Getting their loved ones to accept their wishes is understandably harder because of the emotions and difficult decisions involved.
It is time we recognise that palliative care can make a huge difference. It provides comfort not just to patients but also their caregivers, going beyond physical to also emotional and spiritual care, while honouring the wishes of the patients.
Importance of a good death
Let me leave you with one final thought, about my grandmother. She led a hard, but full life. Her final decades were often spent with family members and relatives, celebrating birthdays, going on vacations, watching grandchildren like me grow up.
Even on her death bed, she was surrounded by loved ones. It would have been better if she was at her own home, but perhaps home is where family members are. These are the ‘what if’ questions that loved ones like me will continue to ponder, perhaps with a tinge of regret.
It is so important to have a good death, for the patient and also for his or her loved ones. I hope that our collective efforts will allow every Singaporean to live well and leave well, according to their wishes.