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In a Singaporean survey:

  • Only 50% have ever talked about death or dying with their loved ones.
  • Only 36% feel comfortable talking about their own death. (Lien Foundation Survey on Death Attitudes, 2014)
  • You do not need to be seriously ill or dying to start talking.

Think & Talk

Think about what is important for you in the areas of:

Thinking through these issues on your own before sharing them with someone you trust allows you to reflect on what matters to you. This process will help you prepare and be more comfortable when you are ready to share with your loved ones.

The following site is a useful resource to help you think through the issues: https://www.aic.sg/care-services/advance-care-planning

Opportunities to Start

Care to Listen!

Not everyone will be comfortable with such conversations.

If you are on the receiving end, don’t kill the conversation…

… by responding like thisInstead, try this …
Touch wood, this will never happen!
Don’t say such things!
Help me understand what is important for you.
Don’t worry, things will be alright.Tell me what you are worried about.
I am not going to let you die!What are the things I can do to help you?
No, this is not what you should do.I can see this is important to you.

Listening to someone who wishes to share what is important to them as they reach the end of their lives is a privilege. Consider it a gift. Reciprocate with respect and love. So…

1. Hold your own views first. Respect that this is their journey and what they share stems from their experience and values.

2. Encourage them to share. Your body language is important. Leaning forward with good eye contact shows you are interested. Nod your head as a sign of acknowledgement and if necessary ask questions that helps you clarify what is important.

3. Stay calm. This is not always easy as there can be tears. You may also be feeling awkward or embarrased. Breathe in slowly to calm yourself if you have to.

4. Be honest. Don’t deny your feelings or the reality. Often, we do not know the ‘right thing’ to say, but just acknowledging these feelings (uncertainty, grief, fear, love) can be liberating and helpful. You may also have your views and may wish to share them. Do so respectfully (“I know that this is important to you. I wonder if you will consider…”).

5. Accept silence. You can remain quiet. Don’t feel either of you have to talk all the time. The conversation can be emotional. Allowing for silence and just being present is a sign of respect and affirmation of your care and concern.

Die

logues...

…are important as we all die one day.

…are conversations that address our personal views on death and dying.

…are conversations focusing on matters that are important to us as we approach the end of life. These include:

Dare to Talk, Care to Listen

Some find it hard as they...

  • Do not wish to face their own mortality. But we know that,
    • Talking about dying won’t make it happen.
    • Not talking about dying does not prevent it.
  • Fear upsetting others.
    • Yes, it can be an emotional conversation but your views and concerns need to be heard. Likewise, be a good listener when your loved ones share theirs.
  • Do not know how.
    • The biggest reason for discomfort with talking about death/ dying is that they do not know how to broach the topic (45%).

Everyday about 55 people die in Singapore

We had a patient with a severe neurological condition. She was bed-bound and deteriorating very rapidly. She was also suffering from recurrent chest infection. Her husband had said that she was very clear that she only wanted to be kept comfortable if she could no longer communicate with others. However her relatives came and demanded that she be sent to the intensive care unit. That would not have helped much except maybe increase her suffering with all the tubes and lines. Fortunately, she had documented her preferences in an advance care plan. This helped to resolve the conflict between her husband and her siblings. She died peacefully 2 weeks later.
Dr Beverly Siew
Palliative Care Physician
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