SEPTEMBER – NOVEMBER 2018 • MCI (P) 072/01/2018

LIVE WELL. LEAVE WELL.

DISCOVER, RESPECT, IGNITE LEAVING A

LEGACY OF HOPE PLUS Views from the pros

1

THE HOSPICE LINK • SEPTEMBER–NOVEMBER EDITOR’S NOTE Members’ Contact Assisi Hospice Contents Building a legacy 832 Thomson Road, S(574627) T: 6832 2650 F: 6253 5312 www.assisihospice.org.sg [email protected]

Bright Vision Hospital 5 Lorong Napiri, S(547530) T: 6248 5755 F: 6881 3872 www.bvh.org.sg [email protected] egacy building” is an important Dover Park Hospice aspect of palliative care. It 10 Jalan Tan Tock Seng, S(308436) T: 6500 7272 F: 6254 7650 focuses on creating meaningful www.doverpark.org.sg [email protected] “L and lasting memories for both HCA Hospice Care the patients and their loved ones. We all enjoy 12 Jalan Tan Tock Seng, S(308437) T: 6251 2561 F: 6352 2030 doing something meaningful with our families www.hca.org.sg [email protected] and friends, be it going on an outing, taking family photos, giving memorabilia or writing Metta Hospice Care 32 Simei Street 1, Metta Building, S(529950) letters. Sometimes, it can even be a way of T: 6580 4695 F: 6787 7542 creating space for reconciliation. These simple www.metta.org.sg [email protected] acts can mean a world to those who have limited time with their families. MWS Home Hospice 2 Kallang Avenue, CT Hub #08-14, S(339407) We are thankful for the many angels in our T: 6435 0270 F: 6435 0274 www.mws.sg [email protected] midst, from the palliative care medical teams to the volunteers, venturing great lengths

Singapore Cancer Society to help fulfil the wishes of patients. This 15 Enggor Street, #04-01, Realty Centre, S(079716) T: 6221 9578 F: 6221 9575 work would not have been possible without www.singaporecancersociety.org.sg their sheer determination and heart for the [email protected] patients. Legacy building can start right now for St Andrew’s Community Hospital 8 Simei Street 3, S(529895) T: 6586 1000 F: 6586 1100 anyone. In June 2018, the Singapore Hospice www.sach.org.sg [email protected] Council launched our “Live Well. Leave Well” national campaign, with the aim of raising St Joseph’s Home 36 Jurong West St 24, S(648141) T: 6268 0482 F: 6268 4787 awareness and generating conversations on www.stjh.org.sg [email protected] end-of-life matters. There are tools to help you 4 along. One such tool is “Time of My Life – Past St Luke’s Hospital Perfect, a Journal of Self-Discovery”, which can 2 Bukit Batok Street 11, S(659674) T: 6895 3216 F: 6561 3625 www.slh.org.sg [email protected] 2 Members’ Contact be downloaded from our website at www.singaporehospice.org.sg. Changi General Hospital 3 Editor’s Note I wish the best for you even as you explore 2 Simei Street 3, S(529889) shared values together with your loved ones, T: 6788 8833 F: 6788 0933 www.cgh.com.sg 4 Live Well. Leave Well. and find a deeper meaning to building your Khoo Teck Puat Hospital legacies together. 90 Yishun Central, S(768828) 7 Talking about death? No problem. T: 6555 8000 F: 6602 3700 www.ktph.com.sg

KK Women’s and Children’s Hospital 8 A legacy of hope Legacy building is Ms Yeo Tan Tan 100 Bukit Timah Road, S(229899) “ Chief Executive T: 6394 8008 F: 6291 7923 www.kkh.com.sg 10 A legacy of gratitude an important aspect Singapore Hospice Council Ng Teng Fong General Hospital 1 Jurong East Street 21, S(609606) 12 From war to peace T: 6716 2000 F: 6716 5500 www.ntfgh.com.sg of palliative care. It [email protected] 13 Flowers always blooming National Cancer Centre Singapore 11 Hospital Drive, S(169610) 14 A legacy of spirit focuses on creating T: 6436 8183 F: 6220 7490 www.nccs.com.sg 16 Discover, respect, ignite Tan Tock Seng Hospital lasting memories for 11 Jalan Tan Tock Seng, S(308433) T: 6359 6477 F: 6359 6294 www.ttsh.com.sg 18 Views from the Pros both the patients and Lien Centre for Palliative Care Tips for Caregivers Duke-NUS graduate Medical School Singapore 19 8 College Road Level 4, S(169857) T: 6516 4233 www.duke-nus.edu.sg/lcpc 20 Upcoming events their loved ones.”

2 3

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER EVENT

Live well. Leave well. Singapore Hospice Council launches a campaign to raise awareness of end-of-life issues and to encourage end-of-life conversations

hat do you say when a loved one is diagnosed with a terminal illness? W What are the important topics to talk about when considering end- of-life care? How do you approach the topic of end-of- life care with your loved ones? According to a survey conducted in 2014, 82% of respondents agree that the general public needs to know more about hospice and palliative care, and 71% agree that there should be national conversations about death and dying. But, almost half of the respondents have not started the conversations, for the simple reason that they do not know how to broach the topic.

The two-day event attracted over 1,800 participants and featured informative and interactive booths with different patient care settings. Other programme highlights included: talks on palliative care in four languages, tips on starting early conversations on end-of-life care, performances by various performing groups.

4 5

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER EVENT REFLECTION

On 9 and 10 June 2018, the Singapore Hospice Council (SHC), with active participation by our member organisations Talking about death? and community partners, organised a Community Engagement Event at Bedok Town Square to encourage early end-of-life conversations. No problem. The campaign, themed “Live Well. Leave Megan Teo, an intern at the St. Andrew’s Community Hospital’s Medical Well.”, was officially launched by Guest- of-Honour, Dr Amy Khor, Senior Minister Social Work Department, reflects on talking about death. of State, Ministry of the Environment & Water Resources and Ministry of

Health, together with Mr Lee Yi Shyan, Top: Launch of the SHC he community about such a morbid topic?” say “I’m sorry” to their loved ones, I Member of Parliament, East Coast Television Commercial engagement event, I was befuddled when the crowds was amazed and humbled. – Because I love you. Group Representation Constituency. From left: Dr Angel Lee, “Live Well, Leave Well” came. At our booth alone, we counted Before the event, death was also The launch included a two-minute Chairperson, SHC; SMS T held on 9 and 10 June 982 participants who were willing to very much a taboo topic for me for Health Amy Khor; Mr television commercial entitled Lee Yi Shyan, MP of East 2018 and organised by the Singapore engage in conversations about the and I would avoid such discussions. “Because I love you” and a community Coast GRC; Dr Patricia Hospice Council, left a lasting end-of-life care. It dawned on me that The large crowd participating in Neo, Vice-chairperson, engagement kit developed by SHC. SHC; & Ms Yeo Tan Tan, impression on me. The event allowed it is indeed important to be able to the event also showed me that Through community partnerships Chief Executive, SHC. me to view death as a natural express our feelings towards our increasingly people are open to such Left: Launch of the SHC and media engagement, SHC hopes Community Engagement process that all of us have to accept, loved ones. discussions. Although the topic of to use the developed materials to Kit. From left: Ms Yeo be it our own death or that of of our Tallking to people, I found the death and dying can sometimes Tan Tan, Chief Executive, generate public awareness and SHC; Dr Angel Lee, loved ones. phrase that struck me the most was, trigger negative emotions, it can be encourage Singaporeans to start Chairperson, SHC; SMS Together with the Palliative Care “I’m sorry”. I can understand it when a great relief to some who find it for Health Amy Khor; conversations early regarding end- Mr Lee Yi Shyan, MP Teams from Changi General Hospital people feel the need to say “Thank difficult to express their feelings. of-life care. of East Coast GRC; Dr and St. Andrew’s Community you”, “I love you” or “Good-bye”. But, This experience has given me Patricia Neo, Vice- chairperson, SHC. Hospital (SACH), SACH Medical Social “Sorry”? Who would ever say that greater insight into the topic of death Workers and volunteers, we “set up they are sorry? and how people respond to it. It has shop” in Bedok Town Square with I find it most challenging to say also encouraged me to talk about my several other organisations. “I’m sorry” to a loved one because it feelings with my loved ones as I have Before the event, I had wondered: is difficult to admit that I am wrong. come to realise that it is important to WHAT’S INSIDE THE “Who would want to be at such When I found that there were indeed convey my feelings and not wait till COMMUNITY ENGAGEMENT TOOLKIT? an event? Who would want to talk people who wished for the courage to the last minute.

The Community Engagement kit is to equip community partners to help patients and care- givers to better understand what palliative care can offer and to provide tips on how to start early conversations about end-of-life matters.

i. “Palliative care – What You Need to Know” brochure by Singapore Hospice Council (in four languages). ii. “Planning for My Care” brochure by Agency for Integrated Care (in four languages). iii. Lasting Power of Attorney brochures by Office of the Public Guardian (in four languages). iv. “Time of My Life – Past Perfect, the Journal The purpose of these cards is to help players of Self-Discovery” by Yang Xinyan Alexis, a discover what is important for them to live and reflection journal to help one reflect on their leave well including their values, motivation, CGH-SACH Palliative Care life experiences whilst discovering values that beliefs, life goals etc. Team and matter to them. volunteers at the “Live Well, v. Conversation Cards – jointly created by Tan For more information on the “Live Well. Leave Well.” Leave Well” Event. Tock Seng Hospital Advance Care Planning campaign and the community engagement toolkit, Megan is third team and SHC. visit the website: singaporehospice.org.sg. from left in front row. SINGAPORE HOSPICE COUNCIL COUNCIL SINGAPORE HOSPICE WORDS COUNCIL SHU JUN/ SINGAPORE HOSPICE KOH PHOTOS UNIVERSITY NATIONAL WORK, OF SOCIAL DEPARTMENT UNDERGRADUATE, TEO, MEGAN WORDS HOSPITAL ANDREW’S COMMUNITY ST. OF SINGAPORE PHOTO

6 7

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER LEGACY

A legacy of hope A young patient’s dream of publishing his biography to inspire others is being fulfilled, courtesy of Project Legacy, run by students from the NUS Yong Loo Lin School of Medicine.

t’s a story of gratitude students from NUS Yong Loo Lin School and perseverance,” says of Medicine, who are running Project 23-year old Wong Choon Legacy this year, to help palliative “I How. One of HCA Hospice patients create a keepsake for their Care’s patients under the Star PALS loved ones and leave a legacy through paediatric palliative care service, life telling their stories. has been fraught with challenges ever Project Legacy was founded in 2011. since Choon How was diagnosed with “We hope that during their journey in Duchenne Muscular Dystrophy (DMD) search of their legacy, patients will find when he was just five years old. a renewed sense of personal power, But it is these same challenges that purpose and importance and be able have served as inspiration for his to reconcile their feelings with their biography. It is a dream project that is in prognosis,” says Rachel Goh, 22, who is progress and nearing completion, with a leading Project Legacy this year. few more chapters to be written. Chronicling his experiences living A Flair for Storytelling with DMD, being bullied at school and Choon How and his mother, Madam the personal pursuits that fuel his zest Susan Tan, were linked up with the Diagnosed with Duchenne for life, Choon How hopes that his story Project Legacy volunteers last year, Muscular Dystrophy since about their struggles and personal will raise awareness on the condition when Lily Li, Nurse Manager of Star he was five years old, victories. “During these sessions, I was Choon How has not let and offer hope and encouragement for PALS, first mooted the idea of publishing that stop him from living struck by his fighting spirit and zest others in similar situations. It is also a biography. his life with zest, zeal and for life,” Rachel shares. gratitude. Seen here with an avenue through which he hopes “Choon How was inspired to produce his mother, Choon How The biography, which will be written to express his gratitude for the ample his own biography after attending a was inspired to write his in both English and Chinese, is Choon biography as a legacy for support he has received. talk given by actor Li Nanxing at the his loved ones. How’s way of leaving his legacy of The biography, which will Bukit Panjang Methodist Church on hope for his loved ones and others “ The Spirit of Giving his personal failures and successes,” who are facing similar difficulties. It is Like many people with special needs, Mdm Tan explains. “We also got the same flair for creative expression be written in both English Choon How can attest to the difficulties an autographed copy of the actor’s that manifests in his watercolour and associated with daily routines. He uses biography, ‘The Real Picture’.” oil paintings, which he sells locally. He and Chinese, is Choon a motorised wheelchair to get around Seeing a parallel between his often paints tranquil scenes depicting and a BiPAP machine to aid in his personal challenges and the trials and flowers and birds wandering idly breathing. While these may seem like tribulations the local veteran actor through the forest, which are perhaps How’s way of leaving his inconveniences to most, it has made had faced, Choon How was inspired to a reflection of his inner strength and Choon How ever more appreciative follow in the footsteps of his idol, by calmness. legacy of hope for his loved of the support and kindness he has writing his story. It is our collective wish that his received from his family, volunteers and The Project Legacy volunteers jumped biography, when published, will touch HCA’s clinical staff. into action almost immediately, paying the hearts of others and evoke the ones and others who are Putting together his biography was numerous visits to Choon How’s place same sense of hope and positivity a dream made a reality by a group of to listen to him and his mother share CARE HCA HOSPICE & PHOTO WORDS Choon How encapsulates. facing similar difficulties.”

8 9

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER LEGACY

liver cancer. He had to go for surgery immediately, but by then the cancer cells had A legacy of gratitude already spread to other parts of his body. Although life is on the downside, Geok Seng He may not have much material wealth to leave for his family, still counted his blessings – his siblings eased but Geok Seng left behind much more – a life of gratitude. his financial burden by providing him with the necessities for his family, and his church The card and his friends visited him, prepared his meals and “ even celebrated his birthday. photographs in her mobile When his condition deteriorated in June 2017, Geok Seng was admitted to the palliative care programme at BVH. phone would be his legacy.

A tough man with a soft heart It will bring back fond Geok Lian remembers her brother as one tough cookie. Despite his condition, he was still able to smile and put up a brave front. memories of Geok Seng. Never once did he complain about his illness. He was nice to everyone at BVH especially As the saying goes, the the nurses and other patients. They made him feel at home and would invite him to karaoke and movie sessions. ones who leave behind “He said that he was comfortable here. We knew he was prepared to go,” shared Geok great remembrances will Lian. Before he passed away, Geok Seng made a handwritten thank you card to each of live on in our hearts.” his family member. As he did not receive a formal education, Geok Seng requested help from BVH staff to assist him in preparing cards. It was his way to show gratitude to them. That was how Geok Seng as a person: always thanking everyone and counting his blessings.

Geok Seng’s Legacy Receiving the thank you card was the saddest moment for Geok Lian. She was touched by his gesture. It was the most beautiful card she has ever received. ixty-one year-old Lim Geok Lian illness while his son was born with autism and “He is actually a gifted man. From young, smiled as she looked through her Attention Deficit Hyperactive Disorder (ADHD). he can play the guitar. He just has to listen S mobile phone. Her finger was fast Geok Seng would wake up at 10pm daily to once to recognise the keys,” said Geok Lian. scrolling through the dozens of travel to Jurong to collect the fish. By 3am, he His family missed him very much. The photos in her albums. She stopped when she found would be back at the market to set up his stall. weekly gatherings were not the same without what she was looking for. Once work was over, he would make his way him. “We used to meet each other weekly, on Beside her was elder sister, Lim Keok. They were home to help with the household chores. Saturday or Sunday, to eat,” said Geok Lian. back at Bright Vision Hospital (BVH) a year after “His business was the best among the other They would gather at Lim Keok’s place at Pasir their brother passed away. fishmongers. He always ended work early,” Ris when Geok Seng was still healthy. She still praised Geok Lian. It was obvious that he was remembers his favourite food, which was My Brother, Geok Seng well liked by his customers. pork curry. “This is Geok Seng,” said Geok Lian as she showed Things took a turn for Geok Seng in October The card and his photographs in her mobile us her family photo. “He is the 5th child among my 2016. He began to experience pain in his leg and phone would be his legacy. It brings back nine siblings.” made the painful decision to stop working when fond memories of Geok Seng. Geok Seng’s handwritten cards As a sole breadwinner, Geok Seng worked hard it became unbearable. As the saying goes, the ones who leave to his family as a fishmonger to support his family. It was A medical check-up at Singapore General behind great remembrances will live on in members was his way of showing not easy for him. His wife suffered from mental Hospital (SGH) diagnosed him with end-stage BRIGHT VISION HOSPITAL & PHOTO WORDS our hearts. gratitude to them.

10 11

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER LEGACY LEGACY Flowers always blooming Legacy work is not just an activity with an end product; it can also be From war a therapeutic process of reflective and creative exploration.

to peace lowers Always ourselves that the process of creating that sacred time and space, love Blooming” – this was space, encouraging reflections, and transcended beyond what words There is no better legacy “F Madam Mia Sari’s allowing stories to be told is just as alone can do. than the stories of our belief, and the one important. The butterfly, bee and sun Mdm important thing she wanted people Mdm Mia Sari started drawing Mia Sari drew symbolised her pioneers. Methodist Welfare to know. a tree, with leaves, and a big red family – always with her and forever Services Home Hospice’s That was quite a contrast to what flower. She then added on roots for shining for her. This was exactly my eyes initially tell me about her – the tree: “Trees must have roots, what she wanted them to remember 88-year old patient tells us frail, sleeping most of the time, and so that they will be strong like us – bloom, shine, be happy. “Be like this how the strength she gained a lady of few words. Lethargy has humans.” For her, roots are akin to flower - be bright, be blooming”. Madam Chan been getting the better of her in the values such as willingness to work She requested a pink ribbon to (left) and MWS from her past sustains her preceding days. But this afternoon, hard, perseverance in completing be added at the corner of her art Home Hospice nurse Amanda through her illness now. she mustered the energy to prop what we started, and not giving up work. It represented her support for Ong share a herself up in the hospital bed, in life. “And if these leaves fall, know women with breast cancer. It was moment. searched for her spectacles and was that new ones will surely grow out almost as if she was declaring it is ready for something different. again.” So much wisdom, so much not a fight she had lost, but a long It was one of those days where I faith in those few words. journey she is completing, and now had no confident idea of what to do. That afternoon, Mdm Mia Sari cheering the others on. With a smile udging by 88-year-old had fled to a bomb shelter, leaving with three other friends, the death of When I sit down with a patient, spent every ounce of her energy she said: “This, is good enough.” Madam Chan Geok her to guard their belongings, alone. one of them ended their gatherings. I do not always bring up the issue immersing in this precious moment, Legacy creation can take on J Sian’s cheeky grin, it As a young girl then, Mdm Chan Today, she looks forward to seeing of “doing a legacy”, or asking, “how with her family who contributed various forms. But at its purest, it is is impossible to guess did not understand much about the MWS Home Hospice nurse Amanda would you like to leave a legacy?” in their own pieces to this tapestry of found in the everyday life. It’s in the how hard her life has been. As an war. She remembers being intrigued Ong, who has been visiting her the first instance. narratives. narratives of what defines us, the 8-year-old, she was shipped off by the sight of the planes. After the regularly since March 2015. Mdm The concept of leaving a legacy Her husband and son were clearly building of memories, the celebration from China to Singapore alone to war ended, her employer match- Chan enjoys reminiscing about her may often be foreign to many of heartened by her spontaneity, but of both joys and pains, and the escape the Chinese civil war. She made her with an acquaintance’s past and chatting about everyday our patients. In a fast-paced and more so, by the meanings embedded unfolding of a unique story – we all lost contact with her entire family son. She was only 16. affairs with Amanda, whom she transitory environment such as within every stroke and colour. In have one to tell. shortly after. Today, the widowed Mdm Chan considers a friend. that of a hospital, and more so When she arrived in Singapore, faces hardships of a different kind. The hospice has a full-fledged with palliative care, I have realised she was sold to a Peranakan family She lost her eldest son to lung medical team providing palliative the importance of recognising to work as a servant. “I wasn’t paid, cancer in December 2017, and she care to Mdm Chan in the comfort opportunistic, ordinary moments, but they provided me with food and has end-stage renal failure and of her own home. They also trained and capitalising them for therapeutic lodging,” says Madam Chan. “My job possible malignancy of her stomach and equipped volunteers and and meaningful exchanges. was to carry the matriarch’s purse and pancreas. She declined further caregivers to care for her. Such is also the case with legacy wherever she went.” investigation and dialysis treatment The hospice’s 24-hour nursing work: it is more of a therapeutic To her horror, the war soon due to her advanced age and fear hotline also gave Mdm Chan and her process as oppose to a mere aim of followed her to Singapore. Fearing of discomfort. She opted for home- family the assurance that they could producing something. that she would be taken away by based medical and nursing care seek medical advice round-the-clock. What appeared to be a Japanese soldiers, Mdm Chan tried provided by MWS Home Hospice to In spite of her illness and frailty, spontaneous activity that afternoon her best to look as unattractive as manage her symptoms. Mdm Chan is determined to live with Mdm Mia Sari soon became a possible. To cope with her living and life fully. Her courage and resilience heartwarming family session and The octogenarian vividly recalls medical expenses, she supplements show through her daily life. She legacy creation, one that brought to Mdm Mia Sari’s legacy hiding in the canal outside her the allowances from her two still meets family and friends for the surface words not spoken before. for her family employer’s house, clutching their remaining children by renting out a coffee and chats at the void deck, “I’m no artist,” she wanted that - a drawing symbolising valuables to her chest, while bomber room in her 3-room HDB flat. While and enjoys going for social outings said first. There may be some truth strength, hope

planes flew overhead. Her employers she used to enjoy mahjong sessions organised by MWS Home Hospice. & ENGAGEMENT COMMUNICATIONS EXECUTIVE, ANDREA TAN, NICOLE WORDS SERVICES METHODIST WELFARE PHOTO WORKER, SENIOR MEDICAL SOCIAL CANDICE TAN, WORDS SENG HOSPITAL TOCK TAN PHOTO SENG HOSPITAL TOCK TAN to that, but we have to remind and faith.

12 13

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER LEGACY

A legacy of spirit A legacy is not always necessarily monetary or tangible objects; leaving behind a spiritual legacy is just as treasured.

r. B* was one of the patients I were aware of their father’s condition but do not encountered during my first year of know that his time is short. M practice as a palliative nurse. I had “I know time is very short, but I don’t know always thought that the story plot how to help him. He used to be very jovial and in TV dramas would never be portrayed in real chatty, but now, he always keeps to himself,” Mrs. life scenarios, but his life story was one of the B said, with tears flowing profusely. Tissues were examples that made me think otherwise. offered, reassurance and validations were given to The 45 year-old Indian architect was diagnosed her that she was doing great to stay involved and with end-stage lung cancer, which had spread informed at every stage and most importantly, she to bones and pleural cavity. He went through was not alone. The palliative team would aim to multiple treatment sessions, none of which helped. get optimal dose of medications to relieve Mr. B’s Instead, they caused him much physical pain, breathlessness during his stay. emotional burdens and also financial drain for During a review, Mr B spoke to our team before the family. we left his bedside. He became increasingly frail and had symptoms “I overheard the conversation between you and of breathlessness which made him feel suffocated. my wife. I know my time is short, and I had not The palliative team has been referred to help in much money to leave for my wife and two girls….I managing his symptom. Medications were titrated had always wanted to leave something for them to help Mr. B feel less breathless. At the same before I depart from this world, but I don’t know time, we talked to Mrs. B to enquire about family’s what to give and I do not have much money left setup, goals of care and patient’s expectations of after all the treatments,” he told the doctor. treatment in the hospital. The doctor reassured him that a legacy does not Mrs. B said they had been married to patient for always mean leaving monetary items for his loved 15 years, and have two beautiful girls (14 years old ones. “It can be something unique and memorable and 12 years old respectively) who were very close to them; example your own handwritten letter to to the patient. The cancer specialist told Mrs. B to your wife and 2 daughters in their favorite letter every year at their birthdays till they are 21 years connected deeply even after the departure be mentally prepared for the worst, as the patient design or cartoon characters. You can also pre- old. This is a big task, which means you have got of life. has only less than three months to live. Their girls write the letters to your 2 daughters and give them several letters to write,” the doctor told Mr B. Legacy can be something that is very simple. The palliative team help purchase stationeries for It can be an album of photos that keep the Mr B to write his letters during his hospitalisation. memory of the deceased and the living being We got the Medical Social Worker (MSW) involved together. One can only imagine the meaning to help with this legacy activity, assisting with the letters carry when the family reads such placement for patient to move to an inpatient letter every year. hospice for end-of-life care (as wife is not able to Legacy can be the record or artwork that cope with care at home), providing psychosocial the deceased is good at doing, such as a book support to family and helping in liaising with school of recipe, book of poems, a book of articles, a counsellor to help and support the patient’s two book of artwork, or a record of music. Legacy Legacy can be something that is very simple. It can daughters during this difficult journey. can be even spiritual, such as the spirit of being “ Mr. B was accepted to be placed in an inpatient filial, caring and loving; the spirit of being be an album of photos that keep the memory of hospice where he could spend his end-of-life hardworking, brave and resilient. moments. Some of the hospital’s palliative team Legacy is not necessary to be monetary or members visited him before he left for inpatient tangible objects, spiritual legacy is equally the deceased and the living being together. One hospice’s admission, and he told them that he had important, because the living can pass down finished writing the letters to his wife and children. this gift in the family and it is a better way to can only imagine the meaning the letters carry As a novice nurse then, I began to understand remember the spirit of the deceased who has the meaning of leaving legacy after the team’s set an excellent model in life. explanation and began to be aware that such a

when the family reads such letter every year.” CGH NURSE, GOH HWEE JIN, PALLIATIVE WORDS simple act could make a patient and his family be *Name has been changed to protect his confidentiality

14 15

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER CONVERSATION

After thirty years of practising“ medicine, I realised that physicians are actually gardeners of the garden of life. The gardener can’t change the four seasons of spring, summer, autumn and winter, but he can help the flowers in the garden bloom brightly during the four seasons. In the same way, doctors can’t cure the elderly or the sick, but they can make the elderly and sick comfortable.” Professor Ke Wenzhe, renowned and respected intensive care physician from National Taiwan University Hospital; Mayor of Taipei.

after she had received her “death to us. She continued to comment that is enjoyable to them, but as the sentence”? Dr Ong Eng Koon, the on the characters in the drama. She gardener of the life, we can make an team consultant, gave Dr James Cai even analysed her preference for effort to provide extra care to them and I a special task: to talk with Korean dramas over Singaporean during the extreme chill of winter. Mdm Lo without using any medical or Taiwanese ones: the Taiwanese We can put aside the medical jargons. If one of us mentioned a drama serials were too long to diagnosis, scans, blood results, and Discover, medical term, the person must be follow and the current Singaporean look at the persons that our patients warned to stop the conversation. serials did not live up to her were before they became dependent With uncertainty, we took up the expectations. and disabled, with their unique challenge. In between, she sighed and said interests and desires. respect, ignite Madam Lo told us she had never that due to recent illness she did not I picked up the phone, called Sometimes, the last thing someone needs in worked before, and that she was manage to catch up with her shows. Mdm Lo’s son to discuss what I a housewife. She had dedicated Mdm Lo also shared with us that have learned about her, and asked the final lap of life is the complexity of medical her entire life to taking care of her she has been to Europe, when her whether the family could bring jargons. A simple conversation about life may family. A typical day for her included daughter brought her along during a device for her to watch her watching drama serials and cooking her own honeymoon. She fondly favourite shows. I also offered to be all that is needed to bring on a smile. for the family. Her specialty was stir- remembers that period as the arrange home leave for them to fired cauliflower with meat. She has happiest time of her life. bring her home for a meal. Her son been cooking this dish for more than At the end of the conversation, gladly agreed and expressed his t was just another morning round, just 20 years and her children still enjoy we asked Mdm Lo for permission appreciation at the suggestions. another routine assessment of a patient’s this dish very much. to let her children know what we The last lap of the life is not about understanding of their condition. But, Madam Lo also revealed that she discussed. We wondered if they dying, it is about living. To help the I Madam Lo was different from most of loved watching Korean dramas and could bring a device to let her watch patient live before leaving this world, our patients. That morning, she told us that there is said the Korean actors were very her favourite drama series and it is important for us to learn how to no more treatment for her, that she may have left handsome. At that moment, I saw a bring some of the dishes she used drop our “armour” of medicine and less than three months to live, and that she would be smile appear on her face. to prepare for the children. She to don on a heart of humility and going to a hospice. Her face was drowned in sadness, I asked her what her favourite declined quickly as she did not want talk about life. Behind every life there disappointment, and hopelessness. show was. Although she could not to trouble her children. is always a special chapter belonging Mdm Lo has reached the winter of her life. What recall the name of the drama, she A terminal illness may rip away to it. Discover it, respect it and ignite

does it mean to be able to live happily and comfortably CANCER CENTRE SINGAPORE NATIONAL KEHUA, RN LIAO WORDS described the drama in great detail a person’s freedom to live the way it till the last drop.

16 17

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER VIEWSCARING FROM HANDS THE PROS

gives the family comfort and fulfilment her, but she vehemently refused. legacies now and we could start that they have done something But in an unexpected turn of an by having conversations with our Why is legacy together with the patient before the event, she came to visit him in the loved ones. To aid the process, you patient eventually departs, which also hospice. They reconciled despite can visit www.singaporehospice. helps in the grieving and bereavement having not spoken to each other org.sg to download “Time of My building important? process thereafter. for years. Past grievances were Life – Past Perfect, a Journal of Secondly, it can bring reconciliation put aside, tears were shed. Even Self-Discovery” by Yang Xinyan Ms Violet Yang has over 30 years of experience as a Medical Social Worker, and mangement to families. I once had a male patient as my patient breathed his last, his Alexis. The journal is part of the in eldercare and psychological services, eight of which are in the palliative care industry. She who was divorced. When he was heart was light, and he left with no Community Engagement Kit has joined the Singapore Hospice Council as the Community Engagement Manager to train close to dying, he asked to see his regrets. designed by the Singapore Hospice and share the latest updates with community workers about hospice and palliative care. ex-wife, whom he had not met for Council as a tool for individuals to years. I decided to make a trip down Are patients the only ones who do a life review so that they can to meet his ex-wife. Unexpectedly, I should build their legacies? be better prepared to talk about Patients may occasionally present met another volunteer who was on the Who should do it? end-of-life conversations with their some challenging wishes that they same mission as mine. We talked to Anyone can start building their loved ones. have, but our palliative care team work within the limits of what the patient’s goals are. Additionally, we also do other types of legacy building, such as allowing patients to express their gratitude, or to value their contribution. This also helps Tips for Caregivers in the coping of their emotional pain. DR JAMIE ZHOU Resident Consultant (Palliative Care), St Joseph’s Home Who can start legacy work and how do we do so? This issue’s theme is about leaving behind Legacy work can be done by anyone, a legacy. A legacy does not just mean leaving a will or expensive items to your from nurses, social workers or even loved ones. It means leaving behind volunteers. The key is to have a something that people can remember you personal connection with the patient by. It can come in the form of a physical so that the facilitator can act in the object (e.g. a watch, a letter, etc) or What are legacies in hospice work carries with them hopes and dreams. best interest of the patient. something non-physical (e.g. a memory, a and why is it important for patients Once, I had a cancer patient who The execution takes a team effort. life story, etc). Here are some tips on how to “leave legacies”? used to actively participate in singing Once, we worked to help bring a you can help in legacy work: Legacy work means leaving good competitions. In the later stage of patient to an outdoor event so that she memories of the individual to their her illness, the cancer had damaged could share her journey’s testimony to Caregiver tip #1: It’s best to discuss and families and friends. This could include her voice, but she still insisted on a crowd. There were weeks of planning plan legacy work early. activities from creating recipe books, participating in one last singing involving everyone in the medical Many leave it to the last minute when photo journals, lifestory montages, to competition. team. The list of to-dos ranged from there is little energy left. This may result giving testimonies, or compiling love The medical team understood her logistical preparations to nursing needs, in incomplete legacy work especially if the messages for their loved ones. This is intentions to leave good memories to mental preparation by the therapists, intended legacy takes time to complete. Caregiver tip #3: Inspire your loved ones to important for both the patients and their for herself and her loved ones. But and rallying the family members to leave a legacy by reviewing their life with loved ones. the team was also stuck with the attend the event for support. No stone Caregiver tip #2: Be ever-ready to take them. The concept relates to the highest dilemma that it may be too physically was left unturned. photos. A life review is allowing your loved ones to tell tier of Maslow’s “Hierarchy of Needs”, challenging for her throughout the Thankfully for us, camera-phones are now a their life story. You can tell them how you would which is self-actualisation. It refers to entire competition. Instead, they asked How does building legacy for the norm. It does not take much effort to capture remember them and this may inspire them to one’s needs to reach full potential and the organiser to allow her to join the patients help their loved ones? a happy memory. It will go a long way. leave a legacy behind for their loved ones. feel fulfilled. Even at the end-of-life, competition as a guest singer. She did There are two ways legacy building

the patient is still an individual who still so, enjoying herself in the process. can benefit their loved ones. Firstly, it COUNCIL SINGAPORE HOSPICE & PHOTO WORDS

18 19

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018 THE HOSPICE LINK • SEPTEMBER–NOVEMBER CALENDAR Upcoming Events 19 - 22 SEP 2018 Time:11.30am – 9pm (Tee-off at 1pm, Contact: secretariat@singaporehospice. LAST DANCE dinner at 6.30pm) org.sg/ 6538 2231 A son throws a party to Contact: Ms Mel Basuki, Fundraising commemorate the 100th day of his Manager/[email protected]. 31 OCT – 1 NOV 2018 father’s passing. Through dancing, sg/6891 9392 Grief and Bereavement Conference conversations and sharing of stories, (GBC 2018) LAST DANCE invites the audience to 25 SEP 2018 Organised by SHC, the inaugural reflect and “come closer to death”. SHC Multidisciplinary Palliative GBC 2018 hopes bring together A collaboration between Both Sides, Care Forum community workers to foster Now and Yishun Health. Hear a pharmacist’s perspective of a network of support for the Venue: Basketball court next to managing cancer patients. bereaved. Registrations closes on Blk 109 Yishun Ring Road Venue: KK Women’s and Children’s 15 October 2018. Time: 7.30pm – 9.30pm (19 & 21 Sept Hospital, Women Tower Level 1, Website: www.gbcs.sg 2018 - performed in English; 20 & 22 Lecture Theatre Contact: gbc2018@singaporehospice. Sept 2018 - performed in Mandarin) Time: 1.00 pm – 2.00pm org.sg/ 8823 3686 Contact: [email protected]/ Contact: secretariat@ 6324 5434 singaporehospice.org.sg/ 6538 2231 3 NOV 2018 Celebration of Life! 19 SEP – 6 OCT 2018 1 – 31 OCT 2018 Held in conjunction with World CLOSER NLB-SHC “Live Well. Leave Well” Event Hospice & Palliative Care Day 2018, Created in collaboration with In collaboration with the National this event aims to raise awareness Chong Pang’s seniors, this public art Library Board, SHC, its members and and understanding of the needs and installation trail hopes to inspire partners will hold a series of talks concerns of Singaporean about end- vistors to reflect on what it means to and exhibitions in various libraries of-life matters. Jointly organised by be living. Jointly organised by Both island-wide. Tan Tock Seng Hospital (TTSH) and Sides, Now and Yishun Health. Website: singaporehospice.org.sg ACE Seniors. Venue: Various locations between Contact: secretariat@ Venue: National Museum of Singapore, Blk 108 to Blk 115 Yishun Ring Road singaporehospice.org.sg/ 6538 2231 Gallery Theatre and Canyon at B1 Time: Various timing Time: 11.00 am – 4.00 pm Contact: [email protected]/ 23 OCT 2018 Event participation is free-of-charge. 6324 5434 SHC Multidisciplinary Palliative Care Forum 27 NOV 2018 20 SEP 2018 Guest speaker is Dr Richard Harding, SHC Multidisciplinary Palliative HCA Charity Golf 2018 Reader in Palliative Care at the Cicely Care Forum The HCA Charity Golf 2018 aims to Saunders Institute, Department Spiritual Beliefs in Palliative Care raise at least $200,000, which will of Palliative Care Policy and Venue: HCA Hospice Care Auditorium, enable us to make 800 more visits to Rehabilitation, King’s College London. Level 3 our home hospice patients. Venue: Assisi Hospice, Essery Hall, Time: 1.00 pm – 2.00pm Venue: Singapore Island Country Level 5 Contact: secretariat@singaporehospice. Club, Island Course Time: 1.00 pm – 2.00pm org.sg/ 6538 2231

EDITORIAL COMMITTEE

Editor Ms Yeo Tan Tan Associate Editor Jaime Koh

Assisi Hospice David Fong Bright Vision Hospital Muhammad Azhar bin Abdul Rahim Changi General Hospital Rasidah Bte Alias Dover Park Hospice Ethan Ang HCA Hospice Care Toh Wei Shi Khoo Teck Puat Hospital Ong Min Li Lien Centre for Palliative Care Madhurima Bagchi 1 Lorong 2 Toa Payoh Level 7 Metta Hospice Care Alicia Lum Yellow Pages Building MWS Home Hospice Yanni Tan Singapore 319637 Singapore Cancer Society Kumudha Panneerchelvam St Andrew’s Community Hospital Peh Lay Koon T: 6538 2231 St Joseph’s Home Geraldine Soh E: [email protected] St Luke’s Hospital Sarah Lim www.singaporehospice.org.sg Tan Tock Seng Hospital Dr Ho Si Yin

Singapore Hospice Council Koh Shu Mei

Designer Christian Subrata Contents are not to be quoted or reproduced without the prior Printer Yung Shung Printrade Pte Ltd written permission of the Singapore Hospice Council.

20

THE HOSPICE LINK • SEPTEMBER–NOVEMBER 2018