Being with patients in the last hours of their lives
published by Straits Times on May 16, 2023
Retired translator Eva Maitra, 67, remembers the day in 2017 when she first accompanied a dying stranger.
She had just joined Noda, a programme that supports dying people who have no family or friends to be with them in their final hours, and she had no experience in such a role. Noda stands for No One Dies Alone.
A nurse “grabbed” and ushered her to the man. She ended up holding his hand and comforting him for about three hours.
Then he died.
“It was my first (death of a stranger) and I was not mentally prepared then. I needed time to come to terms with that, so I sat in the chapel,” she said.
Ms Maitra is no stranger to death, having taken care of her father in France for the last two weeks of his life.
That episode at Noda did not deter her, and she has since held the hands of several lonely dying patients at Assisi Hospice, where she volunteers. She has witnessed three of them dying on her watch.
She was a volunteer at Assisi when she found out about Noda and joined the programme in 2017.
Unlike a number of elderly people here who were reported to have died alone at home and were not found till much later, those at Assisi Hospice do not die alone – not if the volunteers there can help it.
There are 46 Noda volunteers, including Ms Maitra, and they provide companionship to dying patients who have few or no family members or friends.
“We are in a WhatsApp chat group under Noda and we take turns staying with lonely patients during the vigil. We sit by their bedside when death is near,” said Ms Daphne Lim, 50, a corporate trainer who has been volunteering with Noda since March 2016.
The volunteers are aged 30 to 70, and comprise a mix of retirees and professionals of both genders.
All of them are existing Assisi Hospice volunteer-carers who have gone through basic volunteer-carer training and have served regularly for at least four consecutive months.
The hospice identified those who had an affinity with the programme’s mission and the maturity for it, and invited them to be trained as Noda volunteers.
Noda was started by Ms Sandra Clarke, a nurse at the Sacred Heart Medical Centre in the US state of Oregon, after she was once unable to find time to be with a dying patient.
Overcome with guilt and frustration, she launched the movement in November 2001 at Sacred Heart.
Today, Noda operates in hospitals and hospices in the United States, Singapore and Japan.
It was set in motion in Singapore in 2004 at Alexandra Hospital by then palliative nurse Sim Lai Kiow.
Together with fellow nurses and volunteers, Ms Sim acted as a surrogate loved one, spending time with dying patients who had outlived their spouses, had no kin, were estranged from their families or whose families were overseas.
When priorities at the hospital changed, the programme found a new lease of life at Assisi Hospice after a group of volunteers and staff met Ms Clarke and were inspired. Noda@Assisi was launched in July 2014.
“Our specially trained palliative care volunteers befriend lonely or isolated patients and accompany them until the very end of their lives. They do not accompany patients only during the ‘active dying’ phase,” said an Assisi Hospice spokesman.
These volunteers make friends with the terminally ill patients as soon as they are admitted at Assisi Hospice so that there is a connection between them.
This makes it easier for the volunteers to become the patients’ surrogate family members and for them to be there during the patients’ final hours.
Over what could be a patient’s last 48 hours, “the volunteers take turns to sit in vigil, so that the patient does not die alone”, the spokesman added.
This process could be from a few hours to a few days.
As at the end of 2022, Noda@Assisi had journeyed with 249 patients.
Ms Lim said these patients often gaze beyond the volunteers, appearing to see “people there that we could not (see)”.
Ms Lim, who was brought up a Catholic and is inspired by the work of Mother Teresa, said: “I volunteer because I want the patients to know that they are not alone when they die, that we are there with them, and that they are not alone going to the other side because someone is waiting for them there.”
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