Assisi Hospice

Never Alone

published by The Straits Times on December 10, 2017

Mr Tay Cheng Tian, who had oesophageal cancer, died in a hospice on Nov 4. None of his family members was by his bed when he breathed his last, but the 54-year-old did not die alone. In the last few weeks of his life, a group of strangers befriended him and committed to spending time with him till the very end.

At a quarter past noon on Nov 2, a group of 40 volunteers from Assisi Hospice received a text message in their group chat.

“He could pass away any time so it’s good for us to start the vigil,” wrote Ms Jaki Fisher, 39.
Ms Fisher, who runs the No One Dies Alone (Noda) programme at the hospice, was referring to 54-year-old Tay Cheng Tian.

“I can do 10pm to 1am tonight,” texted Ms Fisher as she set in motion the makings of a vigil schedule.

In two hours, the “roster” for the round-the-clock watch for Mr Tay from Thursday to Saturday morning was finalised. Ten volunteers signed up for three-hour daytime or six-hour overnight shifts.

Noda is a programme in which volunteers provide companionship to dying patients who have no or few family members or friends. They usually befriend patients weeks before the “active dying” phase – when the body begins its final process of breaking down – and take turns to sit by their bedside when death is near.

So far, volunteers have done vigils for 41 patients in the hospice. The shortest lasted a few hours and the longest stretched up to five days.

Mr Tay had oesophageal cancer and was admitted to Assisi Hospice on Sept 19 for palliative care. This cancer is mostly associated with risk factors such as smoking and alcohol consumption. Tumours had spread around his neck and lymph nodes, obstructing blood vessels.

Chemotherapy and radiotherapy were no longer effective, so the hospice had been managing the symptoms with medication instead.

Dr Vibha Prasad, Assisi’s resident physician, said on Nov 2 that it was likely Mr Tay would “go very fast”.

Never Alone 1

TAY CHENG TIAN, 54 Nov 8, 1963 – Nov 4, 2017. A man who loves life and is generous with what little he has

That was the day the vigil started. Mr Tay had been restless before the first Noda volunteer arrived. Sitting up with his head bowed low, he rasped and gasped for breath, chest heaving.

A general ward volunteer wanted to know if he needed oxygen but did not know what it was called in Mandarin. She googled and asked him hesitantly if he needed yang qi. Her husband laughed at her pronunciation and Mr Tay gave a wide grin, his shoulders shuddering as he laughed. It would be one of his last.

The next moment, Mr Tay mumbled “Ah Mui”, which the volunteers later deduced to be his sister. Then he called “Ah Jui” repeatedly, and waved his hand as if he saw someone. The volunteers were unperturbed. They had been trained to expect that the dying sometimes see people that others cannot.

By 2pm, Noda volunteers Paul Koh, Lydia Tan, and Karen Sng, all 63, had turned up. Mr Koh, a former bank dealer, held Mr Tay’s hands and played his favourite Hokkien and Mandarin songs.

As the tunes wafted through the ward, Mr Tay bent his knees and waved his hands. Ms Sng and Ms Tan tapped their palms on his arms.

A candle, an artificial plant and a laminated Kuan Yin image was placed on his bedside table, a shawl draped over it. These were placed in Mr Tay’s line of sight to bring him comfort and peace. By 4.30pm, an oxygen mask was fitted on him. His eyes were closed, as if he had gone into a deep sleep.

As the volunteers arrived for their shift, they would introduce themselves before sitting down.

Ms Tan thought Buddhist chants would soothe him and searched her phone for them. Mr Tay saw himself as a nominal Buddhist or Taoist.

Throughout the vigil, volunteers held his hands in different ways. Some held his whole hand, others interlocked fingers with his and a few pressed their palms on top of his. Yet the message they sought to convey was the same: You matter and we are here with you.

At 5.30pm, Mr Tay’s younger sister arrived from work for a visit.

Another volunteer, Ms Juliana Chia, 44, showed up before his sister left at 7.30pm. With his sister’s permission, she massaged Mr Tay’s head and neck with an ointment balm. Volunteers Shirley Yap, 64, and Toh Qi, 30, also came by to see him though it was not their shift.

At 10pm, Ms Fisher’s shift began.

She lit another electronic candle and hummed a Buddhist sutra.

When her shift ended at 1am on Nov 3, she kissed his forehead and hands to say goodbye.

Corporate trainer Daphne Lim, 45, arrived for the overnight shift. “It’s important for someone to be with Mr Tay at every moment as this transition from life to death can be very scary and lonely,” she said. Her father had died in hospital. Through the night, she sat by Mr Tay and counted his breaths as rain pelted down outside. Twice, he seemed agitated so she called in the nurse to change his diapers.

When he had settled down, she took out her notebook to sketch him, contemplating his life and what he must have been feeling then.

At 6am, Mr Koh arrived and the roster continued. Ms Tan, Ms Yap and Ms Chia came by again that day, as did four others. Ms Fisher took the overnight slot on the second night going into Saturday.

By then, the weekend roster was ready but Mr Tay died at 8.30am on Saturday, Nov 4, under volunteer Angela Sho’s watch.

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