No One Dies Alone
published by on December 10, 2017Mr Tay Cheng Tian, 54, died in a hospice on Nov 4.
His family was not at his bedside at all times, but volunteers who befriended him held his hand and whispered to him to let him know that someone was always with him during the vigils by his bed.
One of the volunteers from Assisi Hospice’s No One Dies Alone (Noda) programme saw him take his last breath.
The Noda programme is part of a growing movement here to support dying people who have no family or friends to accompany them in their final hours. Demand for the service is likely to grow as the number of elderly folk who live alone in Singapore surge.
Number of households comprising only residents aged 65 or older, according to the General Household Survey released last year.82,600Number of households comprising residents aged 65 or older who live alone.41,200Number of seniors likely to live alone by 2030, according to government estimates.83,000
Death schedule
At a quarter past noon on Thursday, Nov 2, a group of 40 volunteers from Assisi Hospice received a text message in their group chat.
“He could pass away anytime so it’s good for us to start the vigil,” was the message from Ms Jaki Fisher, 39.
Ms Fisher, who runs the No One Dies Alone (Noda) programme at the hospice, was referring to Mr Tay Cheng Tian, 54.
“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 had 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 few or no 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 type of cancer is mostly associated with risk factors such as smoking and alcohol consumption. Tumours had spread around his neck area 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 is likely Mr Tay “will go very fast”.
That was the day the vigil started. Mr Tay was restless before the first Noda volunteer arrived.
Sitting up with his head sunk, he rasped and gasped for breath, with his chest heaving up and down.
A general ward volunteer wanted to know if he needed oxygen but did not know what it is 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 and his shoulders shuddered as he laughed. That would turn out to be one of his last laughs.
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, as they had been trained to expect that the dying sometimes see people that others cannot.
By 2pm, Noda volunteers Paul Koh, 63, Lydia Tan, 63, and Karen Sng, 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 into the air, Mr Tay bent his knees and waved his hands. Ms Sng and Ms Tan tapped their palms on his arms.
A candle, artificial plant and laminated Kuan Yin image was placed on the bedside table, which had a green 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 put on Mr Tay. His eyes were closed, as if he had gone into deep sleep.
The volunteers introduced themselves and asked Mr Tay if there was anything he would like before they sat down. He may have heard them, but did not answer.
Ms Tan thought Buddhist chants would soothe him and searched her phone for them. Mr Tay saw himself 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 rushed from work to see him.
Another volunteer, Ms Juliana Chia, 44, came 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 shifts.
At 10pm, Ms Fisher’s shift begun.
She lit another electronic candle and hummed a Buddhist sutra.
When her shift ended at 1am on Nov 3, Friday, 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 breath as rain pelted the window. 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 Mr Tay, thinking of 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 8.30 am on Saturday, Nov 4, under volunteer Angela Sho’s watch.