April 23, 2009
Life before death
Talking about death brings closure
Q: My sister has advanced breast cancer but no one in the family will acknowledge that she is getting weaker and weaker. How do we begin to talk about dying? Is it appropriate to tell a loved one that it is all right to let go?
A: Talking about death is never easy, especially among family members. The difficulty lies in their own fears and the family's concern for one another which may lead them to avoid talking about death in case they cause alarm to their loved ones.
However, this 'silent conspiracy' among family members may not be in the patient's interest, said Dr Tan Yew Seng, the medical director of Assisi Hospice. 'The patient may then be unaware of treatment options. He also can't move on, express his wishes or talk about closure. If no one is prepared to talk about him dying, this kind of conversation can't take place,' he said.
Some may imagine the worst that can happen and face a lot of anxiety. It is by talking to the dying about their fears that they may become calmer, he said. 'It may not be easy for family members to initiate the conversation, so hospice staff may act as facilitators,' said Dr Tan.
Dr Cynthia Goh, the centre director of the Lien Centre for Palliative Care and head of the department of palliative medicine at the National Cancer Centre, said it is important to be alert to hints dropped by the patient.
'Some may say that they are not getting better. You could pick that up and ask what makes them think so. Explore further and try to find out what they meant to say,' said Dr Goh.