‘Choi, touch wood!’ Many times we’ve accidentally say something ‘bad luck’ only to immediately try in negating that quickly, by touching the nearest ‘wood’ next to us. The mere notion of Death itself is a taboo topic, but how far will we let fear define us? Especially with our multi cultural races here, is it really preemptive to start the conversation? We tackle the topic today as Amutha shares what she feels about ‘Death’ as a taboo in Singapore.
Meet Amutha Murigasin, Senior Staff Nurse, Department of Continuing and Community Care. Carrying a vast experience, she has been nursing since 1982 and in Tan Tock Seng Hospital since 2009. She’s trained in palliative care, communicative care and counselling.
How did you first join hospice care as a nurse?
Amutha: I have been working in nursing back when tuberculosis was on the rise. In SATA (Singapore Anti Tuberculosis Association) I saw many walk-in patients. I took a break after 17 years as a nurse, before I heard about HCA Hospice Care from a friend. With no prior knowledge about hospice care, I found satisfaction especially in dealing with patients on a one-to-one basis. Death is part and parcel of life and I found deep connection in my job. Personally I felt that there is a lack of funding and care resources in supporting nursing homes stemming from various reasons, either due to caregiver issues or financial issues. My main job revolves around visiting various nursing homes and providing care and support. That is where I felt that I finally found my calling.
‘The very fact that my patients are alive despite being terminally ill, if they were to die – I believe they should die with dignity.’
Amutha: Coming to this field made me realise that life is worth living no matter what happens. You can fall sick, acquire a terminal disease but it’s about moving on with life daily. Especially those who are dying, we cannot assume these people have no quality of life. The very fact that they are alive and living is important for us to give them proper care – so they die with dignity.
‘Accepting the day you learn to die is probably the day you learn to live your life fruitfully.”
Amutha: Dying is not a taboo. Accepting the day you learn to die is probably the day you learn to live life fruitfully. That’s very important to understand in overcoming the fear of death. When we overcome the fear, that’s when we will live fruitfully. Why live fearfully when we all die at the end? Understanding death will help in accepting death, not only for oneself but for the surrounding. If the patient accepts death, the living will find it easier to move on. It’s only when you don’t accept death, that’s when you struggle. I feel sad when death is being prolonged and dragged on but we want to put an end to the suffering. We always wonder what else can be done and why are we holding on for. I read a book where it says some people don’t get attention. They enjoy the attention from people fussing over them before their deathbed, until they decide to give up.
‘..the beauty in giving is, to continue giving even when you have enough’
Amutha: I’m a very lively person, I like to travel and I’m very expressive and love to talk. When I’m not around my family members always say the house is extremely quiet. I would like to be remembered as a person who gives and forgives and shares. Sharing and giving is my motto in life. When I can’t finish food, I will pack for workers in the nursing homes. When we outgrow our clothes, we will give it to nursing homes. Why waste? Let somebody take it, as they take it and use it happily. My entire family give donations, as my mother always say the beauty in giving is, to continue giving even when you have enough. So we all practise that mantra.
When should we begin doing Advance Care Planning(ACP)?
Amutha: For me my mom had a diagnosis done and that was a reason for us to start and touch base on the health issue with her. I always tell my siblings or husband to talk to their own families about ACP. So my husband could start with ‘My wife has started talking about this (ACP) so maybe it’s time for us to start too…’ For my husband, he sees a need to talk about ACP as well. I’ve done my ACP and although I’ve not written my will yet, my family knows what to do, since I have told them. The kids think it (death) won’t happen to me, but my husband is more accepting.
Most people say they are ready to go, they say when God tells me to go, I need to go. But they’re not ready because there are things to be done and in understanding the pain that comes hand in hand with death. They’re ready as they have no choice. I told my husband that if he can start the conversation with his siblings, I don’t mind giving tips and have the opening conversation with his mother. Most of the time, patients usually prefer their own children than someone else talk about it.
I believe that ACP should be done by the person himself and that we should do it as early as possible. We should share it with someone close to us, or with our next-of-kin so that it lifts the burden off the family.
If you have 30days left to do what is important?
Amutha: If I have 30days I will be sad, as my parents are still around. We’re close and I’m the youngest and most doted on. I’m okay to pass on, but I will be sad for my mom. In 2011, I did ACP with them and I thought their expected emotions were to become emotional while doing ACP but unexpectedly, it went very well. In 2015 we reviewed the ACP again, as my parents were diagnosed with illnesses and it went well again. Now my kids are participating and we have a family chat group that discusses about our parents issues as well and also helping to observe the changes in the mood and behaviour of our parents. We have an open communication in my family and it mainly came from my mother.
In our nature of work, the doctors always tell us that withholding information from the patient’s caregivers is the patient’s own rights. But I think not knowing is as frustrating, clueless and fearful. My mom was diagnosed with Parkinsons and she was in denial when it happened. Especially when she led a discipline life of healthy diet, yoga and control. It put me in a position where I felt stressed and strained, especially on taking the burden as the only nurse in the family. But it’s better to have control and knowing what can still be done to comfort the patient.
A book I would like to recommend is: ‘Conversations with God.’
Amutha: When I first chanced upon the book, I was hesitant as I thought it would be something to do with Christianity. Chance encounters with three different people recommending the same book finally convinced me to read it. It was not about religion but it was an autobiography. With his vast experience and his innate flair of writing, the author wrote hilarious dialogues questioning the various topics on life and death. I always felt that this book is a message and it motivated and inspired me. It piqued my interest to read more books on motivation and positivity to inspire me constantly. That’s when I realised, despite the difference in Hinduism and Western religions, we all have similar values and we’re all interdependent.
^Conversations with God, An Uncommon Dialogue: Living in the World with Honesty, Courage, and Love, Book 1
The Good Death seeks to transform the negative notion of death itself and is focused on promoting early planning for one’s end-of-life care, especially so for adults over the age of 50. Find out all about The Good Death, ACP and Palliative care here!