SCMP Monday, September 3, 2001

Life's final lesson - the facts of death


A recent conference in Kwun Tong attended by more than 100 elderly people dealt with a subject normally regarded as taboo in Chinese communities: preparing for death.
Faye Chan Man-yu, the community development director from the Society for the Promotion of Hospice Care, started her talk with a slogan: "When days cannot be added to life, add life to days."
The elderly people who gathered were all single, having lost their spouses, and had no children. Some have a dread of passing away alone.
It was the first time they attended a talk which seeks to prepare them for their own death and also to help them cope with the loss of loved ones.
Ms Chan has been spreading her message through visits to centres for the elderly since 1999. "It is an education about living. We are telling people how to face losses in life."
More than 33,000 people die every year in the SAR, or 90 people a day. But the society is the only group in Hong Kong providing the public with education about death. Reticence about death is deep rooted. In Chinese tradition, the word death is synonymous with bad luck.
Ms Chan's organisation is trying to get rid of this stigma by inviting lawyers and social workers to brief elderly people on practical matters, such as preparing wills and funeral arrangements.
Tsang Yuk-king, 84, who attended the seminar, said the sudden loss of her husband four years ago made her realise how fragile life is. "One day, he complained about chest pains and I sent him to hospital. He passed away two hours later without much pain. He did not leave me any word," Ms Tsang said.
She believes that dying without pain is fuqi - good fortune. "My husband was lucky. I am not afraid of death, as long as I can leave this world in a comfortable way. I treasure every day. Every morning I wake up, I feel happy because I can live another day."
But her friend, Chan Pik-wah, 76, held a different perspective. Having suffered from breast cancer, she believes euthanasia should be legalised to enable people with chronic illnesses to die in dignity. "I think it is not a bad idea for a doctor to give me an injection and then I can die in peace and comfort."
The society plans to extend the education programme to young people in schools and youth centres next year.
Faye Chan said parents and teachers in Hong Kong seldom broach the subject with children. "It is like sex education or a secret no one is sharing. Everyone knows that death happens, but emotionally, they are not prepared for it," she said.
Even terminally ill patients often do not share their anxieties with relatives. "A typical scenario is when the mother is very ill, but she is not able to share her feelings and fears of death with her son. And the son ends up pressing medical staff for treatment which may be futile, " Faye Chan said.
"When the mother dies, nothing has been said or arranged. There should be a healthy dialogue so that the two can share their anxiety."
Terminally ill patients and their families are helped to come to terms with the inevitable by creating a harmonious atmosphere instead of one based on fear. A memorial photograph can be taken and detailed arrangements for the funeral calmly discussed.
Lesley Sinclair, who works with the hospice society, said traditional views towards death were reflected in the design of Hong Kong's public mortuaries. "There is not a chair, nothing around to give a sense of comfort to the family members and relatives. It is so cold and unfriendly."
She said in Britain, public mortuaries were designed in a way sensitive to the families' feelings. "There is a sofa, curtains and a place for privacy and comfort."
The society provides bereavement counselling to people whose loved ones spent their final days at the Jessie and Thomas Tam Centre in Cheung Sha Wan. Several support groups made up of people who have gone through bereavement are at hand. Counsellors are aware of the anguish bereaved people can suffer and try to ease their emotional burdens.
Lisa Chu, 51, joined a support group after her husband died of cancer in 1999. She was prepared, because he had been diagnosed the previous year. Ms Chu was devastated by her husband's death. "I wish I could have died before he did, so I would not have had to face all this pain."
During the cancer treatment, the couple were silent about the word "death". "I dared not talk to him about the illness. Sometimes we did talk, but only about the treatment, not really sharing feelings about dying."
Ms Chu recalled how she tried to suppress her feelings, even after breaking down in tears when the doctor told her that her husband was beyond hope. "My eyes were swollen when I walked out of the consultation room. My husband asked me why I looked so terrible. I did not want to show my emotion to him. I did not want him to worry about me."
She described her feelings after his death. "I felt so numb. I showed no interest in anything around me. I stayed at home most of the time. Sometimes I sat on the sofa for hours, staring at the wall, focusing on nothing."
Agnes Tin Fong, a bereavement counsellor for the hospice society, said: "Sometimes the family members of the deceased feel numb. It is a kind of self-defence. It helps a person avoid a nervous breakdown."
Ms Chu said sharing her feeling with other widows helped her get over the ordeal. "For the first time, I feel there are people who can really understand my problems."
She said she had mostly recovered from the ordeal. But that does not mean she has forgotten her husband.
"I bury him deep in my heart. I know he is always with me forever."
Ella Lee ( ) is a staff writer for the Post's Editorial Pages.