The hospices I visited in Singapore.


When I travel throughout the world, I make it a point to visit hospices and homes where they care for their dying.

In Singapore, I was greeted with enthusiasm, elegance and grace at two hospices. They each spent a day with me and generously shared their opinions while we brainstormed about cultural and legal differences in end of life care in our countries.

The differences fascinated and surprised me.  Singapore is a very wealthy country: custom cars, high-end shopping, very cool underground Bollywood nightclubs…but the options the hospices offered for symptom management were sparse and dated. When I shared our current choices in the United States, the medical and executive directors became quiet. One very kind Buddhist executive director told me that if the narcotic count is wrong at the end of the shift, two police are called to recount. This is the reason they keep the medications very simple and predictable.

I want you to understand something; this is a new, luxurious, Buddhist-influenced, koi pond, water elements, glass, wood and stone structured gorgeous hospice. I was shocked!

Two other facts floored me. One was if a staff member got injured—for example helping a patient as they fell; then the staff member was immediately fired. They have no tolerance for “martyrs” and there’s training and procedures for not getting hurt. Another fact was that if a patient is placed in a private room they felt ostracized, abandoned and isolated from their community. The rooms all had six and eight beds, with families helping one another. Remember that this is a newly built hospice! They had wonderful sunny rooms where they had a day care for those who were ill but were still at home. It made my heart hurt with love as I saw the beautiful recliner chairs in rows with personalized items surrounding them. There was a sense of community and sharing the experience of dying here.


I loved it. Somehow our sense of individualism in the United States alienates us from our neighbors and those who want to serve and be served. I hope we could visit this idea of communal caring for one another. I wonder if our competitiveness will ruin the experience.

I wonder if our competitiveness and fierce need to be individuals will ruin us in the long run. Perhaps that child who you never knew until now will calm and sweeten your clutch on fear. Perhaps the stranger we judged as “not one of us” has a heart of gold and knows the words of comfort.

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