SINGAPORE: She had 48 hours earlier than the affected person was going to die.
That was on a regular basis Melissa Chew needed to persuade the person’s household to see him on his deathbed. She needed to inform them the story they by no means knew, which he informed her — about why he had deserted them.
His eldest baby was 10 years previous, and the youngest, solely three, when a fortune-teller informed him “his presence in the home would deliver dangerous luck to the household”. So he left, they usually have been left with questions and anger.
However “all through the years”, even when his kids have been grown-ups, he had been “secretly watching them” and taking pictures of them.
“They’d performed properly in life, however additionally they had struggles,” stated Chew, who had traced the household and wished to indicate them the pictures earlier than he died of most cancers.
No one ought to die alone — that’s what the principal medical social employee at Tan Tock Seng Hospital, and her counterparts, “really feel very strongly about”, she defined.
“The opposite factor is unfinished enterprise. If household relationships break down due to previous points, generally it’s additionally the affected person’s craving to … make amends (and) go away on a very good word.”
Whether or not it’s about reconciling a household or tracing the following of kin, even after a affected person’s loss of life, the 39-year-old sees it as a “essential” a part of her job.
That function within the end-of-life course of means she is typically the final hope for the dying and the lifeless in ageing Singapore.
ONE LAST VISIT
The development in direction of seniors right here residing alone is one thing she notices in her job.
A few of them have a home helper or reside with a distant relative. Some are additionally estranged from their household, however no case so unusual to her because the one she described above.
At first, the most cancers affected person didn’t need his household to know his aspect of the story. All that Chew may do was replace his eldest baby — the one one keen to be contacted — about his situation.
However she persevered for 3 weeks, till the person relented with a few days to reside. “And I shared the story. So the eldest son broke down in entrance of me. It was very, very troublesome,” she recounted.
“(He) informed me he had 10 years of his lifetime of superb recollections of the daddy.”
She was there when he visited the hospital and informed his father he “couldn’t perceive why he had believed the fortune-teller and left them”.
“However the father stated to him, ‘You’re doing very properly now — it’s as a result of I left.’”
Although the son couldn’t persuade his siblings nor his mom to make one final go to, they did attend the person’s funeral wake.
There are households, nevertheless, who need nothing to do with a dying or lifeless affected person, regardless of a medical social employee’s efforts.
“There’s no trick to it — it’s not that we didn’t attempt onerous sufficient. Generally the previous issues are so dangerous that there’s no approach (the connection) can get well,” stated Chew, citing home violence and extramarital affairs as powerful instances.
She and her colleagues encounter “a lot of feelings” once they face fractured households.
“However after a number of hours of calming down and reflecting, the household (might) name again and say, ‘I’m sorry. I shouldn’t have slammed the door (in your face), however I haven’t seen him for a really very long time,’” she stated.
The “breakthroughs” come when she sees households reconcile. However even when a household steps ahead solely after the affected person has died, that could be a “triumphant” second in her job.
“It’s very ironic as a result of we’re coping with loss of life,” she admitted. “Nevertheless it’s the sense that, ‘hey, the individual isn’t occurring this final journey on his personal’ — that (throughout) the cremation course of, the final rites, the household’s there.
“It’s the sense that I couldn’t save his life — I can’t undo that — however at the very least I could make the final journey respectable and dignified.”
WATCH: She tracks down long-lost households of the lifeless (four:52)
Whereas it’s one factor when sufferers can inform her about their family, it’s one other once they can’t and had are available in with none identification. And a few of them die abruptly.
That’s when medical social employees like her should play sleuth to trace down the following of kin — just like the time an aged man had a coronary heart assault on his approach to purchase dinner.
There was solely a key pouch on him, however that was sufficient to offer “preliminary info”: A phone quantity written on a pocket calendar. The quantity belonged to a buddy he had met simply days earlier.
“So the buddy had to assist us however vaguely gave us sure info,” recounted Chew.
With a few housing blocks given as the person’s potential handle, and uncertainty as to which storey, she went to the close by neighbourhood police put up “to see whether or not anybody had lodged a lacking individual report”.
“That’s the place we met the household,” she stated. “We have been there on the similar time.”
The contact tracing took a number of hours on this case, but it surely normally entails “many days of onerous work”, going to the positioning the place the affected person was picked up and once more getting doorways slammed in her face.
As an illustration, a affected person might not have modified the handle on his id card. “Whenever you knock and say, ‘Have you learnt so and so’, and other people know you’re from a hospital … generally they don’t react very properly,” she cited.
“Generally if we get referred to as in the course of the night time … they’re very upset, as a result of they don’t know the individual.”
The longest she has taken to trace down a deceased individual’s subsequent of kin was per week.
The affected person, who was residing alone, had a brother, and all she knew about him was the espresso store he went to, as gleaned from an 80-year-old buddy of the affected person.
However the brother was abroad on the time, so she needed to wait till the affected person’s buddy noticed him once more.
“He didn’t even know the affected person was again in Singapore. As a result of that they had some disagreement, the affected person had left for abroad. The household … stored considering that he was away,” she recalled.
“Sadly, the affected person had already been cremated then.”
She pressured that it was important for medical social employees to swing into motion when contact tracing is required.
“There’s a distinction between seeing your beloved simply handed away and there’s nonetheless some heat, in comparison with an individual being within the mortuary for one or two days,” she stated.
TENDING TO THE LIVING
Chew had at all times wished a fast-paced job, and it has now been 16 years for her as a medical social employee.
Over time, contact tracing has change into “somewhat bit simpler as a result of our sufferers are fairly well-known to a variety of providers these days”, corresponding to senior exercise centres, household service centres and different businesses.
Dying and bereavement instances, nevertheless, make up on solely 20 per cent of her work. Her other forms of case administration embody offering monetary help for sufferers.
However households might also want monetary help when a affected person dies, particularly if she or he was the only real breadwinner. They might want grief counselling too.
So medical social employees are there when docs inform family of a loss of life, particularly sudden deaths.
Essentially the most traumatic case Chew noticed was two years in the past when a 16-year-old boy — her youngest affected person up till then — who had collapsed outside died within the A & E after resuscitation efforts failed. He was the one baby.
“It was very troublesome for the mom. She was simply breaking down,” she recalled. “(She was) even saying that … (she didn’t) need to reside any extra.”
In such instances, TTSH’s medical social employees are ready to accompany the household dwelling. However the group managed to establish “sturdy pillars” — family who may “stabilise the household”.
“In a case whereby there’s superb household help, you principally solely have to … information and train the relations what they should look out for, what they should say (and) what they should do,” Chew defined.
Shut collaboration with the mortuary employees can also be wanted, to stop any hiccups for a grieving household.
“Each single factor we do, each single factor we are saying, issues as a result of they’d at all times do not forget that course of,” she added. “What social employees can do is to make sure that all the course of is easy.”
These professionals can even do observe ups after the funeral, “to verify the household is okay”.
Chew stored in touch with the household who misplaced their teenager for 3 months. Her longest case, which concerned “difficult grief” and psychiatric intervention, lasted a yr.
The work she does to assist all these households is “very significant” to her, and it additionally stays “very thrilling”. She stated: “Each single day, I do not know what’s going to occur.”
That’s what she reminds her group too. “I hold telling my social employees, ‘An accident, a break up second, the household’s lives change ceaselessly,’” she shared.
“Life’s very treasured. That’s why I make it some extent to inform my father and mom I like them so much — each single morning earlier than I go away the home.”