https://www.straitstimes.com/life/this-is-how-youre-going-to-die
2026-05-16
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DEATH GETS A MAKEOVER
Instead of the taboo topic it used to be, death is slowly becoming something to be discussed, and sometimes, a celebration of life
Teo Kai Xiang
“She’s looking for you,” reads the text from your mother, during the first five minutes of the thriller film Bugonia (2025), right as American actress Emma Stone begins her villainous chief executive montage sequence. “I don’t know if she can hold on.”
You’ve spent every other day of the past three months at the hospital by your grandmother’s bedside. Tonight was a rare reprieve, a date at the cinema.
A sense of unease has been building up inside of you throughout the day, and now, at the sign of the text, it breaks.
You exit the cinema just as Stone’s character gets kidnapped and climb into a Grab to Yishun Community Hospital. Your date understands why you need to leave in a hurry.
The next six hours are spent by your grandmother’s bed.
Few words are exchanged. There is only the soft sound of Sikh meditational prayer music playing in the background of the room she shares with three others.
She can hardly speak now. At age 84 and diagnosed with idiopathic pulmonary fibrosis, a lung disease, she has trouble breathing. The doctors have put her on a liquid diet because she can no longer swallow.
On this night, she is restless, moving her hands a lot. You cannot tell if she is in pain or trying to tell you something.
For the past few weeks, she has been talking about wanting to be comfortable. Part of what keeps her holding on is that her brother, your grand-uncle, is due to arrive from Australia in two days.
You sit with your wrist over hers, feeling her pulse.
When you leave at 3am, you do not yet realise that this is the last time you will see her conscious.
A long goodbye
When it became clear that this hospitalisation would be her last, your family began planning the funeral. On the recommendation of a friend in the local Sikh community, a funeral director was hired.
Unlike many in the generations before you, you had time to say goodbye. Though she raised you, your grandmother wasn’t the kind to say “I love you”.
But in the last weeks of her life, she said it many times – through an oxygen mask.
Across your many visits to the hospital, you notice that there are just as many domestic workers as there are family members sitting at bedsides. You see one of them tear up after the doctors tell her the elderly woman she has been caring for has died.
(This story is based on an interview with a 30-year-old Singaporean who lost his grandmother in October 2025.)
In Singapore, the median duration spent in palliative care – from referral to death – is 21 days, according to the Singapore Hospice Council (SHC). However, this statistic conceals the longer process that death has become in Singapore over the course of a generation.
Since 1957, the life expectancy (from birth) of Singapore residents has risen from 61.1 to 83.5 years, according to Ministry of Health data. Life expectancy from age 65 had risen from 8.1 more years of life to 21.2 years.
Causes of death have also shifted over time. Since 1950, the percentage of deaths by neoplasms (tumours and cancers) and cardiovascular diseases have increased from 2.8 and 6.3 per cent respectively in 1950 to 28.8 and 30.5 per cent in 2019. In 2025, there were 26,499 deaths recorded in Singapore, an average of 72 deaths each day.
Consider something as ordinary as a hip fracture, an ailment suffered by thousands of Singaporeans each year, often as a result of a fall.
When Dr Christopher Lien, 61, started working at Changi General Hospital (CGH) in 2001, the rate at which those with hip fractures would undergo corrective surgery was around 50 per cent.
The implications for one’s quality of life are significant. Without corrective surgery, one does not regain independence. “Some accept the disability, and it sometimes leads to more complications,” says Dr Lien, now a senior consultant with CGH’s department of geriatric medicine.
Today, more than 90 per cent of these patients receive what has become a “bread and butter” surgical procedure, and over 50 per cent return to their previous level of functioning. “Something that was so anxiety-provoking has become fairly normal.”
“In terms of how death is viewed in society, we’ve moved from seeing death as something inevitable to something that technology, discovery and science could increasingly put off and delay,” says Dr Noreen Chan, 59, a senior consultant at the National University Cancer Institute’s division of palliative care.
There was a time when Singaporeans would give their children unpleasant nicknames out of a superstitious belief that it would ward off spirits that might take them away. “This happened in my family even,” she says.
These days, death is seen as a failure of the medical system.
Dr Chan, who recently published a book, Approaching The Finishing Line, which reflects on her career in palliative care since 1998, is also an adjunct professor at the National University Hospital.
She recalls a time when patients diagnosed with kidney cancer faced a grim prognosis: a few months to live unless they took a risky treatment that offered just a 5 per cent survival rate.
Complexities of care
These days, medical advances have turned what was once a death sentence into something more akin to a chronic condition to be managed, giving these patients years to live.
The result is that dying has become a slower and more complex process, where deterioration is defined by “multi-morbidity”, or the accumulation of many co-existing conditions such as cancer, dementia, stroke, or heart disease.
These complexities of care – and growing demand for people who can address them – have meant a remarkable turnaround for what was once one of Singapore’s least glamorous specialisations.
When Dr Chan began working in palliative care, it was a niche field “very much on the periphery”. Hospice care had begun only a decade earlier as a grassroots movement at St Joseph’s Home in 1985, mostly run by volunteers and lay staff.
In 2005, she was profiled by The New Paper as part of a story with a grim proclamation: “No takers for saddest job. Situation desperate as only 20 doctors left to care for dying in S’pore.”
All of this has changed as dealing with the long decline towards death has become a societal challenge. As at 2026, Singapore is officially a super-aged society, with over a fifth of the population aged 65 and up.
In a sign of the times, the number of palliative care doctors has nearly doubled from 47 in 2014 to 88 in 2024. To Dr Chan, the clearest shift stems from how palliative care – once seen as the purview of hospices and charities – now has a home in every major hospital in Singapore.
“Death is a social phenomenon, not a medical one,” she adds. This means that Singapore’s changing social fabric is also influencing what death looks like.
Nowhere is this more apparent than what Dr Lien calls “grey conversations” around dying: Would the patient be all right with living on a feeding tube? Under what circumstances would he or she prefer if care ceased and the focus shifts instead to making him or her comfortable?
“There is a resourcing challenge,” says Dr Lien, who notes that clinicians often lack the time to have in-depth conversations with patients about their final wishes. “We can’t give everybody everything.”
For instance, a 2014 survey by the Lien Foundation – of which Dr Lien is a governor – finds that 77 per cent of respondents want to die at home. However, an enduring trend of the past decade is that over 60 per cent are dying in hospitals.
Dr Lien also notes that domestic workers now form an essential part of Singapore’s social fabric of care. Singapore families see the hiring of a domestic worker as customary when an elderly family member loses his or her independence after a fall or a debilitating diagnosis.
Increasingly, conversations about patient care are playing out between doctors and domestic workers.
“In many ways, we are being very unfair to our foreign domestic workers,” says Dr Chan, noting that the question of how grief impacts these workers or how they might be juggling caregiving responsibilities for multiple seniors is often neglected.
The death industry
After your grandmother dies, your mother is angry about leaving the body alone in the hospital’s morgue. The funeral must wait a day, so all family members have time to fly in for the wake.
You don’t know how to feel. Mostly, you remember her passing as a series of tasks.
You call the funeral director. Send out the obituary you designed on Canva, the image editing tool, to the Singapore Khalsa Association, the local cultural group for Sikhs which then circulates it within local Sikh groups. It is an eerie feeling to see that obituary pop up on your grandmother’s phone notifications.
You run out to buy the raisins, nuts and rock sugar that must be given to each guest, a Sikh custom. You fumble with the audio equipment so that everyone can hear the prayers during her void-deck wake.
Much of the significance of these last rites is lost upon you, even after the priest explains. Coming from an inter-faith household, though your grandmother is Sikh, neither you nor your mother are.
You watch from behind a glass window as your grandmother’s coffin disappears behind the furnace doors at the Mandai Crematorium, and return the next day to collect the ashes.
When the staff hand you small brushes to sweep the ashes into the clay urn, you cannot deny the slight feeling of horror at having to pick up fragments of your grandmother’s bones, which are not quite dust yet.
You would later find out that this is a consequence of Singapore’s multiculturalism. For the Chinese, bone picking is a way to pay respects to the dead. One must specifically request for the ashes to be pulverised.
But in the moment, all you can think about is how difficult it is to separate, by hand, the melted acrylic of the coffin’s viewing window from your grandmother’s bones.
For previous generations, death was a far more closed-off affair, in both the literal and metaphoric sense.
In 2004, the newly constructed Mandai Crematorium came with expanded viewing galleries and a rail system that gave mourners more time to say goodbye to the deceased.
The absence of embalming and Singapore’s humid climate also meant that it was often not possible for some mourners to catch a glimpse of the deceased.
“Only close ones would get to see the body on the first day,” says Mr Hoo Hung Chye, 47, executive director of the Association of Funeral Directors (AFD) and co-founder of Singapore Funeral Services. “You had to seal the casket or else decomposition would set in.”
It was only after the 1990s that embalming became the norm in Singapore, as the equipment and training that made it possible became commonplace. Mr Hoo estimates that more than 90 per cent of clients now request it.
But even as death has become less hidden and less remote, funerals have become smaller and closer-knit affairs than previously.
Evolving last rites
The trend towards smaller families means that wakes are not only smaller, but last rites have also become less elaborate, simply because there are fewer mourners to perform them, says Mr Hoo.
That there are often not enough next-of-kin is why funeral homes increasingly offer hired services for things that were once the purview of family: setting up the wake, keeping vigil over the body, welcoming guests and collecting donations (now via QR code).
In some cases, the funeral director stands in for the family entirely.
Mr Calvin Tang, 49, assistant general manager of Singapore Casket, estimates that his company handles up to four cases of the lonely dead a month: people who die without anyone to mourn them. These are cases referred through social workers.
Singapore Casket has been in business since 1920.
For Mr Tang, the biggest change to the death industry is that younger generations increasingly get involved in planning funerals, resulting in more and more breaks with tradition as they create new ones of their own.
He observes that the bereaved increasingly ask for religious rites to be altered or discarded entirely.
For instance, the Chinese practice of placing a pearl in the mouth of the deceased, to ensure a smooth passage into the afterlife, is one that many mourners dispense with. Similarly for the Taoist tradition of burning paper houses for the deceased.
Even mourning attire has changed. In the past, Chinese mourners might wear patches of cloth on their sleeve indicating their relationship to the deceased. Today, younger mourners simply wear uniform black T-shirts. And rather than dress the dead in ceremonial robes, more opt for suits or casual attire.
The conditions of modern life often force traditions to evolve, says Mr Kalidas Suppiah, 47, operations manager at Singapore Casket.
The Hindu ritual of bathing the body of the deceased has become unfeasible in modern HDB flat kitchens, often too small for the task. And the practice of carrying the body to the crematorium furnace has evolved due to safety concerns.
Now, mourners carry the body to the hearse instead.
In Singapore, rules have an outsized impact on practices surrounding death and mourning.
The rise of cremation, as part of a government-led campaign in light of the country’s land scarcity, has been the most consequential change to last rites in Singapore. As for cemeteries here, they operate on 15-year grave leases, after which the body is exhumed and either cremated or interred in smaller graves, depending on the religion of the deceased.
These rules continue to evolve today.
One sign of mourning in modern Singapore has been the use of LED wreaths to express condolences to the family of the deceased in Chinese funerals. The practice drew community backlash over fire safety, light pollution and energy consumption.
In 2022, new guidelines were issued by the National Environment Agency and AFD limiting each wake to a maximum of 10 LED wreaths.
Under the surface, however, the most consequential change for funeral directors is a shift in attitudes: Death increasingly occupies a less taboo space in society.
Earlier in his career, Mr Tang recalls being rebuffed when asking nursing homes if he could visit to give a presentation about his funeral home’s services. These days, active ageing centres regularly invite funeral directors and these presentations draw curiosity rather than hostility.
Ice cream and ashes
Funeral directors are not the only ones finding a more receptive audience in Singapore today.
Between 2024 and 2026, the number of followers of Facebook page Death Kopitiam more than doubled from 25,000 to over 63,000.
The page has become a go-to source for all things death-related in Singapore, and its tributes have become a new-fangled take on age-old obituaries, complete with comments from the bereaved and condolences from strangers.
Mr Bryan Hong, writing on behalf of the page’s team of administrators, attributes this growing popularity to societal interest in discussing difficult topics like suicide or Singapore’s lonely dead.
“Facebook is the largest digital cemetery in the world,” writes Mr Hong in an e-mail response to ST, referring to how accounts belonging to the deceased are projected to outpace those belonging to the living in the coming decades.
“It thus makes sense that a page like Death Kopitiam is situated on Facebook.”
When Ms Angjolie Mei, 46, began her life celebrant business in 2010, she faced resistance from clients when she proposed creating video montages of the deceased – something seen as too celebratory for the sombre occasion.
She received her first pre-planning client in 2013, who wanted to set out her wishes for her funeral ahead of time.
Another client hired her 14 months before dying from kidney cancer to spare his wife the burden of having to plan his funeral alone. His requests ranged from a reminder to trim his eyebrows if necessary, to the blue Adidas jacket he wanted to wear for the wake, to a reminder to order a buffet before collecting his ashes.
At a recent funeral, a recording of the deceased’s voice called out at the end of the wake: “Alamak, why are you all still here?” That small, feisty touch drew laughter from attendees.
For another client, Ms Ang arranged to have the ashes of the client’s father stored in a sake bottle of personal significance to him, and for the wake to be “BYOB” (bring your own booze) – to mark the event as a celebration of his life.
She attributes the change in Singapore mindsets partly to a generational shift. “I remember in my mother’s era, we didn’t even get involved,” says Ms Ang, referring to herself and other grandchildren. “We didn’t even go to the wake. It was hush hush.”
Similarly, Ms Tan Ming Li believes that changing practices are often a response to the funerals and grief that Singaporeans themselves have experienced in the past. Ms Tan, 51, founded the non-profit The Life Review in 2023 to normalise conversations around dying and grief.
“When I lost my mother, there was no conversation,” she recalls. “It was just ‘Go back to school, continue’. The adults go back to work. Nothing happens. People didn’t have the language. They didn’t have a way to deal with it. What does processing death even mean?”
Even as death literacy has reached an all-time high, Ms Tan is wary of how unnervingly efficient Singapore institutions have become at dealing with it, often at the expense of making space for grief.
The loss of many last rites, many of which helped make sense of a death, is something that concerns her. “That has eroded the whole grief process and how we feel as human beings,” she says. “Now, in doing this work, we’re almost recreating these rituals.”
“What’s very efficient now is that if you don’t have somebody to keep watch over the body, they can have someone stay over for you,” she adds. “Things have become so efficient and sanitised. When does the grief process start to hit you?”
That same efficiency seeps into the recent policy push to get Singaporeans to complete Lasting Power of Attorney forms and advance care plans since 2023. Uptake has risen, but remains low: About one in seven Singaporeans have completed their LPAs as at February.
Ms Tan worries that these documents are often ends in themselves, when they should be starting points for important conversations. She observes that many complete these forms without discussing their full implications with family, potentially creating new forms of stress.
It is stressful to have the responsibility of making decisions for an incapacitated loved one, especially if you are unsure what he or she wants.
In her non-profit work, she observes that one of the common reasons people seek out death doulas – a paid service to guide the dying and their loved ones through the process – is that they are wrestling with regret over how they handled a former loved one’s dying wishes.
With the last 10 years of one’s life likely to be spent in the grip of chronic illness, Ms Tan thinks it is better to ponder these difficult questions and talk them through with loved ones sooner rather than later.
Your grandmother had wanted a traditional funeral, and that meant hiring a ferry to take you out to sea.
What she had probably not wanted was an argument over who should get on the boat, which could only seat five. That left bruised egos for those left behind.
Simmering tensions come to the fore. Anger over who got to see your grandmother in her final hours, anger that so few bothered to come then.
Despite that bitter prelude, the boat ride out is a peaceful 15 minutes. When the boat stops, you walk to the edge and lean over until you are dangling out over the water.
Slowly, you pour out the ashes, watching your grandmother disperse into the waves. You hadn’t, until that moment, understood why scattering one’s ashes at sea is such an enduring practice.
But grief and mourning is not a clean process.
Six months after, your family still returns to the temple for monthly athma shanthi prayers, following your mother’s Hindu beliefs.
Even now, your grandmother’s possessions remain, as she left them, around the family home. Her room is still her room. One of her final requests before she was hospitalised was for you to buy her ice cream.
The tub sits unopened in the freezer.
kaixiang@sph.com.sg
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