Begin with the End in Mind: Principles of Personal Vision

I have just stumbled upon this article below and felt that the subject is one of utmost importance in life but is one of the least that we actually think and talk about. I was reminded about one of Stephen Covey's "7 Habits of Highly Effective People" principles - Begin with the End in Mind: Principles of Personal Vision.

In order to live a life that counts, we must first be able to see what's the end in mind and everything will fall in place. Hope that this entry will spark off a series of questions and thoughts about what is of meaning to our lives and how we are actually living with respect to the meaning.


Speaking openly about death and dying
15 Apr 2009
938LIVE

In a conservative society, the subject of death is often held taboo. But, if you only had a few months left to live, would you be more comfortable to talk about death and dying? What would you consider important if you were in the last stages of a terminal illness? 938LIVE’s Shereena Sajeed learns what it means to die with dignity.

38 year old Rani Muniandy first discovered she had breast cancer almost one year ago. After suffering symptoms such as a heavy cough, feeling tired and constantly out-of-breath, she later found out the devastating news, after an emergency operation she had to undergo. To make things worse, Ms Muniandy has to take care of her 14 year old son who already is fatherless, after his dad passed away in a traffic accident 10 years ago. She describes what ran through her mind upon learning she only had four months to live. "Because they say I only can stay (alive) for four months, I really sad already, then I cannot see my son's face, always I feel because my son already no father, then I feel like my son (is) lonely, what I am going to do, then like everyday I am confident that I must (be) alive, to take care of my son, then I everyday pray, and alot of friends all motivate me, you don't give up, I think your life is not going to end, it's a very long life."

It was with those encouraging words together with her own will power to fight the disease that has given her the strength to pull through. Unfortunately, the cancer has spread to Rani's bones and she’s not responding to the chemotherapy treatment anymore. She’s on morphine drip because of the extreme pain that she has to endure. Already, she's had to deal with the physical changes to her outward appearance, still, she maintains it's always a mind-over-matter attitude that keeps her going.

"When I fell sick, there were alot of changes. Last time I see my face, very pretty, then suddenly become, after I go for chemotherapy, my hair started to drop, my skin all change colour, totally my face, my body all totally change ready, everyday I see my face in the mirror, I am very sad you know, then I cry why I become like that then in my heart, I say, this is not my actual (self), one day I will surely be changed as per normal, like last time, I'm more pretty then, everytime my mind says I am not ugly, I'm pretty then always I say, "I can do this, I can win from this sick(ness)." Her unfazed determination stems from her positive outlook to life, her religion and the constant reassurance she gets from her son and her close friends.

Like Rani, 55 year old Mr Chua Buay Lim, a successful Chief Executive Officer of an SME was diagnosed with liver cancer more than 2 years ago. He too had to deal with the disease which left him with half a liver. To control the tumor from spreading further, he has to take oral chemotherapy tablets twice a day.
Though the odds may be stacked against him, he’s taking one day at a time and doesn’t fear death at all. "Well, I am now 55 years old, so I've seen alot of people die from cancer and I know that death is part and parcel of living, so when I was diagnosed with the disease , I did not feel anything, the only thing is what is the option for me, what medical options are there and I try to find the best doctors to handle my case."

In the first ever survey on death attitudes in Singapore, the greatest fear that Singaporeans have is being a burden to family and friends before they die.
The next was medical cost, followed by fear of pain.

Commissioned by the Lien Foundation, the survey was designed to provide a rough picture of attitudes and perceptions people have about death and end-of-life care. The Lien Foundation survey revealed that 60 percent of the respondents said they were comfortable with talking about their own death or dying. Having no children himself, Mr Chua, had no qualms talking about pre-death arrangements with his spouse who is a Vice-President of a bank. "I've already sat my wife down and I already settle all the finances with her, I also even told her which undertaker to contact and what type of ceremonial I would like to have and in fact all the practical needs that are attached to my death have already been arranged." He views death very practically, acknowledging that we will all face the end of our lives one day. Still, talking about his death with others close to him, is something which doesn't sit well with them.

"I'm very open about death but when I am talking to friends, relatives, you know they always like to put in good words, trying to allay your so-called fears all this, so they do not like to open up about death, whereas I am more open about it, but that's the realities of life.”

When it came to being open about the idea of being in a hospice, most of the respondents in the survey answered no. Though they knew that hospices provide a place of care for the terminally ill, half of them didn’t know that hospices also provide home daycare services and care as well.

Currently, about 55 percent of Singaporeans die in acute hospitals and only about one third die at home. Palliative care experts warn that about 65 percent of Singaporeans will need hospice care in the future as Singapore’s ageing population increases.

Mr Lee Poh Wah, CEO of Lien Foundation:
“I think most people if given a choice they would want to die at home you see, and from the survey you also see that only 20% of the respondents are receptive to assessing hospice services, I think this partly because of the myth, they think that it’s actually a physical place itself, so if public education is done well, I think we can infer that there is a massive latent demand for home hospice care, waiting to be tapped you see. So the challenge that is how to develop and scale up services to meet this new demand responsively and also affordably.”
Still, Mr Lee feels there needs to be more of an open dialogue about death within the society.

“Like any phobia, the fear about dying can be elevated when we have knowledge, when we can talk more openly about it, when, we are prepared, when we have the power to make it a better experience for ourselves you see, so which is why the Foundation is embarking on this public engagement exercise to get people to have more dialogues, to see the idea of dying well and to promote the importance of hospice and palliative care.”

For many, the issue of dying and the fear of it may seem like an abstract idea in the not-so-distant future. But for self-assured businessman like Mr Chua, every day given to him is a gift.

"Dying well means I have taken care of my family, I've done some good in my life and I don't want to be a burden to anybody and I can go off knowing that the family can be well taken care off."