How Covid-19 has made dying and grieving more lonely

Civil servant Irene Teo says the pandemic made her family focus on what was essential when her mother died of bile duct cancer on April 16. ST PHOTO: GIN TAY

SINGAPORE - After her 97-year-old mother died of pneumonia on June 1, Ms Yeo LiLi was unable to fulfil what she saw as her filial duty.

The older woman was a devout Buddhist who had been part of a 20-strong group that chanted prayers most days of the week, before she became too frail to continue at 90. But none of her fellow devotees could go for the funeral service, which was limited to 10 persons under Covid-19 restrictions at that time.

A lone monk chanted prayers at the funeral and only two other relatives, besides Ms Yeo, walked in procession behind her mother's hearse. Some older relatives, who knew her mother well, could not attend because they were ill.

An only child who had been her widowed mother's full-time caregiver for 10 years, Ms Yeo, 57, describes the funeral as "leng leng qing qing" (a Mandarin phrase that means cold and comfortless).

Ms Yeo, who is single and works in the services sector, says: "There were things that I was not able to do for my mother because of Covid-19 guidelines.

"She had been a member of the temple for 20 years yet she could not have many people chanting for her. Luckily, she was not around to see that, but I felt the pain and my relatives did too."

Covid-19 has overturned social norms of dying and grieving. Across the world, traditionally communal events like wakes and funerals have been scaled down as part of wide-ranging efforts to stem the spread of the pandemic.

While grieving families in Singapore accepted that social distancing was necessary, these measures took an emotional toll during an already distressing time.

Many bereaved kin felt they failed to give their loved ones a proper send-off, which could impede their emotional healing.

Ms Gladys So, a senior counsellor at Tsao Foundation, which provides care and other services for the elderly, says: "Covid has made people more lonely.

The pandemic prompted many changes to our lifestyle, including to end-of-life practices. "

Some of the bereaved may blame themselves for any "unfinished business" in their loved one's last days, she says. Lost opportunities for final conversations and farewells, she fears, could be "re-traumatising" weeks and months later.

Ms Angjolie Mei, managing director of The Life Celebrant, a funeral services firm, observes: "There is more disenfranchised grief, such as for those not able to pay their final respects at the crematorium, due to Covid-19 restrictions."

Disenfranchised grief, also known as hidden or unacknowledged grief, may be minimised or poorly understood by others, which makes it harder to process.

Staff working at funeral services firm The Life Celebrant. PHOTO: THE LIFE CELEBRANT

In her book, Dying To Meet You: Confessions Of A Funeral Director, whose second edition was published in July, Ms Ang recounts how one man apologised in Teochew to his dead father in a eulogy during the circuit breaker.

He regretted not being able to give his father, who died at 100, the grand funeral that he wanted.

Mourning from afar

In Singapore, social distancing measures from late March included limiting attendance at funerals and wakes to family members as far as possible, with a maximum of 10 persons gathering at any one point.

When restrictions were relaxed in phase two, which started on June 19, the limit was upped to 20 persons. Since early August, up to 30 persons may be present at any one time for wakes and funerals.

Other coronavirus-related changes to funeral practices include no live music or singing in groups, and no catered buffets for mourners, but options like packed bento meals instead.

Mr Calvin Tang, assistant general manager at funeral services firm Singapore Casket, says that some families found it too difficult to decide who to turn away.

Because the majority of those who died were elderly, they tended to have more siblings and came from larger families. Feeling unable to limit visitors to 10 persons at any one time, some families preferred to do away with a wake entirely and settle for a cremation service, says Mr Tang.

Shorter wakes, lasting one to three days, were more often requested in recent months, he says, compared with three or five-day wakes, pre-Covid-19.

Mr Iskandar Dzulkhairi Abdul Aziz Kajai, operations manager at Singapore Muslim Casket and Marble Contractor, has witnessed bereaved family members giving up their chance to be present at Covid-19-restricted Muslim burials, so their siblings can attend instead.

A handful bridled at the restrictions over what is usually a community event, feeling that "you can go to someone's funeral only once", he notes.

But he has also seen others who mourned from afar, parking their cars or motorbikes by the road and standing at the perimeter of the cemetery.

"It's a symbolic show of last respects to the deceased while practising social distancing," he says.

A lonely death

For Ms Yvonne Fung, 42, caring for her husband while he was dying during the pandemic meant that both of them lacked social and familial support.

Her husband, Mr Tee Koon Beng, had been diagnosed with lymphoma two years ago. His condition worsened at the beginning of the year and he died at the age of 42 on June 12. Married for five years, the couple, both former teachers, have no children.

Ms Yvonne Fung and her late husband Tee Koon Beng. PHOTO: COURTESY OF YVONNE FUNG

Since January, Ms Fung had been his main caregiver, after receiving training from the hospital on how to use a feeding tube and administer palliative care.

He did not want visitors to come to their home as his immune system was weak. She had to rely on online shopping as she could not leave him alone. At times, alcohol swabs, which he needed, were out of stock in stores due to panic buying during the early days of Covid-19.

"We were isolated but it didn't feel lonely because we had each other," she says.

Last year, when Mr Tee's condition nosedived, both their families had converged at the hospital for a final farewell.

He rallied but in June, two days before he died, Ms Fung's family - her parents and two brothers are based in Hong Kong - could not visit. They could only do a video call with him. Only his mother and three siblings were at his hospital bed.

"My family felt so bad that they could not fly in from Hong Kong after the borders closed. He wanted to see everyone at one go and thought he could do the same as last year. It wasn't easy for him to say goodbye," she recalls, speaking to The Sunday Times via a video call from Hong Kong, where she is visiting her family.

After Mr Tee's wake, she remembers that more than 20 of his family members boarded a hired bus to Mandai Crematorium. More than half of them were prevented from attending his funeral service as the limit was 10 persons then.

"The undertaker had notified us about the restrictions, but our family members hoped to send my late husband to the farthest point possible. That was why they still boarded the bus," she explains.

"My wish was for everyone to have closure but it didn't happen. Losing Koon Beng, especially during this Covid-19 season, has taught me what it really means not to take things for granted. I thought I knew that, but I realised I didn't really, until my husband fell very ill and until Covid-19 changed every norm we were used to."

The human touch

In July, Ms Fung went for grief counselling with Wicare Support Group, which supports widows and fatherless children. She found it helped her to be with people who understood what she had gone through.

At Wicare, she could talk openly about her complicated feelings regarding loss. For instance, she found that she could not bear to look at her wedding ring. She took up a suggestion to place both rings - his and hers - in front of his photograph next to her bedside. That way, she could look at them again without being overwhelmed by grief.

Ms Lena Soh, general manager of Wicare Support Group, notes that there are many practical ways to support the bereaved, some of which are unfortunately curtailed by the pandemic.

"Taking the kids to school, cooking a meal, coming over to clean the house - these are all forms of support that are somewhat limited because of Covid-19 restrictions," she says. "Human presence counts for a lot - being there when words fail."

Since the pandemic has reduced physical contact, a hug or a caress on the cheek may now have added value.

Funeral services firm The Life Celebrant offers a service, Showers of Love, which allows bereaved family members to help to clean, dress and apply make-up on the deceased.

Managing director Angjolie Mei says one client, whose mother died in April, was comforted at being able to touch her mother's body one last time.

There had been fewer opportunities for physical contact when her mother was laid up in hospital and then the hospice, before she died.

Rise of e-funerals and e-eulogies

As Zoom and other digital connections exploded under Covid-19, technology stood in the gap and provided solace for the dying and the bereaved.

At Dover Park Hospice, pet therapy sessions went virtual from June till September, when such volunteer activities resumed.

Some hospice residents were stroking the screen on the iPad when volunteers' dogs and rabbits made an appearance, says Ms Cheong Ee May, its head of social work and psycho-social services.

One patient, who was confined to his bed, watched his therapist taking the route he used to walk at the hospice. He was happy when the therapist showed him his favourite fish pond on the live stream.

Funeral services firms like Singapore Casket, Ang Chin Moh Funeral Directors and Direct Funeral Services told The Sunday Times there has been greater demand for live-streaming services for funerals.

Workers prepare for a funeral while observing social distancing at the Direct Funeral Services parlour on Nov 5, 2020. ST PHOTO: KUA CHEE SIONG

Ms Jenny Tay, managing director of Direct Funeral Services, says: "Live-streaming funerals has become more acceptable. With many Singaporean families living abroad, this will probably stay in the future."

Ms Ang of The Life Celebrant foresees a "rise in e-pek kim". These condolence donations were more readily made via e-payments with social distancing in place, and the ease of transfer is attractive for future use, she says.

Some feel the greater social isolation wrought by Covid-19 has been both bane and blessing.

Civil servant Irene Teo, 40, says the pandemic made her family focus on what was essential when her mother, 68-year-old Ng Poh Hua, died of bile duct cancer on April 16.

"The restriction on numbers helped us narrow down who we really needed to be present at the funeral. We also ensured that my mother was seeing the people she really wanted to, while she was in the hospice," says Ms Teo, who has an elder sister. Her 70-year-old father is a retired taxi driver.

FaceTiming daily with her boyfriend in the Netherlands also gave her comfort.

But in the end, she says only she can do the work of recovering from grief. "Without Covid-19, I probably would have gone travelling to get away from it all. Staying in Singapore has given me the solitude and space to have a real conversation with myself," she says.

"Maybe it's a blessing in disguise, that I'm fully facing the new reality of life without my mum."

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