Palliative care teams help patients with life-limiting illnesses leave legacies for their loved ones. We unpack legacy works and hear about the lessons legacies leave behind for both the patient’s loved ones and their palliative care team.
Madam Lim Siew Geok’s family portrait was scheduled to be taken in the Woodlands Healing Garden, a serene setting on the Woodlands Health Campus (WHC) surrounded by nature. This plan changed when a violent thunderstorm swept in.
The hospital room then became the backdrop, adorned with crocheted flowers and folded paper cranes made by her grandchildren. Madam Lim’s smile was radiant despite her pain, dressed in her favourite floral attire, signature golden earrings, and carefully applied makeup. It was a scene of bittersweet joy — love and laughter masking the heavy knowledge that this would be their last few moments together.
Months after Madam Lim’s passing, the photos and videos from that day still provide tremendous comfort to her grieving family. Her framed photo set by her husband Jimmy’s bedside; it became his daily morning ritual to talk to her, pray for her, and reflect on the love they had shared. When they missed her, they would watch the videos and look at the photos to remember her love, generosity, and selflessness.
Before Madam Lim’s late-stage cancer diagnosis, her eldest son, Clarence Tan, had only a vague understanding of palliative care, much less the concept of legacy work. To him, legacy work initially seemed like a pragmatic task — a way to settle assets and ensure proper distribution. Now, he and his family have discovered that it could be so much more.
Legacy work, the process of creating meaningful memories and connections, helps families navigate their emotions and find peace with the impending loss of a loved one. It can take many forms, from crafting artwork and writing letters to family gatherings or documenting life stories.
Passing on values, beliefs, and strengths, such as philanthropy, supporting the poor, or spreading faith, is also an important way to leave a legacy, in addition to writing a will and distributing assets after death.
SUPPORTING LEGACY MAKING
The dedicated WHC team makes legacy work possible. Medical Social Worker April Chan’s role is to connect families with the right resources, whether that means introducing them to an art therapist to bring their vision to life or directing them to an online platform for will writing. April works closely with families to identify their goals, utilise their strengths, and determine the best ways to honour their loved ones’ legacy.
Art therapy also often plays a significant role in this process. Senior Art Therapist Roxanne Chew explained, “Legacy work in art therapy is about turning the intangible expressions of a person’s life, values, and relationships into something tangible.”
This could involve using the media that patients are most comfortable with, such as acrylic or watercolour painting, sculpting, or even making something as simple as a collage, guided by what best reflects the patient’s life and identity.
By creating a meaningful piece of art or memory, they not only reflect on their own lives but also provide their loved ones with something to hold onto — a piece of their essence that lives on.
Assistant Nurse Clinician Nursyahidah also plays an important role; she ensures that the nursing needs of the patient are met while keeping them comfortable throughout the process. Nurses work together with the medical team, supporting patients from the nursing and medical perspectives.
For Madam Lim, Nursyahidah and the other nurses’ attention to detail — such as preemptively managing her pain through medication — allowed the family photoshoot to proceed smoothly, ensuring it became a joyful memory.
April’s idea to decorate the hospital room with crocheted flowers was an example of how simple details can make a big difference. As live flowers were not permitted following infection control measures, the handcrafted ones left a lasting impression. “I promised Uncle Jimmy that they would accompany him,” April said.
Organising the photoshoot enabled the family to fulfil a long-held dream and gave them the chance to say their final goodbyes, share parting words, and express their love. Though the reality of it all was setting in, the photoshoot allowed the family to focus on joy. For a moment, they were able to set aside the impending loss and create memories together.
Even the hospital team shared in the excitement. “In an inpatient hospice, where the inevitable destination is death rather than discharge, having the opportunity to celebrate such a joyous occasion brought a sense of happiness to everyone involved,” said April.
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NAVIGATING CHALLENGES AND EMOTIONAL BARRIERS
Legacy work, while rewarding, is not without challenges. Logistical constraints, time pressures, and emotional readiness are constant considerations. As Nursyahidah pointed out, the “window of opportunity is short and limited,” or it may open suddenly, and we must take advantage of it.
Families may be eager to create lasting memories, but patients might not always be physically or emotionally ready. Some may experience pain, shortness of breath, or delirium, making it difficult to engage.
Another challenge lies in family dynamics. Some family members may be more willing than others to confront the reality of death. “For many, it’s difficult to face the impending loss of a loved one. Some may avoid legacy work because it feels too painful,” said April. The key, she explained, is to guide families gently, helping them find a shared path forward that respects both the patient’s and the family’s wishes.
Some families may simply want more private time with the patient and prefer minimal involvement from the care team. In other circumstances, family members may feel forced to participate in legacy work before they are emotionally prepared, which can cause distress. The focus, then, is to pace the process according to the family’s needs, offering support without overwhelming them.
Even if the family is united in its desire to create a legacy, the patient may not be physically or emotionally capable of participating. This is why open, honest discussions with both the family and patient are crucial to avoid causing additional anxiety or conflict.
If a patient isn’t ready to engage in legacy work, the goal is to support them emotionally and proceed at their own pace. The focus is on creating a safe, respectful environment where both the patient and their family can express their legacy in their own way.
It is also important to respect each family’s religious and cultural background, as these deeply influence how they approach death and legacy, explained April. Sometimes patients may not know what they want to create. “You have to really listen, even to the smallest cues,” Roxanne said. “For example, if a patient mentions their grandchild in passing, that could be the foundation for a legacy project. You need to listen first and come in at the right time.”
Many people find the idea of making art intimidating, believing that it’s only for those trained in it or that it must be perfect. Roxanne reminded them that their life story in itself is a narrative worth capturing. “Legacy work isn’t about perfection; it’s about expression,” she said. She often shared examples of elderly artists, like Mr Lim Tze Peng, who found new ways to create art later in life.
While traditional art forms are vital, Roxanne also values creative approaches to ensuring dignity and personalisation. For example, she has used technology such as an image generator to turn a patient’s hospital wristband into a beautiful bracelet post-photoshoot.

MAKING A LASTING IMPACT
The impact of legacy work on families can be profound.
One patient, unable to speak, worked with his 10-year-old son to create twin paintings — one from the son expressing love and gratitude, and one from him, encouraging his child to listen to his mother and do well in school. “It was a reminder to us as healthcare workers that this is someone’s dad, not just a patient,” Nursyahidah recalled.
In another example, a couple made a cast of their hands clasped together. Having spent more time at work than enjoying each other’s company, it became a tangible reminder of their bond, something for their son to cherish.
In a similar art project, a couple painted a picture of their favourite beach spot in the Philippines, symbolising their dream of spending retirement together there even though the husband was terminally ill. “We often underestimate the power and the importance of love as people grow older,” she added. “It’s a reminder that love still exists at any stage of life.”
Nursyahidah recalled one particularly moving experience with a patient who had a neck tumour. Despite his illness, the patient was able to create beautiful artwork that raised funds for palliative care.
In many Asian families, emotions can remain deeply buried, but Roxanne has a way of helping patients express these feelings through their artwork. “Often, family members will say, ‘I never knew this is how my mom or dad felt.’ The artwork becomes an eye-opener, revealing previously buried emotions.”
Some families have even gone beyond creating art, donating clothes to charities, or bringing treats to the hospital as an expression of gratitude. “Even in their grief, the family still thought of us and brought us sweet treats in appreciation for caring for their loved one who had always reminded them to do so for anyone who had taken care of her. They also donated her clothes and assets to charity,” said April.
A LASTING LEGACY
In their personal lives, Roxanne and Nursyahidah engage in their own forms of legacy work. Roxanne captures everyday moments with her children through short videos, while Nursyahidah creates humorous clips for her friends and loved ones, bringing joy and laughter to their daily routines.
Clarence’s experience of legacy work impacted his understanding of palliative care. “I used to think it was all doom and gloom, with my mother lying in bed all day, just waiting for death to take her away,” he reflected. However, with the help of the palliative care team, he learnt that this path could also be about generating meaningful, joyful moments in the midst of loss.

“My experience with the WHC palliative team was very impactful, proving to me that palliative care and hospice don’t have to be dreadful,” he said. The team was conscientious in explaining their approach to support, and he witnessed how staff made small adjustments to ensure his mother’s comfort. Everyone was attentive, carefully noticing her discomfort and adjusting her oxygen mask with genuine care, he said.
Clarence noted that the process of legacy work bonded the family as they made many decisions together along the way. “It was a beautiful gesture, and we didn’t hesitate to agree to it.”
The last year has been a challenging journey of grief for his family. Initially, Clarence’s father was reluctant to take his medication, giving up on looking after himself and getting well. However, with the support and counselling from April and the team, he gradually began to strive to live on. Jimmy still pulls up the photos and videos of his wife, finding comfort in her memory. “These serve as a daily reminder to live well, despite the fact that she’s no longer around,” said Clarence.
This experience has renewed their commitment to love and live fully, to remain strong and continue to care for the family, as she always did. The legacy she left behind — her selflessness, love, and generosity — continues to guide the family.
For Clarence, the values his mother embodied are something he hopes to pass on to his own children. “She always put others before herself… It was second nature to her,” he reflected. “We should all aspire to do that.”
In the end, legacy work is about more than memories — it’s about love, resilience, and the bonds that endure beyond a patient’s final days.