The first-ever study on Singapore’s death preparedness level was released on Thursday (Sept 25) — and results showed significant gaps in knowledge and awareness among Singaporeans when it comes to dealing with death.
Named the Singapore Death Literacy Index (DLI), the study — commissioned by the Singapore Hospice Council (SHC) and conducted by Temasek Polytechnic — marks the first time the nation has had a quantitative measure of how well its people understand and act on end-of-life (EOL) and death care options.
The DLI evaluates four key aspects of death literacy: factual knowledge, practical knowledge, experiential knowledge and community knowledge.
The term ‘death literacy’ refers to a set of knowledge and skills that enable individuals to understand and act on EOL and death care options.
Lack of factual knowledge on death literacy, survey shows
The DLI surveyed 1,087 participants between Nov 1, 2024 and April 20, 2025. The sample size was adjusted to 1,157 after weighing age, gender and ethnicity to reflect national demographics.
The survey prompts respondents to indicate their level of agreement or disagreement from one to five, with one being ‘not at all able’ to five being ‘very able’ across the four key aspects.
The total score for each aspect is then calculated from the survey responses.
The DLI highlighted a lack of awareness in navigating the EOL journey — with the factual knowledge category presenting with the lowest score (at 5.62). Factual knowledge refers to how much an individual knows about legal, medical and procedural aspects of EOL planning.
According to the DLI, fewer than one in three (32 per cent) Singaporeans knew how to navigate the healthcare system to support a dying person, and only one in four (26 per cent) knew the regulations involved when death occurs at home.
About one-third (34 per cent) knew what documents were needed in EOL preparations.
The DLI also revealed a low level community knowledge score (5.33), as more than one in five (23 per cent) did not know how to access community EOL support and resources. Community knowledge refers to the person’s awareness and ability to access community-based EOL support and resources, and an awareness of existing community support groups for different populations affected by EOL issues.
The overall rating for practical knowledge — which refers to an individual’s confidence and ability to talk about death, dying and grief with others, as well as ability to provide hands-on care for individuals in EOL situations — is also generally low to moderate (at 5.62). More than half (61 per cent) of Singaporeans revealed to be comfortable speaking to a close friend about death.
That said, this indicates that people might feel more comfortable discussing the topic with those they trust personally.
More than half (55 per cent) of the respondents also felt confident talking to a healthcare professional regarding support for a dying person.
The study also showed a reluctance in speaking to a newly bereaved person, with two in five (40 per cent) uncertain about how to talk to or comfort them.
In terms of hands-on care, approximately half (52 per cent) were comfortable and able to provide feeding assistance.
Among the four categories, experiential knowledge — which refers to how experiences with death and dying have influenced personal growth, understanding and resilience — scored the highest (6.69).
According to the study, 66.5 per cent were reported to have become more compassionate towards themselves after experiencing death and loss.
Close to two-thirds (63 per cent) agreed that their experiences with death had led them to re-evaluate what’s important in life.
It’s worth nothing that while Singapore’s overall DLI score is moderate at 5.66, the nation still has a higher literacy level than other countries that have also conducted the study like Australia (4.7) and the UK (4.8).
The overall DLI score is derived by calculating the sum of the average score for each key aspect.
Raising awareness on a taboo topic
Speaking to the media at the DLI’s launch event, Dr Wu Huei Yaw, honorary secretary of SHC and chief of department of integrated care at Woodlands Health, shared that Singapore’s moderate DLI score and low awareness might partly be due to avoidance of the topic.
“Death and dying is still a taboo topic. I think many people would not try and will not look into this aspect until the need arises,” he explained.
But why is there a need to raise death literacy?
Speaking at the event, Sim Bee Hia, executive director of SHC, said that the median time between palliative care to a patient dying is about 29 days for cancer patients and only nine days for non-cancer patients.
“It’s really so much information, so little time,” she continued, explaining that it then creates a “mad scramble”.
Added Dr Wu: “As doctors, we see firsthand how families struggle when conversations about death are delayed or avoided. Improving death literacy would help patients and families make informed end-of-life decisions, ease emotional burden, and allow care to be more aligned with their wishes.”
More public education and resources moving forward
To support raising death literacy in Singapore, SHC has announced that it will amplify its public education, resources and awareness efforts.
Some examples of how it will do so include organising regular talks with experts, creating bite-sized resources and adapting to provide more age-appropriate discussions to appeal to different age groups.
Speaking to AsiaOne, Bee Hia said that there has been a “change in focus” with regards to how SHC is driving the message of palliative care, death, and dying.
Instead of focusing on the “sad” parts of the topic, SHC emphasises more on living well through mediums like interactive chat shows with local artists, pet therapy and even a blindbox series which will be launched next month at the organisation’s Live Well Leave Well Festival.
SHC will also work with other organisations to provide structured palliative care training for general practitioners (GPs) and polyclinic doctors by 2026. It will also form a Community Palliative Care Network to connect GPs to specialists for stronger communication and to encourage earlier palliative care options.
Additionally, SHC will also work closely with the community to expand outreach by leading initiatives like the Compassionate Communities Singapore and other community-driven projects.
“We hope to build a system where no one dies or grieves alone,” said Bee Hia.
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carol.ong@asiaone.com
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