Dr Wai Peng Lee on 17 years of caring for a diverse community at St Luke’s

This year’s Dying Matters Awareness Week explores The Culture of Dying Matters – how the way we die is shaped by who we are, where we come from, and what we believe. In a community as ethnically diverse as Harrow and Brent, these questions are especially important. That’s why we sat down with Dr Wai Peng Lee, Consultant in Palliative Medicine at St Luke’s Hospice, to reflect on 17 years of caring for people from many different cultural backgrounds.

Dr Wai Peng Lee has worked at St Luke’s Hospice for 17 years as a Consultant in Palliative Medicine. In that time, she has supported people from all walks of life in Harrow and Brent. Her experience demonstrates that end-of-life care is never purely clinical. It is deeply shaped by cultural identity, personal beliefs and family circumstances.

“Some cultures, which may be influenced by faiths, are traditionally very life affirming,” she explains. “This, together with life experiences, shape personal views on illness and treatment. Hospice care may be viewed as giving up and not fighting which is of course is the opposite of what we do here”. Even in cases where people have migrated to different countries or religion isn’t actively practised, Dr Lee observes that cultural and societal values instilled from childhood continue to inform people’s attitudes to dying.

She reflects on Asian communities in particular: “There’s often a strong belief and sometimes expectation that family should look after their dying loved ones at home,” she says. “Whilst this can be a real strength that pulls some families together to be able to do this, for others, their circumstances can make this really challenging and at times not possible. We as clinicians can have honest conversations with patients and families, offering help that’s available and feels acceptable.”

Throughout her years at St Luke’s, Dr Lee has seen just how wide-ranging cultural practices around dying and bereavement can be. For hospice staff, having an awareness of different rituals around death is important. “For instance, you maybe from a culture where communal prayers, chanting or wailing is a mourning ritual” she says. “The noise and crowd may seem distressing and overwhelming to others until you understand that it’s a normal expression of grief for people.”

The main message is to avoid making assumptions. “Rather than say, ‘you’re from this particular culture, so you must want this, we actually ask,” Dr Lee says. “It’s very individual. People have different views and experiences, even within the same community. That’s why we ask: what matters to you?”

Her decision to specialise in palliative care was rooted in her dissatisfaction with how dying was often managed in hospitals. “Seeing how some people were dying in hospital in those days—it didn’t feel very holistic,” she says. “Hospice care gave me the ability to look after patients in two different settings, where the focus wasn’t just on the illness, but on the person as a whole.”

She values the multidisciplinary approach at St Luke’s. “We work as a team—nurses, doctors, social workers, physiotherapists and also faith leaders. Everyone brings a piece of the puzzle. We’re not just treating symptoms. We’re supporting someone as a whole.”

Dr Lee is also a strong advocate for early and open communication around death. “I often get asked, ‘How can I bring it up?’ I say, have the conversation while you still can. It will be emotional. People might cry. But just because you talk about death doesn’t mean it will happen sooner.”

She recalls one particularly powerful example. “One woman kept getting very breathless at night, and her family didn’t want her told her diagnosis or prognosis. They were afraid she’d give up hope. But she was frightened, and what she really wanted to know was: ‘Am I dying?’ and ‘Will I be gasping for air at the end?’” Dr Lee and her team helped the family understand that gentle honesty could ease fear, not increase it. “She needed someone to talk it through, to explain what might happen. That helped her… and her family.”

This year’s Dying Matters Awareness Week is themed The Culture of Dying Matters. It calls on us to recognise the profound influence of background, tradition, and belief on how people face death—and how professionals must respond with sensitivity and respect.

“At the end, what people want most is to be heard,” Dr Lee says. “You don’t have to have all the answers. Just listen. Just ask what matters.”