End-of-life visions common, can ease dying: study

Barry, an 88-year-old patient in a hospice in upstate New York, had an extremely vivid dream one night in which he was driving somewhere unknown. While dreaming, he heard the voice of his deceased mother saying to him, ''It's all right. You're a good boy. I love you.''

Experiences like Barry's are extremely common, according to a new study in which he participated. In the last days of life, many people report having extraordinary visions and dreams that they say help them become less afraid of death.

The research, which was recently published in the Journal of Palliative Medicine, finds that end-of-life dreams and visions are a natural part of dying, and that they tend to be "comforting, realistic, and often very meaningful."

At least half of conscious dying patients experience these visions, and they often describe them as profound. But as typical as these experiences are, they're a seldom-discussed aspect of the dying process.

"It's always been spoken about in the humanities - Shakespeare, Plato, the Bible - but medicine has had very little to say about it," Dr Christopher Kerr, chief medical officer at the Center for Hospice & Palliative Care in New York and the study's principal investigator, said. "I wanted to draw attention to the fact that this is a legitimate phenomenon during dying and that there is a therapeutic opportunity in it, because for most people it is very comforting."

Scientists have tended to dismiss these experiences as a result of delirium or mental confusion, although the patients in the new study were lucid and did not exhibit any signs of delirium.

For the study, the researchers interviewed 59 male and female patients (with an average age of 75) admitted to a New York hospice inpatient unit. The researchers asked the participants about their recent dreams and visions.

Based on more than 400 interviews, they then analysed the frequency, content and significance of the dreams and visions, as well as the amount of time that passed between the patient having the dream and the patient dying.

"End of life dreams and visions have been anecdotally reported by caregivers and family members through history," Dr James Donnelly, a psychologist at Canisius University and one of the study's authors, said. "Our study was the first to prospectively interview patients themselves during their last weeks and months of life, rather than rely on retrospective reports of caregivers."

It's easy to imagine how these vivid dreams and reveries would provide comfort to the dying. Many patients described having visions of going to some unknown place, or preparing for a departure. In other visions, the patients said that loved ones or religious figures told them everything would be all right, or that they weren't alone.

"A person's fear of death often diminishes as a direct result of [dreams and visions], and what arises is a new insight into mortality," the study's authors conclude. "The emotional impact is so frequently positive, comforting, and paradoxically life affirming. The individual is physically dying, but their emotional and spiritual identity remains present as manifested by dreams."