From palliative care to End-of-life dreams and visions

Ending the circle. with three stepping stones.

Daily mail NEWS.  (click on her name) 

People who have had a near death experience describe hauntingly similar visions? Intensive care nurse PENNY SARTORI has spent years investigating them.

A) Palliative Care is comprehensive care, provided by an interdisciplinary team, for patients living with a chronic, often progressive illness and their families. Care is focused on alleviating physical and psychosocial symptom burdens, and promoting quality of life according to the patients' goals.

        Major issues addressed are:

• pain and symptom management

• information regarding the illness

• advance care planning

• psychosocial and spiritual needs

• coordinated care with other community resources.

B) DEATHBED VISIONS: A STUDY OFFAMILY OBSERVATIONS IN NORTHERN KERALA 

This is an interview-based study of 104 families and their observations of the last weeks and days of a dying family member. Socio-demographic factors such as gender, age, occupation, or cause and place of death were not found to be significant. Hindu patients appeared to be more likely than Muslim patients to report these experiences. Use of opiates (or not) did not appear to influence reports.

• Forty families reported “unusual experiences and behaviors” from the dying person in their last period of life. 

• Thirty of these dying persons displayed behavior consistent with deathbed visions—interacting or speaking with deceased relatives, mostly their dead parents. 

• There were six cases of reported premonitions of death and five possible confusional states with one patient reported to have had both a deathbed vision and confusional experiences. 

C)) End-of-life dreams and visions (ELDVs) are well documented throughout history and across cultures with impact on the dying person and their loved ones having profound meaning. Published studies on ELDVs are primarily based on surveys or interviews with clinicians or families of dead persons. 

This study uniquely examined patient dreams and visions from their personal perspective. This article reports the qualitative findings from dreams and visions of 63 hospice patients. Inductive content analysis was used to examine the content and subjective significance of ELDVs.   

Six categories emerged: 

• comforting presence, 
• preparing to go, 
• watching or engaging with the deceased, 
• loved ones waiting, 
• distressing experiences, and 
• unfinished business.