A 2015 systematic review found that unusual Death Bed Phenomena (DBP) reported by patients in palliative care appear to be a relatively common, but not well-understood, and have a significant psychological and spiritual impact on palliative care patients.
It is also an area of significance for family members who are told of these experiences but may not see them as an indicator of the impending death of the patient.
Types of Death Bed Phenomena
In practice many palliative care health professionals have heard accounts from ill and dying patients of DBP events which are difficult to explain. The unexplainable phenomena described by patients could be any of the following:
- A significant dream or vision experienced either awake or in a dreaming state;
- The presence of a deceased relative or friend;
- Seeing, hearing or feeling something such as a bright or warm light, lovely music, or a beautiful place;
- Seeing heavenly places or experiencing religious visions;
- Travel analogues, such as going on a journey or getting in a car or getting ready to go on a trip;
- Being aware of their own time of death;
- Moments of lucidity following from states of unconsciousness.
DBP experiences are mostly reported in the last 24 hours before death. Just under half of DBP (45%) are experienced less than 24 hours before death, with 36% experienced more than a week before death.
The review found that DBP are deeply meaningful experiences that bring comfort, peace and reassurance to the dying person. While patients and their families typically found the experience to be reassuring and comforting, patients and/or carers are often reluctant to disclose their experiences as staff might not be prepared to discuss this experience with the patients.
Summary
As DBP are an important indicator of impending death, there are implications for preparing the patient and family for what is happening and what these experiences might mean.
The review recommended that professionals normalise these experiences for patients and families. However as current scientific models cannot explain these phenomena, medical health professionals often feel ill-equipped to respond to DBP, leaving them unsure how to respond to their patients’ stories and accounts. There is thus a need for pastoral care, caregiver support, professional supervision, training and education on DBP and on the dying process.
References:
A full list of references is available in the Reference Material section.
- Devery, K., Rawlings, D., Tieman, J. and Damarell, R. (2015). Deathbed phenomena reported by patients in palliative care: clinical opportunities and responses. International Journal of Palliative Nursing, 21 (3).
- Fenwick, P. and Brayne, S. (2011). End-of-life Experiences: Reaching Out for Compassion, Communication, and Connection – Meaning of Deathbed Visions and Coincidences. American Journal of Hospice & Palliative Medicine, 28(1).
- Renz, M. (2016) Hope and Grace – Spiritual Experiences in Severe Distress, Illness and Dying. London: Jessica Kingsley Publishers.
