As an 88-year-old man lay dying, he dreamed of driving somewhere unknown and then heard his mother say, “It’s all right. You’re a good boy. I love you.”
A 54-year-old dying woman dreamed of a deceased childhood friend who had caused her great pain. The friend appeared as an old man and told her, “Sorry, you’re a good person” and “If you need help, just call my name.”
A dying 62-year-old woman reported comforting visions of a little girl dancing in her room.
These are just some of the dreams of the dying collected in a recent study in Buffalo, the first rigorous examination from dying patients’ perspectives.
As the end of life approaches, people experience dreams in which they see dead relatives waiting for them or describe preparing to take a trip. Deceased friends visit and tell them everything will be OK.
It’s a mysterious phenomenon reported since ancient times and given little attention by science.
But the project in Buffalo indicates the experiences can be profoundly meaningful to patients and warrant more attention from doctors.
“In the dreams, you can see the person working through their fears and becoming more peaceful,” said Kathleen Hutton, whose sister, Rosemary Shaffer, participated in the studies.
Rather than dismiss dreams and visions, or try to stop them with drugs, the research strongly suggests that caregivers understand their significance.
Among the key takeaways of the work here: Dreams and visions are common among the dying, they’re so vivid they feel real, and they appear to be part of a process of coming to terms with death.
“It’s a built-in mechanism for soothing a dying patient,” said Dr. Christopher Kerr, chief medical officer at Hospice Buffalo.
The researchers took pains to distinguish end-of-life dreams and visions from hallucinations or delirium.
Seeing the deceased
The dreams and visions of dying patients follow a handful of common themes, according to the studies. Patients generally describe a comforting presence, usually dead friends or relatives, preparations to take a trip, engaging in some way with the dead, or a sense of loved ones waiting for them.
One 96-year-old woman told investigators about a dream of her late mother in a beautiful garden telling her that everything will be OK.
They’re not always positive, though. Patients also replay distressing life events.
Shaffer, a Catholic school educator who died of cancer about a year ago, initially dreamed of frightening spiders. Later, in another dream, the spiders turned into friendly ladybugs. As with the other patients, the dreams occurred with an unusual vivid quality, like a waking reality.
“Rosemary told me the ladybugs meant she didn’t have to be scared anymore. They were a good thing. It put death into perspective,” Hutton said.
In interviews with 66 dying patients, the investigators found that near-death dreams and visions don’t resemble typical dreams and are distinctive from the hallucinations or confusion associated with medications, dementia or illness.
Nearly 90 percent of the patients in the studies reported having at least one near-death dream or vision, and 99 percent of those believed the dreams or visions to be real. About 50 percent of the experiences occurred while the person slept, 16 percent while they were awake, and the rest while both asleep and awake.
Sixty percent of the patients said the dreams and visions provided a sense of peace, while 19 percent considered them distressing, and 21 percent found them both comforting and distressful. Religious content was minimal, but there was a common existential thread.
“A statement we heard from people is that very little is said in their dreams and visions, but they extract huge meaning and comfort from them,” said Pei C. Grant, director of research at the Palliative Care Institute.
Two studies, done in collaboration with faculty at Canisius and Daemen colleges, were published last year in the Journal of Palliative Medicine and the American Journal of Hospice and Palliative Medicine. The institute, a part of the Center for Hospice & Palliative Care in Cheektowaga, anticipates publishing more results after examining the phenomenon over a longer period of time this year with patients who received hospice care at home.
Still ‘spiritually alive’
As people in the studies got closer to death, their dreams became more positive attempts to find meaning and reconcile past life events.
“Death is a paradox,” said Kerr. “You are dying physically, but still emotionally and spiritually alive.”
Previous studies suggest that as many as 60 percent of conscious dying patients experience end-of-life dreams and visions, but the actual number likely is higher because the phenomenon is considered underreported by patients and family members for fear of embarrassment.
The researchers urge doctors to carefully consider how they treat dying patients, because dreams and visions mistakenly medicated with drugs for delirium may prevent the comfort and sense of acceptance that the experience appears to evoke in many people.
Families also lose an opportunity to make a deeper connection with loved ones when dreams and visions are discounted as the ramblings of a confused person.
“Dreams and visions lessen the fear of dying and make the transition easier,” Grant said.
The findings of the project provide much-needed recognition that the spiritual side of the end of life deserves more serious study and attention from caregivers and family members, said Betty Ferrell, a palliative care expert at City of Hope cancer center near Los Angeles. Ferrell reviewed the research.
“Patients are having these experiences whether or not we acknowledge them,” she said. “We’re so busy, with good intentions, providing medical care. But, in our haste, we’re not focusing enough on what’s happening spiritually. We need to honor what’s happening and help people talk about it.”
Kerr will describe the research he and his colleagues are doing at TEDxBuffalo, a daylong event taking place Thursday in Asbury Hall at Babeville, 341 Delaware Ave. The conference is an offshoot of the national TED series devoted to sharing ideas.