What Impact Do End-of-Life Experiences Have on Grief?

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In the past 50 years, our knowledge about death and dying has increased significantly. Since Dr. Kubler-Ross's 1969 book On Death and Dying, death is no longer a forbidden topic. People have been able to talk more openly about their own death and express their wishes for the end of life. The use of hospice has increased, as has palliative care. There are death cafes where people can go and share their thoughts, feelings, and questions about the dying process. Now there are also end-of-life doulas available to assist the dying and their families at this difficult time.

Exceptional deathbed experiences

Among the things we have learned about death is that there are also some exceptional experiences that occur around the deathbed that can have a profound impact on those experiencing or witnessing them. These are deathbed visions and deathbed dreams.

Deathbed visions and dreams of the dying are experiences the dying have in which they report seeing and visiting with deceased family members, religious figures, and/or seeing beautiful scenery. The content and impact of these experiences are similar. The only real difference is that one occurs when the person is asleep and the other when awake.

In the past, deathbed visions (DBV) and deathbed dreams (DBD) were dismissed as delusions and hallucinations. Rather than exploring these experiences, patients were often medicated and families told to ignore the dyings’ words as they were just ramblings. We know now that these were common experiences occurring around the world regardless of age, sex, or religion. We have also come to understand that these experiences can have a positive impact on all involved and not just at the deathbed.^[1]

How a loved one's end-of-life experience affects grief

Research by Grant, et al.^[2] has examined the relationship between grief and exposure to the dying loved ones' end-of-life experience. Their findings indicate that nearly half of the respondents believed that their loved one was comforted by the experience. When respondents were asked how their loved ones' experience affected their personal grief, more than half reported that it helped them accept the reality of the loss. It was also beneficial in working through the pain of their grief as well as adjusting to their new world without their loved one.

For the dying who reported seeing a deceased family member, caregivers were comforted that their loved one would not be alone and that they would be united again. Many reported that they lost their fear of death and that their loved one became more accepting of their death. The researchers also reported that the words most frequently mentioned by those relaying the experience were comfort, solace, peace, or reassurance.

Knowing the impact these experiences can have on the family, it is important that these experiences be a part of death education for hospice staff and volunteers. They can then help the family process what they have experienced. Since hospice staff can be very busy, these experiences might be overlooked. Families could be encouraged on admission to let staff know if their loved ones exhibit any of the behaviors that are associated with these experiences, i.e., calling out a deceased loved one's name, staring at the corner of the ceiling, or having a conversation with someone no one else can see.

There has been much speculation about the source of these experiences. Whether these end-of-life experiences are a result of medication or a spiritual or cognitive change in the dying brain, who knows? But what a gift of comfort we receive as we leave this world. In our final moments, is that not what we all would want?