COMMENTARY

Deathbed Visions at End of Life

Betty R. Ferrell, PhD, RN

Disclosures

May 23, 2017

End of Life and Deathbed Visions

The field of palliative care encompasses the broad trajectory from diagnosis of a serious illness until the time of death. There has been extensive interest in the final hours or days before death as a specific period in which patients may experience new symptoms or concerns that affect both patients and their families.

In a recent study, Chang and colleagues[1] explored the experience of deathbed visions and the potential link to spiritual care at the end of life. Deathbed visions were defined as "visions of deceased relatives or friends, religious figures, or a visionary language pertaining to travel."[1]

Using a Delphi technique, nurses (n = 18) and physicians (n = 13) participated in surveys on the topic of deathbed visions. The participants were required to have at least 5 years of experience in caring for patients at the end of life. The surveys addressed the clinicians' interpretations of the spiritual aspects of deathbed visions, and the process was intended to create a research instrument to assess deathbed vision experiences and implications for care.

Viewpoint

Several previous studies have documented deathbed visions in the final days of life.[2,3,4,5] Most studies have described these visions as comforting to the patient, although sometimes such reports are misunderstood by family members and clinicians. Patients report talking with and seeing deceased relatives, traveling to a life beyond, speaking with God or other religious persons, and being comforted by these experiences. Clinicians often interpret these experiences as physiologic processes, such as confusion or delirium.

Death is a universal experience. The dying process involves "an instinctive need for a spiritual connection and meaning, requiring compassionate understanding and respect from those who provide end of life care."[1] A not-unexpected finding from the study by Chang and colleagues was that nurses were more likely to view the deathbed visions as spiritual events, whereas physicians were more inclined to relate these to physiologic processes. However, both groups were instrumental in reinforcing the importance of this topic and the need for clinicians to support dying patients who experience deathbed visions.

This article provides a thoughtful, scholarly approach to advancing care at the end of life. It is an important contribution to the universal goal of palliative care to make death a sacred time and to recognize spiritual needs as central to the end of life.

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