A Study of What Happens at the Hour of Death
“As she died we [a nurse, another nurse and the patient's husband] just noticed like an energy rising from her... sort of a bluey white sort of aura. We just stood there watching and we saw it. We looked at each other, and the husband was on the other side of the bed and he was looking at us... he saw it as well and he said he thinks that she went to a better place. It was definitely some sort of energy there, you know, some sort of spiritual thing happening... and it probably changed the way I felt about people dying and what actually happens after death.” (O'Connor, 2003).
This excerpt is from an interview with a male palliative care nurse who along with his colleagues participated in a study of their experiences in a small hospice in New South Wales, Australia. All participants reported more than three occurrences of paranormal phenomena while caring for dying patients; most of them disclosed that their patients told them of seeing dead relatives, and also reported buzzers inexplicably activated after a patient's death. Nurse Jared declared that a patient who had been moved to a room just vacated because of her previous occupant's death, felt immediately the presence of the dead person's in the room and identified her correctly by name, though unaware of her identity; he obtained to be moved to another room. Another patient, who had undergone a similar experience in another room but had chosen not to leave it, 'was quite scared the whole night'.
The repertoire of baffling end-of-life experiences (ELEs) is broader than reported above. The following list resulted from my collecting the findings of several studies published in academic journals: unusual lights or shapes seemingly originating from a dying person's body; dazzling lights surrounding the patients or even filling the whole room; deathbed visions of deceased relatives coming to 'take away' the dying person (in most cases only the dying person reports such visions; occasionally, medical personnel and visitors shared them); the dying person appearing to remotely located relatives or friends; relatives suddenly acquiring the certainty (later confirmed) that a relative just died; a seeming ability on the part of the dying person to transit to and from realities, such a transiting being accompanied by phenomena that bears a close resemblance to descriptions of near death experiences (e.g., Moody, 1975); synchronistic phenomena occurring at the moment of death, such as the ringing of bells, the flickering of lights, sudden malfunctioning of televisions and other devices, or the stopping of clocks ; unusual animal behavior; the sensing of recently dead persons still lingering in a room.
This perplexing array of phenomena has been referred to as 'transpersonal' end-of- life experiences (Fenwhick et al., 2010), owing to their seemingly 'otherwordly' or 'transcendent' qualities that seem to elude simple explanations in terms of the pathological processes that characterize dying. Another class of end-of-life experiences are referred to as 'final meaning' ELEs, and include profound waking dreams; powerful dreams involving deceased relatives that help the person 'let go'; a desire to reconcile with estranged family members which induces the dying person to hold onto life until their arrival. A possibly related phenomenon is the entirely unexpected and so far medically unexplained return of mental clarity and memory shortly before death to patients suffering from severe mental disorders such as Alzheimer's disease and schizophrenia (Naham and Greyson, 2009), as well as tumours, meningitis, stroke and affective disorders (Nahm et al., 2012).
How Frequent are Transcendental End-of-Life Experiences?
This hub addresses specifically the ostensibly paranormal phenomena that characterize transcendental ELFs; its main purpose is to enquire about the frequency of these occurrences, as reported in the medical and gerontological literature. The question concerning the real nature of these phenomena is also more indirectly addressed, through the opinions of the medical personnel involved in the care of terminal patients.
I am singling out here by way of example a recent study (Fenwick et al, 2010) of the experiences of 38 nurses, doctors, and end of life carers from two hospices and a nursing home in England. Its findings are based upon tape recorded interviews and the administration of questionnaires to these caregivers. Specifically, this research consisted of a 5-year retrospective and a 1-year prospective study of the ELEs of their patients, based either upon the direct (first hand) observation on the part of the caregivers, or upon the (second hand) received narration of these experiences as relayed to them by patients and their relatives.
The overall results of this study are consistent with those of several previous studies: the paranormal aspects of transpersonal end of life experiences are far from rare.
Up to 62% of interviewees reported that either their patients or their relatives had spoken about deathbed visions involving relatives; up to 35% of them reported mostly second hand accounts of light-related phenomena. For instance, one interviewee, asked if she had ever seen light around patients replied: 'A light often; especially my therapists often report on a light around patients and more towards when they die'. A third of the interviewees described clocks stopping at the moment of death. More than half of them reported second hand accounts of death-bed coincidences involving people who had woken in the middle of the night and 'knew' with absolute certainty that their loved one had died, and saw their insight confirmed in the morning. 57% reported first hand a sensation of being 'pulled' or 'called' by a person around the time of his or her death. The list could go on, reporting comparable figures for the remaining phenomena listed above.
How Are Transcendental End-of-Life Experiences To Be Explained?
These findings strongly suggest that transcendental ELEs are fairly common. What, then, is their nature? What can explain them?
The caregivers involved in the study conducted by Fenwick and coworkers (2010) were not reluctant in offering their opinion.
Up to 79% of the respondents regarded ELEs (both transcendental and not) as profound experiences that were considered very meaningful by the dying persons; 68% felt they were profound spiritual events.
Up to 79% percent also claimed that ELEs could not be solely attributed to brain related changes, fever, medication, or the toxicity that accompanies the dying process: for in most cases, they reported, the patients were clearly lucid and conscious when these events occurred. As a caregiver said, seemingly voicing the views of many others, 'there is something transitional going on with the spirit, the mind as well, that is not just the physical'.
In sum, a majority of well trained caregivers of terminal patients experienced first or second hand these phenomena, and a large majority of them felt that strictly physiological accounts of transcendental ELEs were manifestly inadequate. This is far from inconsequential: for who is better qualified than these individuals, both in terms of training and experience, at providing an informed opinion about the ultimate nature of these phenomena?
Still, anyone who wanted to claim that these deathbed events lend strong support to the view of death as a 'door' rather than as a 'wall': as more than a purely physical terminal event, would have to face the exacting demands of those 'naturalists' who argue that a purely psycho-physiological model of these supposedly paranormal events in fact suffices to account for most of the evidence (and conveniently sweep under the carpet those parts of it that stubbornly refuse to conform).
Bear in mind, the 'naturalists' would likely argue, that dying is a complex, highly variable psycho-physiological process involving the totality of a person. We simply do not know enough about it to rule out a strictly psycho-physiological account of most of these transcendent ELEs phenomena as resulting from i) hallucinations of the dying; and ii) misperceptions and misinterpretations of distraught, emotionally upset relatives (and some caregivers) keen on validating to themselves and the dying person the seemingly otherwordly occurrence of all too mundane events.
We all know the power of wishful thinking; and straightforward psychology can help us appreciate how some of these phenomena – such as the visitation of loving long dead relatives eager to help us make the fateful transition to the 'undiscovered country' – could help us reduce the stress associated with dying, and enable us to 'let go', thus easing the severity and length of the final agony. Indeed, a study (Barbato, 2000) reported that deathbed visions tended to be perceived as comforting by the patient, as did the studies surveyed above. However, more than 50% of involved relatives in Barbato's study rated their dying relative's reports negatively: and this raises questions about the supposed willingness of most relatives to be wheedled by wishful thinking into a state of uncritical credulity. Note also that one can accept that the purpose of these visions and other phenomena is to facilitate the dying processs, without at all having to embrace a 'reductive' explanation of their role.
The best way to ascertain whether the standard physio-psychological account of deathbed experiences ultimately fails to explicate the true nature of these events is by relying upon a growing amount of empirical work as rigorously conducted as circumstances afford. Unfortunately, despite the fact that the importance of this topic is increasingly recognized, also for its implications regarding the training of caregivers to the dying, research remains all too sporadic.
Barbato, M. (2000). In A. Kellehear (ed.), Death and Dying in Australia. New York: Oxford University Press.
Fenwick, P., Lovelace, H. Brayne, S. (2010). Comfort for the dying: Five year retrospective and one year prospective studies of end of life experiences. Archives of Gerontology and Geriatrics, 51, 153-179.
Moody, R. (1975). Life After Life. New York: Bantham
Nahm, M., Greyson, B. (2009). Terminal auditory lucidity in patients with chronic schizophrenia and dementia: a survey of the literature. Journal of Mental and Nervous Disorders, 197, 942-944.
Nahm, M., Greyson, B., Williams Kelly, E., Haraldsson, E. (2012). Terminal lucidity: A review and a case collection. (2012), Archives of Gerontology and Geriatrics, 55, 138-142.
O'Connor, D. (2003). Palliative care nurses' experiences of paranormal phenomena and their Influence on nursing practice. Presented at the Making Sense of Dying and Death Inter-Disciplinary Conferences. Paris, France.