Six categories of ELDVs: Kerr excerpt #4

Dr. Kerr writes: After documenting the prevalence and characteristics of End-of-Life Dreams and Visions (ELDVs), we wanted to better understand their content, and what they meant to the dying. In the second study (19), we conducted multiple interviews with 63 Hospice patients. We began the study with patients in our Hospice Inpatient Unit, which included a survey and a structured interview. We visited participating individuals daily to complete the survey and interviewed them for as long as they were able. The study utilized quantitative data as well as open-ended questions and interviews, which allowed each participant to describe their experiences in detail. The data was analyzed using a mixed-method design called concurrent triangulation that is used to confirm or corroborate the findings of 2 different methods; both quantitative and qualitative data were collected at the same time. The results revealed 6 categories of ELDVs:

1. Comforting Presence: Dreams and visions that featured the presence of dead friends and relatives were well represented throughout the data. Some also included living friends and relatives as well as dead pets or other animals. These dreams and visions were overwhelmingly described as comforting to the patient. For example, one patient reported that she had frequent dreams of her dead sister sitting beside her bed. She described these dreams as extremely comforting because ‘‘I am not going alone [my sister] will be with me.’’ Another patient reported dreaming of her dead mother talking to her in a beautiful garden, saying ‘‘everything will be okay.’’ This was very comforting to the patient and she told her family that she wanted to go back to sleep because her mother would be coming back. Another patient who dreamed of both dead and living friends and relatives also reported that they were all ‘‘telling me I will be OK.’’ Yet another patient reported dreaming of his mother who had died when he was a child. The dream was so vivid that he reported smelling her perfume as well as hearing her soothing, comforting voice, say, “I love you”. The following video of Alice, who describes an intense vision of deceased loved ones and is left with a feeling of “enormous love” as well as a sense of “joy and peace that was hard to describe.” 

(Link to Alice Interview Video: https://www.youtube.com/watch?v=V4PzG8BFECM).

     2. Preparing to Go: Some participants reported that in their dreams they seemed to be preparing to go somewhere. One patient described seeing his parents, grandparents, and old friends in his dreams. He observed, ‘‘I know we are going somewhere, but don’t know where.’’ Another patient dreamed that he was driving around [town] and had to go somewhere, but again, he did not know where. A third patient dreamed of boarding a plane with her son and although she could not describe where they were going, she reported feeling comforted. In a subsequent interview, she said that she and her son ‘‘were on the edge’’ of leaving. Although there were a few reports of distress because dreamers felt ‘‘hurried,’’ the participants primarily found this experience of preparing to go somewhere to be comforting. 

     3. Watching or Engaging With the Dead: Participants in this category described the presence of others in their dreams/visions as simply being there or watching but not engaging with the patient. For example, one patient reported that she had dreamed of her two aunts standing over and watching her while she was lying on the couch. She found this to be very comforting. There were also reports, however, where patients described themselves as engaging with people in their dreams. One patient reported that her husband and her dead sister had joined her for breakfast; she also dreamed of playing cards with her dead friends. Another patient dreamed that her father and two brothers, all dead, were silently hugging her and playing games; then she described how ‘‘they were welcoming [her] to the dead.’’ Yet another patient described a dream where he was able to play with and pet his dead dog. Again, these experiences were largely reported as comforting.

     4. Loved Ones Waiting: Some patients in the study described dead friends and relatives in their dreams as ‘‘waiting for them.’’ One woman reported that she had both waking and sleeping dreams of six dead family members in her room. She added that they were ‘‘waiting for me’’ and that it was good to see them. Three days before another woman died, she reported experiencing both waking visions and dreams of being at the top of a staircase with her dead husband ‘‘waiting’’ for her at the bottom of the staircase. Once again, the presence of these dead friends and family members was primarily experienced as comforting. There were, however, some patients who expressed that they were not ready to die. These patients experienced some distress at the fact that the dead were ‘‘waiting’’ for them.

     5. Distressing Experiences: Not all dreams/visions experienced by the patients in the study were perceived as comforting. There were also reports of distressing dreams, some of which replayed traumatic life experiences. One patient, for example, reported dreaming of his previous war experience. A second patient reported dreaming of her son’s serious injury that occurred on a naval ship. Several patients had dreams about abusive childhood experiences. Other distressing dreams were reminiscent of the difficult situations or relationships the patients had had. For example, a male patient reported having distressing dreams of his brother being very critical of him and also reported distressing,

     6. Unfinished Business: Participants also reported dreams that centered on their fears of no longer being able to do the things they felt they needed to accomplish in life. One young mother, for example, had distressing dreams of her daily responsibilities with her children. The dreams involved getting her children ready for school, getting them to practice, and other parental responsibilities. A second young mother experienced distressing dreams related to real-life worries about her bills and her children. The continuity within the dying experience of the preoccupations and experiences that had defined living is itself significant. This too speaks to the continuity of consciousness across living, dying, and death.

      Christopher Kerr, “Experiences of the Dying: Evidence of Survival of Human Consciousness,” an essay written for the 2021 Bigelow Institute for Consciousness Studies in response to the question: “What is the best evidence for survival of consciousness after bodily death?” Dr. Kerr, MD, PhD, is the Chief Medical Officer and Chief Executive Officer for Hospice & Palliative Care Buffalo. The full text with notes is available at https://bigelowinstitute.org/contest_winners3.php.