A REM Intrusion Model for Death Bed Visions: A Palliative Nursing Perspective

Abstract

Nurses often face the end of life conditions in resulting from several etiologies. It may be the end of life situations in chronic debilitating conditions like renal failures, oncological conditions and even progressive old age as such. Often around the clock nursing remains the primary mode of care for such patients. End of life care is complicated by several psychological and physical conditions. One of these psychological conditions which remain poorly understood is the presence of unusual end of life experiences where the exact role of nurses becomes controversial. In this article, we present a review of present literature on the end of life experiences. We will introduce by highlighting the importance of nursing position in observing these experiences. Subsequently, we will touch the neurobiological and psychological theories of near death experiences. We will then move towards the similarities between near death experiences and end of life dreams and visions. We will then elaborate on the REM intrusion model for near death experiences (NDEs). Finally, we will propound a REM intrusion model for end of life dreams and visions (ELDVs) and will see that the conditions of End of life predispose the patients for developing REM intrusions. Additionally, this model explains many of the features of ELDVs in both the phenomenological and neurological contexts.Key Words: death bed visions, end of life dreams, end of life visions, near death experiences, REM intrusion, neurobiology