Expanding the Understanding of Content of End-of-Life Dreams and Visions: A Consensual Qualitative Research Analysis

Abstract

Background: Research has established End-of-Life Dreams and Visions (ELDVs) as prevalent, meaningful valid experiences that may help patients cope with illness and approaching death. However, no inductive qualitative analysis has explored the phenomenology of ELDVs from the perspective of hospice homecare patients. Objective: The purpose of this study is to evaluate the content of ELDVs by using a rigorous qualitative approach. Design: Five hundred forty-eight ELDVs were collected from weekly interviews of hospice homecare patients and analyzed by using Consensual Qualitative Research Methodology. Settings/Subject: Participants were enrolled in a county-wide hospice homecare program between January 2013-March 2015. Results: The following domains emerged: (1) Interpersonal, (2) Affective Experience and Reflection, (3) Activities, and (4) Setting/Location. Conclusions: This study suggests that ELDV content may include a broader spectrum of experiences that reflect waking life than previously believed. Clinical implications suggest that it may be important for providers to engage with ELDVs, as they are psychologically significant experiences that may be a source of clinical insight.

The Importance of the Exceptional in Tackling Riddles of Consciousness and Unusual Episodes of Lucidity

“…On the side of the moribund person, they include visions of deceased loved ones or religious figures who appear to prepare the dying for their transition (near-death visions or deathbed visions), vivid and usually comforting dreams of similar content, perceiving unusual luminous phenomena or hearing inexplicable music, and an unexpected appetite and desire to eat. On the side of the bystanders, they include the sharing of near-death visions (shared death experiences), perceiving unusual lights or music as well, noticing synchronistic events such as the stopping of clocks and malfunctioning of electronic devices, or in case of absence, the distinct sensation that the moribund person has just passed away (for a selection of academic sources on ELEs from only recent years, see e. g. Claxton-Oldfield & Dunnett, 2018;Claxton-Oldfield & Richard, 2020;Depner et al, 2020;Grant et al, 2020Grant et al, , 2021Klein et al, 2018;Levy et al, 2020;Lim et al, 2020;Renz et al, 2018;Shared Crossing Research Initiative [SCRI], 2021, 2022. Although some of these phenomena are likely to be dismissed as irrelevant or hallucinatory by some, building bridges between the field of research into paradoxical lucidity in dementias and the field of ELEs is essential for facilitating knowledge exchange.…”

Terminal Delirium in Hospice: The Experiences and Perspectives of Caregivers Providing Care to Terminally Ill Patients in Home Settings

“…26 The same lack of knowledge relates to the confusion of caregivers over distinguishing TD or misinterpreting it for EOL dreams, and visions. 27 Practical education is needed on how to approach the care of delirious patients and to respond to a patient's visions, anxiety, and restlessness. Understanding of delirium-to recognize it and know how to respond to it-contributed to better caregiver coping and greater confidence.…”

Shared Death Experiences: A Multicultural Survey

“…These experiences are distinct from the so-called end-of-life-experiences, in particular endof-life dreams and visions, which occur to both adults and children during their dying process (Depner et al, 2020;Renz et al, 2018).…”