End-of-life dreams and visions (ELDVs) are a common phenomenon in which dying patients experience dreams/visions often of deceased loved ones before death. Past research has highlighted the need for education and awareness to improve clinical engagement at the bedside in response to ELDVs.
Objectives:
To explore the perspectives of multidisciplinary hospice care providers who are ELDV subject matter experts.
Design/Methods:
Semi-structured interviews with 13 multidisciplinary hospice providers were conducted and analyzed using thematic qualitative analysis.
Results:
Analysis revealed six themes: Normalization, Rapport Building, Active Listening, Individualized Meaning Making, Barriers, and Education. A secondary thematic analysis focused on defining/describing ELDVs and resulted in two themes: Natural Part of Dying and ELDV Properties.
Conclusions:
Findings identified facilitators and barriers encountered when caring for a patient with ELDVs. Based on this, an initial set of recommendations for meaningful clinical engagement regarding ELDVs and initial operationalized definition has been proposed.
FenwickP, LovelaceH, BrayneS. End of life experiences and their implications for palliative care. Int J Environ Stud, 2007; 64(3):315–323; doi: 10.1080/00207230701394458
3.
GrantP, WrightS, DepnerR, et al. The significance of end-of-life dreams and visions. Nursing Times, 2014.
4.
KerrCW, DonnellyJP, WrightST, et al.End-of-life dreams and visions: A longitudinal study of hospice patients' experiences. J Palliat Med, 2014; 17(3):296–303; doi: 10.1089/jpm.2013.0371
5.
Mazzarino-WillettA. Deathbed phenomena: Its role in peaceful death and terminal restlessness. Am J Hosp Palliat Med, 2009; 27(2):127–133; doi: 10.1177/1049909109347328
6.
NosekCL, KerrCW, WoodworthJ, et al.End-of-life dreams and visions: A qualitative perspective from hospice patients. Am J Hosp Palliat Med, 2015; 32(3):269–274; doi: 10.1177/1049909113517291
7.
BettyLS. Are they hallucinations or are they real? The spirituality of deathbed and near-death visions. Omega J Death Dying, 2006; 53(1–2):37–49; doi: 10.2190/188Q-BHFK-Q7DM-JHR4
8.
BrayneS, FarnhamC, FenwickP. Deathbed phenomena and their effect on a palliative care team: A pilot study. Am J Hosp Palliat Med, 2006; 23(1):17–24; doi: 10.1177/104990910602300104
9.
DamA. Significance of end-of-life dreams and visions experienced by the terminally ill in rural and urban India. Indian J Palliat Care, 2016; 22(2):130–134; doi: 10.4103/0973-1075.179600
10.
FenwickP, BrayneS. End-of-life experiences: Reaching out for compassion, communication, and connection-meaning of deathbed visions and coincidences. Am J Hosp Palliat Med, 2011; 28(1):7–15; doi: 10.1177/1049909110374301
11.
FenwickP, LovelaceH, BrayneS. Comfort for the dying: Five year retrospective and one year prospective studies of end of life experiences. Arch Gerontol Geriatr, 2010; 51(2):173–179; doi: 10.1016/j.archger.2009.10.004
12.
KellehearA, PogonetV, Mindruta-StratanR, et al.Deathbed visions from the Republic of Moldova: A content analysis of family observations. Omega (Westport), 2012; 64(4):303–317; doi: 10.2190/OM.64.4.b
13.
LawrenceM, RepedeE. The incidence of deathbed communications and their impact on the dying process. Am J Hosp Palliat Med, 2012; 30(7):632–639; doi: 10.1177/1049909112467529
14.
LevyK, GrantPC, KerrCW. End-of-life dreams and visions in pediatric patients: A case study. J Palliat Med, 2020; 23(11):1549–1552; doi:10.1089/jpm.2019.0547
15.
MuthumanaSP, KumariM, KellehearA, et al.Deathbed visions from India: A study of family observations in northern Kerala. Omega (Westport), 2010; 62(2):97–109; doi: 10.2190/OM.62.2.a
16.
NyblomS, ArnbyM, MolanderU, et al.End-of-life experiences (ELEs) of spiritual nature are reported directly by patients receiving palliative care in a highly secular country: A qualitative study. Am J Hosp Palliat Med, 2020; 38(9):1106–1111; doi: 10.1177/1049909120969133
17.
HessionAA-O, LuckettTA-O, ChangS, et al.End-of-life dreams and visions: A systematic integrative review. Palliat Supp Care, 2022; 1–10; doi:10.1017/S14778951522000876
18.
DepnerRM, GrantPC, ByrwaDJ, et al.Expanding the understanding of content of end-of-life dreams and visions: A consensual qualitative research analysis. Palliat Med Rep, 2020; 1(1):103–110; doi: 10.1089/pmr.2020.0037
19.
GrantPC, DepnerRM, LevyK, et al.Family caregiver perspectives on end-of-life dreams and visions during bereavement: A mixed methods approach. J Palliat Med, 2020; 23(1):48–53; doi:10.1089/jpm.2019.0093
20.
GrantPC, LevyK, LattimerTA, et al.Attitudes and perceptions of end-of-life dreams and visions and their implication to the bereaved family caregiver experience. Am J Hosp Palliat Med, 2021; 38(7):778–784; doi: 10.1177/1049909120952318
21.
MoritaT, NaitoAS, AoyamaM, et al.Nationwide Japanese survey about deathbed visions: “My deceased mother took me to heaven.”. J Pain Symptom Manage, 2016; 52(5):646.e5–654.e5; doi: 10.1016/j.jpainsymman.2016.04.013
22.
SantosCSD, PaivaBSR, LucchettiALG, et al.End-of-life experiences and deathbed phenomena as reported by Brazilian healthcare professionals in different healthcare settings. Palliat Support Care, 2017; 15(4):425–433. doi: 10.1017/S1478951516000869
23.
BarbatoM, BlundenC, ReidK, et al.Parapsychological phenomena near the time of death. J Palliat Care, 1999; 15(2):30–37.
24.
ShinarYR, MarksAD. Distressing visions at the end of life: Case report and review of the literature. J Pastoral Care Counsel, 2015; 69(4):251–253; doi: 10.1177/1542305015616103
25.
LevyK, GrantPC, DepnerRM, et al.End-of-life dreams and visions and posttraumatic growth: A comparison study. J Palliat Med, 2019; 23(3):319–324.
26.
BrayneS, LovelaceH, FenwickP. End-of-life experiences and the dying process in a gloucestershire nursing home as reported by nurses and care assistants. Am J Hosp Palliat Med, 2008; 25(3):195–206; doi: 10.1177/1049909108315302
27.
PalinkasLA, HorwitzSM, GreenCA, et al.Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health, 2015; 42(5):533–544; doi: 10.1007/s10488-013-0528-y
28.
BraunV, ClarkeV. Using thematic analysis in psychology. Qual Res Psychol, 2006; 3(2):77–101; doi: 10.1191/1478088706qp063oa
29.
HillCE. Introduction to consensual qualitative research. Consensual qualitative research: A practical resource for investigating social science phenomena. American Psychological Association: Washington, DC; 2012.
30.
HillCE, KnoxS, ThompsonBJ, et al.Consensual qualitative research: An update. J Counsel Psychol, 2005; 52(2):196–205; doi: 10.1037/0022-0167.52.2.196
31.
Claxton-OldfieldS, HicksR, Claxton-OldfieldJ. A pilot study evaluating the effectiveness of a training module designed to improve hospice palliative care volunteers' ability to deal with unusual end-of-life phenomena. Omega (Westport), 2020; 85(1):75–87; doi: 10.1177/0030222820935222
