End of life experiences and their implications for palliative care

Anecdotal evidence suggests that death may be heralded by phenomena which seem to comfort dying persons and prepare them spiritually for death. Medical practitioners have been slow to recognize these end of life experiences (ELEs) and there has been little research into the way carers respond when patients try to talk about phenomena they have experienced, and how these ELEs influence the carers' work. A pilot study with a palliative care team revealed that patients regularly report these phenomena as an important part of their dying process, and that the experiences are far broader than the traditional image of an apparition at the end of the bed. The study suggested that many Palliative Carers are not trained to help them recognize the wider implications of ELEs, or to deal with difficult questions or situations, which arise from them. Many ELEs may go unreported because of this. The pilot study also suggested that ELEs are not drug-induced, and that patients would rather talk to nurses than doctors about their experiences. There are many subjective phenomena in common between ELEs and near death experiences suggesting that they may form part of a single process. © 2007 Taylor & Francis.