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A deathbed vision is one of the most mysterious events known to occur around the time of death. It is usually, but not always characterised by a vision of a pre-deceased relative, and feelings of overwhelming love, joy and peace. Occasionally the vision may be of someone the dying person does not recognise, a religious being, a bright light, a bird or a vehicle of travel such as a car, boat, bus or train. Rarely there is nothing to see, only the sound of music or a voice speaking to them. In the majority of cases the visions are of great comfort to the dying person, but occasionally they are frightening only because of the way they are interpreted. Hellish or truly frightening visions have been reported, but after 20 years in palliative care I have not had a single person describe such an experience. I have certainly been told of visions that were disturbing, only to find the interpretation changed after the person had the time and opportunity to explore its meaning – the comforting message is often missed because it is disguised or buried in symbolism.

Contrary to what the name suggests deathbed visions are not confined to the deathbed scene. They have been described days, weeks and even months before death, but are, without doubt, commonest around the time of death. The true ‘deathbed’ vision may, however be overlooked simply because the dying person is too weak to describe their experience or to react to it. The few that I have been privileged to witness were remarkable – the person rises, Lazarus-like, from their bed, stares ahead as if looking at a something or somebody, smiles and then lies down and dies.

The cause of deathbed visions is open to speculation, and a number of explanations have been offered. Suffice to say, none of the current theories adequately explain why they occur, let alone their content. It is an important area of investigation, for deathbed visions are clearly important in the debate surrounding life after death. In the absence of any credible explanation however, we must be patient and open to all possibilities, medical or transcendental. In the meantime, we at the bedside should not be distracted from a more pressing issue – what does a deathbed vision mean for the person having one? There is nothing so discouraging for a dying person to hear someone suggest or imply their experience is due to morphine, the effects of the cancer or some other spurious cause (as a matter of interest, morphine and other pain relievers may cause hallucinations, but are not a factor in deathbed visions). If a person describes a deathbed vision our task is to listen attentively, and when they have finished we should ask what it means to them – for that is what they need to share. The experience should be validated and normalised, not investigated or trivialised.

Those who have read Reflections of a setting sun will recognise the following anecdote. The words were spoken by an elderly Italian matriarch (Nina) whose family had insisted she not be told that she was dying of cancer. As she gazed upon a scene, invisible to everyone else in the room, she gesticulated and, directing her words to the family, she gleefully announced, “my bags are packed, my boat has come, I am going on a beautiful holiday and none of you can come with me.” In this case, it was not Nina, but the family who needed to have the vision validated and normalised. Once they knew the significance of the vision they were, for the first time, able to speak openly to Nina about her illness and impending death. The vision was ultimately healing for them as well as Nina.

As in this case, deathbed visions sometimes use symbolism as a way of conveying their message. The symbolism is, as a rule, easily understood by the person having the vision, is delivered in a non-threatening manner and is always appropriate to their age, cultural, religious and spiritual beliefs. Rarely is the message obtuse, but when it is, talking about the experience always brings clarity and comfort. Because of this symbolism, deathbed visions can be mislabeled by doctors as hallucinations and treated accordingly. Hopefully, as doctors become more aware of them, this unnecessary and unhelpful approach will become a thing of the past.

As mentioned already, the most important feature of a deathbed visions is their potential for healing. With impending death, sadness and fear usually dominate the emotional life of the dying person (also their family and friends). This can change dramatically following a deathbed vision. A sense of peace and acceptance comes and in some cases this may be accompanied by joy-filed expectation, particularly when the vision features a much loved pre-deceased relative. I realise this is hard to believe, but, as with the Nina, deathbed visions can be transformative. They are truly a precious gift for those who are dying.

Michael Barbato

Read more: http://caringforthedying.iinet.net.au/essays5.html