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Near Death Awareness

A few years ago, I read a book that had a huge impact on the way I look at those persons I work with who are facing the end of their journey.  I heartily recommend it to anyone who is dealing with a person or persons who are facing a potentially terminal illness.  It’s called “Final Gifts,” written by two hospice nurses by the names of Maggie Callanan and Patricia Kelley.  The book deals with a phenomenon called “Near Death Awareness,” where a person communicates to others that he/she is approaching death.  It’s something I’ve witnessed time and time again, as have many of my co-workers who have been around this population for a while.

Some of the ways that these individuals communicate their NDA are as follows:

1)  They talk about seeing people that have gone before — their parents, a spouse, a good friend, etc.  Or they may talk about seeing angels or Jesus.

2)  They talk about seeing where they are going.

3)  They talk about getting ready for a trip.  This might mean packing, or getting in line, or needing to find a map.

4)  They talk about needing to finish something, or perhaps need to see someone in particular.

5)  Or, they need to accomplish certain rituals to prepare for death.  This may or may not be based on religion.

I’ve seen many of these things personally.  A man with ALS, who had always been extremely diligent about making sure that his family was provided for, needed to be assured that everything had been done that could be done.  A 95-year-old man spoke of seeing his mother.  A woman told her nurse that she saw angels around her bed.  And those who have worked professionally with this population can probably tell other stories of NDA in action.

It’s easy to say that a person is confused, and perhaps hallucinating, when they speak of these things.  I’ve seen staff chide a woman who talks of seeing her mother.  “You’re 85 years old.  Your mother died a long time ago.”  And, to tell the truth, that irks me.  I don’t know if she is having a hallucination, or seeing someone she wants to see, or if the death process triggers something in the brain, or if something else altogether is going on.  But she truly believes her mother was there, and it’s not going to help anything for me to take that away from her.

Those who have studied such things say that the purpose is to help the person get ready for death.  NDA visions do seem to differ from hallucinations in some fairly significant ways.  For example, the person can stop conversing with an absent relative and pay attention to what is happening in the room.  And the person rarely sees an absent living relative; it’s always a person who has previously died.  On occasions, a person may speak of seeing a relative who was thought to be still alive, but who turns out to have passed away recently.  These encounters can actually be very comforting to the person who is experiencing them, if they are allowed to talk about them.

People who are drawing close to death will often review their lives, sometimes in great detail.  And often what is most important in their lives are the relationships they have been a part of in the past.  The person may want to discover what they have learned as they went through life.  Forgiveness and reconciliation are often very important.  The process of saying good-bye to this life, and all that it encompasses, begins in earnest.

I’ve been a witness to this process even in a person with advanced dementia, who may no longer be able to communicate verbally, and who may be bedbound and seemingly little aware of what is going on around them.  A man may suddenly smile broadly, and reach out to something or someone unseen.  Or he may seem to struggle to hold onto life for some unknown reason, until that daughter he hasn’t seen in years comes to offer her love.  As always with this group, the non-verbal is just as important as the verbal.

When someone you care about seems to be at this stage in her life, try to be sensitive to how much they want to talk about it, or how much company they want.  Her skin will most likely become very sensitive; even a gentle touch may seem irritating.  It may be better just to sit and hold her hand.  She may withdraw from the outside world, and seem to focus more and more on something inside herself.  It is not uncommon for people at this stage to appear to choose the actual moment of their dying, often when their loved ones leave the room for a moment.  (Yes, I’ve seen that happen over and over.)    But, these final moments together can often provide some of the most powerful and rewarding interactions that two people may share in their lifetimes.

After the person has died, it’s not at all unusual for those close to her to continue to feel her presence.  Friends and loved ones who were not present at the moment of death may receive a notification of death, or they may detect a familiar scent or hear a voice or see an image.  And it is not at all unusual for a recently deceased loved one to alert friends or family of some impending disaster.  I know of a woman who saw a vision of her beloved grandmother, years after her death, who appeared to congratulate her on her recent marriage.

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