End-of-life doctor what it’s really like in the days before you die – and why it’s nothing to be scared of
DEATH is something we cannot avoid thinking about, whether we want to or not.
It is a huge part of our lives and is one of the only things we are all guaranteed to experience one day.
The process can seem scary, as we don’t know what will happen to us.
However, according to an end-of-live doctor, the process can be quite cathartic.
Palliative care physician Dr Christopher Kerr, from New York, US, has been studying end-of-life events for years.
He said patients usually have dreams that help them make peace with their life decisions or traumatic events, such as losing a child or fighting in a war.
This usually involves being reacquainted with a loved one or forgiven by someone, which helps put people’s minds at ease during their final moments.
“We’ve all been harmed in one way or another for having lived, and we seem to get put back together through these experiences,” he explained.
“And so the life you live gets validated, and inversely, the fear of death seems to lessen.”
Not all these end-of-life experiences are comforting-per-see and can instead be pretty harrowing.
“But it’s these dreams that are often the most transformational or meaningful,” he said.
What an ex-drug addict saw
Speaking on the podcast Next Level Soul, Dr Christopher said: “We had a guy in his 40s who had spent most of his life in prison.
“He had drug addictions, and he had head and neck cancer.
“He was dreaming, he was joking, he was very jovial… and then he starts crying because he’s having these horrible dreams [that] he’s being stabbed by all the people he’s hurt… and he breaks down.”
Just because you are dying doesn’t mean you stop living.
Dr Christopher Kerr
“But then when he comes out of it, he asked to see a daughter that he wants to express his love towards, and apologise,” Dr Christopher said.
“And after that he died peacefully.”
Dr Christopher’s research team from Hospice & Palliative Care Buffalo has published several studies on this topic and documented over 1,500 end-of-life events, many of which are recorded.
What a mother saw
He spoke of another patient, a mother, who was doubting her worth after her children had spent time in prison for drug-related crimes.
“During her end-of-life, her parents came to her and told her what a good mother she was,” the expert said.
In Dr Christopher’s view, patients who have experienced “bad and painful things” do not deny them at this stage. Instead, they use them in a “way that is very interesting”.
What a war veteran saw
He mentioned another patient who had been involved in the invasion of Normandy in 1944 in his teens.
He had been suffering from post-traumatic stress disorder (PTSD) – a form of anxiety caused by frightening or distressing events – ever since.
“He came into our unit at the end of his life… he had such horrific experiences where he’s seeing body parts and bloody water and screams, and he couldn’t rest.’
“You can’t die unless you can sleep. It’s pretty hard to do because you just pass in sleep,” he explained.
But one day, the patient did manage to sleep briefly, and Dr Christopher asked him what he had dreamed about.
“He goes, ‘I had a great dream, where I relived the best day of my life,’ which was the day he got his discharge papers.”
“And I had a really good dream, presumably in Normandy, and a soldier who he didn’t know came up to him and said, ‘No, we’re going to come get you.'”
After that, the man slept peacefully and died in his sleep, Dr Kerr said.
“So that sense that he had abandoned people had gone full circle,” the physician added.
The soldier had gone through something which Dr Christopher coined “post-traumatic growth”, where people grow and learn from negative or traumatic experiences.
He said people who experience this traumatic event at the end of their lives continue to learn and gain knowledge “right to the very end.”
“Just because you are dying doesn’t mean you stop living,” he explained.
“You do some intense living in that latter period.”
What children see
Children have a very different end-of-life experience, the medic explained, possibly because they don’t have a grip on the finality of death.
Dr Chirtsopher said children often see animals who reassure them they are “loved and not alone.”
“Children are creative and imaginative and can access that part of them,” he said.
One patient, a young girl, thought up an entire scene of things she loved surrounding her while in lay in her hospital bed.
“She created a castle for herself… there was a swimming pool, the animals were returned, there’s a piano, there was a window with warm light coming through,'” the medic said.
“When I asked, ‘What does the castle represent?’ she said, ‘A safe place.'”
What is end-of-life care?
END-of-life care is support for people who are in the last months or years of their life.
It should help you live your last days as well as possible and help you die with dignity, according to the NHS.
Depending on your needs, different health and social care professionals may be involved in your end-of-life care. They can include hospital doctors and nurses, your GP, hospice or social care staff, chaplains, and physiotherapists.
End-of-life care can last a few days or months, or sometimes more than a year.
Though it isn’t always possible to predict, people are considered to be approaching the end of life when they are likely to die within the next 12 months.
This includes people who might die imminently, as well as people who:
- Have an advanced incurable illness, such as cancer, dementia or motor neurone disease
- They are generally frail and have co-existing conditions that mean they are expected to die within 12 months
- Have existing conditions if they are at risk of dying from a sudden crisis in their condition
- Have a life-threatening acute condition caused by a sudden catastrophic event, such as an accident or stroke
If you are approaching the end of life or caring for someone who is and want to find out about the care and support available, your first step is to speak to your GP or call the number your healthcare professionals have given you.
They can help you understand the services available to you locally