End-of-Life Experiences (ELEs)
What Are Deathbed Visions and How Do They Occur?
Deathbed visions (DBVs), also termed End-of-life Dreams and Visions (ELDVs), are phenomena reported by individuals nearing death, characterized by the perception of deceased significant others and often accompanied by telepathic interaction. They go beyond the conventional portrayal of an apparition at the foot of the bed. As part of the broader framework of End-of-life Experiences (ELEs), deathbed visions provide instant and profound comfort to dying individuals. This phenomenon cannot be detected by any observers present.
Deathbed visions can be regarded as a specific form of visual ADCs experienced by the dying, whereas the visual ADCs described above ([link active] 1. After-Death Communications (ADCs)) are reported by healthy individuals.
The functions of these two types of ADCs appear to differ. In healthy individuals, ADCs provide comfort, facilitate acceptance of a loved one's departure, and support coping with grief, whereas visual ADCs in dying individuals serve to relieve the fear of death, promote acceptance of impending death, and seem to position the perceived deceased as coming to guide them into the "spiritual world."
The visions are not always verbalized, either because the dying are too weak to speak or because they choose not to share their experience. Those present—family members or caregivers—nevertheless notice that something unusual is happening, as the patients behave in ways that indicate they are experiencing a DBV—for example, smiling, reaching out with one or both arms, or pointing toward someone or something that no one else can see. They express feelings of joy and peace, both verbally and nonverbally, for example, by smiling. It has been reported that the dying person sometimes suddenly sits up during the vision or even attempts to get out of bed—a physical effort they were unable to make shortly before the DBV.
Like ADCs experienced by healthy individuals, deathbed visions depict deceased spouses, partners, family members, or friends with whom the dying shared strong emotional bonds during their lifetime. The individuals nearing death consistently perceive only deceased loved ones, never living persons. At first glance, it may seem natural that someone approaching death would see a deceased partner, parent, or close friend; however, these visions do not appear to simply reflect the dying person's wishes, as in some cases they involve a deceased loved one whose death had been deliberately concealed to spare the patient additional distress.
Sometimes, visions of paradisiacal environments are reported, often described as sublimated terrestrial landscapes, and, far more rarely, religious or mystical entities are perceived.
During these visions, individuals nearing death appear to experience a "double vision". They seem to have simultaneous access to the physical reality and to a spiritual dimension, each perceived as equally real. They are aware that those present in the room cannot see or hear the apparitions, suggesting that their state of consciousness differs from that of healthy individuals. Fully conscious of whom they are addressing, they carry out parallel conversations, relaying the words of the deceased to those present.
Deathbed visions are brief, lasting only a few seconds or, at most, a few minutes. A parallel can be drawn with ADCs in healthy individuals, which are similarly very short in duration.
Apparitions are typically perceived in the minutes or hours preceding death, and their mention or description often constitutes the individual's final words. In some cases, however, apparitions are recurrent, accompanying the person throughout the dying process during the hours or even days before death.
Impact of Deathbed Visions on the Dying
Deathbed visions portray a deceased loved one whose mission seems to consist in escorting the dying to the spiritual world.
They :
Are immediately perceived as real by the dying
Provide instant comfort
Reassure them that they will not die alone
Free them instantly from the fear of dying
Foster serenity and acceptance of the imminent death
Seem to convey comforting information into what awaits them, bringing reassurance, joy, and peace
As for ADCs of the healthy, the dying don't question the reality of these apparitions. Despite differences in personal beliefs and life histories, they consistently assign these visions a remarkably uniform significance. To them, the apparitions' role is to welcome them at the threshold of death and guide them into the invisible world. With natural ease and joy, they receive these visitations, describing them to those around them while fully aware that they alone can perceive them. They are neither astonished nor afraid that a deceased loved one appears and speaks to them; they simply explain the apparition's purpose with unpretentious clarity: "Francis is here—he came to fetch me!"
Deathbed visions possess a spiritual dimension that extends far beyond the fleeting apparition of a departed family member or friend. They provide profound comfort and a sense of certainty, dispelling in mere seconds apprehensions that may have persisted throughout a lifetime. A transfer of information seems to occur that immediately and completely liberates the dying from the fear of death. The anguish and agitation often accompanying the dying process vanish instantaneously. In their place arises serenity—and even a premonition of joy for what is to come—that would have seemed inconceivable just moments before. The impact of deathbed visions is extremely powerful, immediate, and profoundly liberating: a deep psychic transformation takes place. After experiencing such an apparition, the individual is ready to die.
How Common Are Deathbed Visions?
Palliative care professionals, hospice volunteers, nursing home staff, death doulas, family caregivers are well aware of this phenomenon, which they describe as 'very common'. In one U.S. study, 88% of the hospice patients interviewed reported experiencing at least one end-of-life dream or vision (Kerr et al., 2014). In a Canadian study, amazingly enough, precisely the same percentage—88%—of the death doulas surveyed reported witnessing a dying person experiencing a DBV in the previous five years (Claxton-Oldfield & de Ste-Croix Killoran, 2025).
Research in this area remains limited and challenging, largely because individuals often die shortly after experiencing a vision, requiring testimonies to be collected second-hand—either from healthcare professionals or, occasionally, from the relatives of the recently deceased.
A Phenomenon Researched Over Time
Deathbed visions have been reported for centuries and have been the subject of quite extensive scientific research over time. At the beginning of the 20th century, there was considerable interest among both researchers and the public in so-called 'psychic' phenomena. The first systematic study of deathbed visions was conducted by Sir William Barrett, Professor of Experimental Physics at the Royal College of Science of Ireland. In 1926, he published a milestone book entitled "Death-bed Visions" (Barret, 1926).
Years later, Erlendur Haraldsson, Professor Emeritus of Psychology at the University of Iceland, and Karlis Osis, a Latvian-born parapsychologist, conducted decades-long studies of deathbed visions. In 1971, they published the landmark book At the Hour of Death describing their research on deathbed visions in the United States and India. They concluded that deathbed visions are more consistent with the hypothesis of a transition experience rather than with the "extinction hypothesis" (Osis & Haraldsson, 1977).
More recently, in 2006, the results of a pilot project on End-of-life Experiences (ELE), conducted by Professor Emeritus Peter Fenwick of the Institute of Psychiatry and Department of Neuropsychiatry, Kings College, London, and his team, in collaboration with a palliative care team from the Camden Primary Care Trust, were published. The findings indicate that death is a transitional process that can be heralded by various phenomena, including visions that comfort the dying and prepare them spiritually for death. The pilot project found that patients regularly reported visions at the time of death as an intrinsic part of the dying process they were engaged in, and that they were generally more serene when in the company of their "secret visitors". The findings also state that deathbed visions are not caused by pathologies or drugs, and that dying individuals generally prefer to discuss them with nurses rather than doctors. Furthermore, the researchers suggest that people at the end of life may choose not to speak about their visions due to fear of disbelief or ridicule, concern for worrying their loved ones, or because of the lack of public recognition of the phenomenon (Brayne, Farnham, & Fenwick, 2006).
Nearing-Death Awareness (NDA)
Two American palliative care nurses, Maggie Callanan and Patricia Kelley, elaborated a concept that situates deathbed visions within the broader framework of Nearing-Death Awareness (NDA), also called Near-Death Awareness, of which these visions are a central component. This phenomenon concerns individuals who die gradually—due to illness or old age—rather than those who die suddenly, such as in accidents or during cardiac arrest. The concept, describing an expanded state of consciousness associated with the proximity of death, is presented in their book Final Gifts (Callanan & Kelley, 1997). These experiences occur within the larger context of end-of-life experiences (ELEs).
During NDA, dying individuals appear to acquire specific knowledge that, within certain limits, enables them to modulate the dying process. NDA encompasses several key elements, with deathbed visions being the most prominent.
The need for reconciliation is another key component of this enlarged state of consciousness. Those nearing the end of life primarily experience relational needs, feeling the necessity to resolve pending conflicts that burden them, stir guilt, and cause suffering for everyone involved. This awareness prompts efforts to restore harmony, resolve lingering issues, and achieve closure in their final days.
Conditions for dying in peace are also an integral part of this specific state of consciousness associated with the proximity of death. Dialogue is essential during this phase of preparation for death. As long as the omnipresent subject—the imminence of death—is avoided, the dying remain isolated and agitated, alone with their questions and, often, their fears. Once the reality of impending death is openly acknowledged and shared with family and friends, even if the topic is painful and difficult, the dying feel less alone and can engage in final, important exchanges with loved ones, restoring a sense of intimacy and shared complicity.
Awareness of the proximity of death also often enables individuals to instinctively anticipate the moment of their passing with remarkable precision, even when their medical condition does not predict imminent demise. This certainty often seizes them during the final 72 hours. Many dying individuals appear to exercise subtle control over the timing of death, for example, by waiting for the arrival of a relative, passing away the day before the long-feared move to a nursing home, or choosing to die just after family or friends have briefly left the hospital room.
As first described by Elisabeth Kübler-Ross in her ground-breaking book On Death and Dying (1969), individuals nearing the end of life often use symbolic language to announce their impending death. They employ metaphors about an upcoming journey—speaking of needing a passport, booking a plane ticket, taking a boat or a bus. All too often, these words are mistakenly dismissed as mere confusion (which may indeed be part of the dying process) and are not taken seriously or properly understood.
Collectively, these phenomena indicate that Nearing-Death Awareness is not only perceptual but also relational and existential, encompassing visions, need for emotional reconciliation, and an intuitive understanding of the dying process. The study of NDA underscores the complexity of the dying process and emphasizes the importance of sensitive recognition and support from family members and caregivers.
Shared Death Experiences (SDEs) / Shared Crossing Experiences (SCEs)
A Shared Death Experience (SDE) occurs when a loved one or caregiver appears to experience the first stages of entering an afterlife alongside a person who is dying or has just died. The term was coined by Raymond Moody, M.D., whose research found that SDEs share many features with near-death experiences (NDEs). Dr. Moody discusses SDEs in his book Glimpses of Eternity (2010).
Building on this work, the Shared Crossing Project—founded by William Peters—studies unusual experiences reported around the moment of death, particularly when loved ones or caregivers feel they share the dying person's transition. The project prefers the term Shared Crossing Experience (SCE) to highlight death as a transition rather than an ending, although "shared death experience" is still often used interchangeably.
An SCE refers to a type of end-of-life phenomenon in which someone close to a dying person experiences aspects of the dying process alongside them.
Reported experiences include:
Feeling as if they accompany the dying person toward a light or another realm
Seeing deceased relatives or spiritual figures appear
Sensing the person's spirit leaving the body
Experiencing a sense of peace, unity, or connection at the moment of death
These experiences most commonly occur among:
Family members
Close friends
Hospice workers or nurses
For more information, see the Shared Crossing Project https://www.sharedcrossing.com/
Terminal Lucidity
Definition
Terminal lucidity (TL) refers to a sudden, brief return of mental clarity and coherent behavior shortly before death in individuals with severe neurodegenerative, psychiatric, or neurological disorders. Patients who have experienced prolonged cognitive decline—such as in advanced dementia or late-stage schizophrenia—may unexpectedly regain clear thinking, memory, meaningful communication, or recognition of loved ones.
TL is conceptually related to paradoxical lucidity, which describes unexpected cognitive improvement in severely impaired individuals regardless of proximity to death. TL specifically denotes episodes occurring shortly before death, while paradoxical lucidity can arise outside the dying phase.
Phenomenological Characteristics
TL typically lasts from minutes to several days and may involve coherent speech, accurate autobiographical memory, social engagement, and recognition of familiar persons after extended unresponsiveness. Although most often described in dementia, it has also been observed in advanced cancer and other terminal neurological conditions.
The episode usually occurs hours to days before death; studies suggest approximately 43% of individuals die within 24 hours and 84% within one week after experiencing terminal lucidity.
Historical context
Accounts of mental clarity before death date back to antiquity, including descriptions by Hippocrates and later physicians. In the 19th century, medical literature documented similar cases in chronically unresponsive patients. The phenomenon has also been termed premortem clarity, last rally, or energy surge. The term terminal lucidity was formally introduced into clinical literature by Nahm and Greyson in 2009.
Emotional Implications
TL remains a rare and remarkable phenomenon that offers a final glimpse of a person's cognitive capacities shortly before death, underscoring the complexity of consciousness and the end-of-life experience.
Witnessing terminal lucidity can evoke a wide range of emotions, from joy at reconnecting with a loved one to grief as death approaches. Because this phenomenon is largely unrecognized outside medical contexts, family members and friends of terminally ill patients often interpret this sudden return of cognitive clarity as a genuine improvement in the patient's condition—only to realize minutes or hours later that it was, in fact, a final moment of lucidity shortly before death. This misunderstanding can trigger intense emotional responses, including both the disappointment of false hope and the gratitude and comfort associated with one last meaningful interaction.
Scientific Understanding
Although well documented in historical and clinical reports, terminal lucidity remains poorly understood and under-researched, with most evidence anecdotal or qualitative.
Nevertheless, TL has important implications for palliative care, end-of-life counseling, and family experiences, influencing prognosis, care planning, and emotional preparation. It presents opportunities for meaningful interaction but also challenges in interpreting temporary cognitive improvement.
Researchers are investigating neurobiological mechanisms behind this sudden cognitive reversal, though no consensus exists. TL challenges assumptions about irreversible cognitive decline and raises ethical considerations in end-of-life care, including sedation and family interaction.
From an academic perspective, terminal lucidity challenges existing models of brain-behavior relationships, as it occurs despite extensive structural and functional brain damage.