Our dreams become more emotional and symbolic as we approach death

People in palliative care approaching death often have vivid dreams involving deceased loved ones and symbols of transition. Doctors and medical professionals who care for them say that these dreams often bring them comfort and make them less afraid of death.

These dreams “offer psychological relief and meaning to people facing the end of their lives,” Elisa Rabbitti of the Local Palliative Care Network in Reggio Emilia, Italy, and her colleagues wrote in a study.

Rabitti led a team that surveyed 239 local palliative care physicians, nurses, psychologists and others health professionals about dreams told to them by people who are terminally ill.

The most common dreams and visions that occur while people are awake involve encounters with deceased family members or pets. One woman, for example, had a dream about her late husband in which he told her: “I’m waiting for you.” These dreams provide a sense of inner peace and help people accept death, Rabbiti and her colleagues write.

Others have dreamed of doors, stairs, or light, with one describing a dream of walking up barefoot to an open door filled with white light. This may be a coping mechanism to explore and make sense of their impending transition from life to death, the study authors wrote.

Most often, people feel “calmed” and “comforted” about these end-of-life dreams and visions. Only a small number of them – about 10 percent – ​​were disturbing, including one in which one person saw a monster with her mother’s face dragging her down.

Christopher Kerr at Hospice Buffalo in New York State has also conducted research showing that dreams of deceased loved ones are very common in those who are terminally ill, and become more frequent as death approaches. “What’s really interesting is that it’s not random who comes to you – it’s always those people who loved you and provided for you,” he says. His research also found that “getting ready to go” dreams are common. For example, “patients often describe dreams of packing or getting on a bus,” he says.

End-of-life dreams and visions can “bring people back together,” says Kerr. For example, he once saw a 70-year-old woman, a mother of four grown children, move her arms as if cradling a baby while she had visions of her first child, who died stillborn. She found his loss too difficult to talk about, but his metaphysical return at the end brought her comfort. “We’ve also had a lot of veterans, and whatever wounds or burdens they’re carrying are often mentioned in their dreams at the end of their lives,” says Kerr.

The frequency of these dreams and visions increases as death approaches because “dying is a progressive dream,” Kerr believes. “(People are) in and out of sleep, which seems to make their dreams more vivid and striking – often they say it’s not a dream; the feeling is real.”

We often assume that the end of life is a sad and terrifying experience because “built into our survival is a visceral response to threat,” says Kerr. But the final weeks of a terminal illness can be rich with love and meaning, and people “inevitably come to a kind of acceptance,” he says. “One of the most striking things is the lack of fear.”