Dr. David Tribble

It is quite common that folks approaching death speak of encounters with those already dead. Traditional medicine holds these to be hallucinations, and usually seeks to suppress them with medications. 

We, who deal with dying patients regularly, know this to be such a common part of the dying process that it has its own name: near-death awareness. Rather than being frightening, as hallucinations frequently are, these visions are usually comforting and reassuring for the patient. 

Patients who experience near-death awareness may become quite insistent that something must have happened, and it is sometimes difficult to determine just what that is, as it may be very symbolic. But the effort to solve the puzzle is worthwhile, as it may be more effective than medication in accomplishing a peaceful death.

Most importantly, such episodes are not craziness or delirium. They are a common part of dying.  Whether or not we are prone to see the mystical in these events, we should understand them as a normal part of the dying process, recognize that they are not distressing to the patient, and avoid medicating them, where we can.

Dr. David Tribble is Alive Hospice’s chief medical officer.