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End-of-life dreams and visions

2 min read

One of the Cognitive ghosts discussed in the The Rest Is Science episode “Cognitive Ghosts”.

What it is

In their final weeks, days, and hours, a large majority of dying people report vivid, meaningful dreams and visions — most often of deceased loved ones who seem to come to welcome or reassure them, or of journeys (packing bags, waiting for a train, searching for a passport). Unlike confusion or delirium, these experiences are typically coherent, comforting, and remembered as more real than ordinary dreams. The episode treats this as one of the most moving cognitive ghosts — and one science still can’t fully explain.

What’s happening in the brain

Several non-exclusive theories are floated. The dying brain may be compensating for failing sensory input by generating its own rich internal imagery; endogenous endorphins / psychedelic-like neurochemistry may mask the pain of organ failure and produce profound experiences; and, as in Life flashing before your eyes, surges of gamma-wave activity in the final days may underlie unusually vivid mentation. The hosts are careful to leave room for mystery — “there are still so many unanswered questions.”

References from the show

  • Dr. Christopher Kerr — CEO/CMO of Hospice & Palliative Care Buffalo, who spent over a decade systematically documenting these experiences in ~1,400 dying patients. In his landmark study, around 88% of patients reported at least one end-of-life dream or vision, and the overwhelming majority found them comforting and reported less fear of dying.
  • Common themes the show lists: a “welcoming committee” of the dead; journeys; and the resolution of past trauma or estrangement ending in forgiveness.
  • Book: Christopher Kerr & Carine Mardorossian, Death Is But a Dream (2020); see also his widely-viewed TEDxBuffalo talk and the Netflix series Surviving Death.

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