Visitors At The End Of Life

This book is about how, when, and why our dead visit us. Allan Kellehear--a medical sociologist and expert on death, dying, and palliative care--has gathered data and conducted studies on deathbed visions across cultures.

About 30 percent of hospice patients report a “visitation” by someone who is not there, a phenomenon known in end-of-life care as a deathbed vision. These visions can be of dead friends or family members and occur on average three days before death. Strikingly, individuals from wildly diverse geographic regions and religions—from New York to Japan to Moldova to Papua New Guinea—report similar visions. Appearances of our dead during serious illness, crises, or bereavement are as old as the historical record. But in recent years, we have tended to explain them in either the fantastical terms of the supernatural or the reductive terms of neuroscience. This book is about how, when, and why our dead visit us. Allan Kellehear—a medical sociologist and expert on death, dying, and palliative care—has gathered data and conducted studies on these experiences across cultures. He also draws on the long-neglected work of early anthropologists who developed cultural explanations about why the dead visit. Deathbed visions conform to the rituals that underpin basic social relations and expectations—customs of greeting, support, exchange, gift-giving, and vigils—because the dead must communicate with us in a social language that we recognize. Kellehear emphasizes the personal consequences for those who encounter these visions, revealing their significance for how the dying person makes meaning of their experiences. Providing vital understanding of a widespread yet mysterious phenomenon, Visitors at the End of Life offers insights for palliative care professionals, researchers, and the bereaved.

The first book to validate the meaningful dreams and visions that bring comfort as death nears. Christopher Kerr is a hospice doctor. All of his patients die. Yet he has cared for thousands of patients who, in the face of death, speak of love and grace. Beyond the physical realities of dying are unseen processes that are remarkably life-affirming. These include dreams that are unlike any regular dream. Described as "more real than real," these end-of-life experiences resurrect past relationships, meaningful events and themes of love and forgiveness; they restore life's meaning and mark the transition from distress to comfort and acceptance. Drawing on interviews with over 1,400 patients and more than a decade of quantified data, Dr. Kerr reveals that pre-death dreams and visions are extraordinary occurrences that humanize the dying process. He shares how his patients' stories point to death as not solely about the end of life, but as the final chapter of humanity's transcendence. Kerr's book also illuminates the benefits of these phenomena for the bereaved, who find solace in seeing their loved ones pass with a sense of calm closure. Beautifully written, with astonishing real-life characters and stories, this book is at its heart a celebration of our power to reclaim the dying process as a deeply meaningful one. Death Is But a Dream is an important contribution to our understanding of medicine's and humanity's greatest mystery.

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Our experiences of dying have been shaped by ancient ideas about death and social responsibility at the end of life. From Stone Age ideas about dying as otherworld journey to the contemporary Cosmopolitan Age of dying in nursing homes, Allan Kellehear takes the reader on a 2 million year journey of discovery that covers the major challenges we will all eventually face: anticipating, preparing, taming and timing for our eventual deaths. This book, first published in 2007, is a major review of the human and clinical sciences literature about human dying conduct. The historical approach of this book places our recent images of cancer dying and medical care in broader historical, epidemiological and global context. Professor Kellehear argues that we are witnessing a rise in shameful forms of dying. It is not cancer, heart disease or medical science that presents modern dying conduct with its greatest moral tests, but rather poverty, ageing and social exclusion.

Includes bibliographical references and index.

David Kessler, one of the most renowned experts on death and grief, takes on three uniquely shared experiences that challenge our ability to explain and fully understand the mystery of our final days. The first is "visions." As the dying lose sight of this world, some people appear to be looking into the world to come. The second shared experience is getting ready for a "trip." The phenomenon of preparing oneself for a journey isn’t new or unusual. In fact, during our loved ones’ last hours, they may often think of their impending death as a transition or journey. These trips may seem to us to be all about leaving, but for the dying, they may be more about arriving. Finally, the third phenomenon is "crowded rooms." The dying often talk about seeing a room full of people, as they constantly repeat the word crowded. In truth, we never die alone. Just as loving hands greeted us when we were born, so will loving arms embrace us when we die. In the tapestry of life and death, we may begin to see connections to the past that we missed in life. While death may look like a loss to the living, the last hours of a dying person may be filled with fullness rather than emptiness. In this fascinating book, which includes a new Afterword, Kessler brings us stunning stories from the bedsides of the dying that will educate, enlighten, and comfort us all.

Once it was difficult to see end of life care beyond conventional medical intervention, but hospice and palliative care introduced a more holistic approach, providing quality of life for the dying and their families. This ground-breaking work takes end-of-life care beyond these palliative boundaries, describing a public health vision that involves whole communities adopting a compassionate approach to dying, death and loss. Written by a leading academic in the field of death and bereavement, this text outlines the historical, political and conceptual basis of compassionate cities, providing a community development model for end-of-life care. Moving away from infection control and health promotion Allan Kellehear invites us to think of a third wave movement of public health, joining empathy, equality and action together as practical policies. Presenting a radical new perspective to death, ageing and public health, Compassionate Cities is essential reading for academics and professionals alike.