What is Near Death Awareness in Hospice Care?

Near death awareness in hospice is a term used to identify the special occurrences that sometimes happen to dying people. They report seeing and hearing things that others don’t see or hear. They may have dreams or see visions that have significant meaning for them.

Why does this happen? What does it mean? From the medical and scientific to the spiritual and supernatural explanations, there are more questions than answers.

hospice death awareness

Many people who experience near death awareness feel peaceful, calm and reassured afterwards. Loved ones, families, and friends also find great comfort and hope by sharing in their experience.

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Signs and Symbols of Near Death Awareness in Hospice: What to Look Out for in the Dying

People who are experiencing near death awareness may:

  • State that they have seen or spoken to those who have already died.
  • Speak to people and see places not visible to you.
  • Talk aloud to people who have died before them such as their mother, father, or friend.
  • Describe seeing spiritual beings, bright lights, or animals, birds, butterflies, or something else that is symbolic or meaningful to them.
  • Make “out of character” statements, gestures, or requests.
  • Describe another world of peace and beauty.
  • Tell you exactly when they will die.
  • Make hand gestures, reach for or hold unseen objects, or wave to unseen beings.
  • Appear to see someone or something in the room that you cannot see.
  • Talk about going on a trip, packing luggage, or buying tickets for travel.
  • Appear confused and disoriented.

These behaviors do not necessarily mean that the dying person is confused or hallucinating. Near death awareness is often a sign that a person is beginning to transition from this life. The messages from the dying person are often symbolic. They may see tell you they saw a bird take wing and fly out their window. Sometimes they may be looking for healing in a broken relationship and report seeing a person whom they were estranged.

hospice death awareness

Understanding the Symbolism of Dying Messages

These messages of the dying may be a symbolic way to ask for permission to die or to address an end of life need. Maybe they are looking for a way to say goodbye, or address an issue they regret. What is said often has meaning to the dying person and is linked to their own life experience. For example, if they traveled a lot, they may say, “I need to pack my bags” or “I need to get on the plane.” A person who was a boater may talk about the tide going out or getting on a ship.

You Can:

  • Listen. Do not contradict, explain away, correct, or argue. Just listen, it isn’t necessary to say anything.
  • Be present with the person. Simply sit at their bedside and be open to their attempts to communicate.
  • Listen attentively and sensitively and acknowledge the experience. For instance, if a person says “I need to catch the train now.” You might respond by saying, “Yes, I know you want to catch the train now.”
  • Go beyond the details of the story to connect to the feelings that are being shared. “Do you feel you are ready to leave?”
  • Ask gentle questions about what they are saying or doing, such as “Who do you see? What are you seeing?”
  • Allow the person to share this experience with you without judgment and without correction. You may be in the best position to understand what is being said.
  • Work with your Hospice team anytime for more information or support.


How long does near death awareness last?

Near death awareness, a phenomenon experienced by some individuals nearing the end of life, can vary in duration. This condition may last a few minutes to several hours but has persisted for days in some patients. The duration depends on the patient’s medical condition and the nature of their experience. Due to its subjective nature, providing a precise timeframe for near-death awareness is difficult.

Can hospice tell when death is near?

Through their experience and knowledge of end-of-life care, hospice professionals can often recognize signs that death is near. These signs may include increased physical weakness, breathing changes, skin color or temperature, and decreased responsiveness. However, an exact prediction of death is not possible. The hospice team’s primary focus is to provide compassionate care and support for the patient and their loved ones at the end of a patient’s life.

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