In The Health Care Setting, 2002
General ways to be helpful:
- Anticipate possible NDEs in post-CPR (cardiac
arrest) situations and in the last days of
life in a terminally-ill person.
- Ask open-ended questions such as "Do
you wonder about anything that occurred during
your CPR?" and then be guided by their
responses to your question. Merely asking
the question initially may be what they need
at that time to know that you are available
for discussions when they feel ready.
- Be alert for changes in the patient after
a CPR such as withdrawn behavior, increased
sensitivity to noise or violence (such as
an aversion to watching violent television
programs or the news.) If you notice those
behaviors, establishing general rapport with
them and sitting in silence are often helpful
in assisting a person in opening up in sensitive
- In the hospice setting in particular, be
aware of signs that a person is conversing
with someone that you don't see. Don't interrupt
them at the time, but ask an open-ended question
about it later.
- Have a strong base of information so that
you can answer their questions in a matter-of-fact
and factual way.
- NDEs are extremely common. In a Gallup
poll in 1982, 5% of adult Americans had
experienced a NDE. That extrapolates to
about 8,000,000 people in America in 1982.
In people who had undergone CPRs, 35%
of those people reported a NDE. Since
our resuscitative attempts are continuing
to be more successful with advanced technology
and the increased knowledge of basic CPR
in the general population that has led
to an increased success rate for witnessed
cardiac arrests, we can expect that the
number of people that have undergone a
NDE will continue to rise.
- Melvin Morse who reviewed the records
from Operation Airlift Northwest on successful
pediatric resuscitations confirmed these
statistics. He noted that about 35% of
the children remembered NDEs and, furthermore,
that they were more likely to remember
a NDE if they had received fewer medications
during the resuscitation attempt.
- In Michael Sabom's study of successful
CPRs in consecutive resuscitations in
the Atlanta Emergency Room, he discovered
that some 43% of people reported NDEs
when they were interviewed within a few
days of the CPR. He is a cardiologist
who had resuscitated many people without
hearing about a NDE until he began to
sit with people and ask them open-ended
- Numerous studies have now shown that
these experiences are equal for both sexes,
all age groups, and all belief systems.
Statistically speaking, there is no difference
whether or not people expect to have a
- "Visitations" with deceased
relatives are extremely common in terminally-ill
patients in the last few days of life
and are differentiated from hallucinations
in that the patient may be interrupted
during the "visit" with the
deceased relative and will give perfectly
coherent answers whereas the patient having
a hallucination cannot be brought back
to reality to answer questions.
- It is becoming increasingly common for
people to be aware of the possibility
of NDEs, largely because of the media
such as books, television shows, and even
movies. As people become aware of the
frequency of NDEs, it is becoming increasingly
easy to talk about them with family and
friends-and even health care professionals,
- Discuss with NDErs the common after-effects.
They may not experience them all, but it is
comforting to know that these effects are
secondary to the NDE if they do occur.
- Immediately after the NDE, there may
be a strong sense of unreality about everything.
It may seem that the reality of the NDE
is so powerful and so in contrast to everything
that is going on in the hospital setting
that the hospital setting has a strong
sense of unreality about it.
- There are common changes in values experienced
by those who have had a NDE:
- There is no longer a fear of death,
but there is often lingering fear
about the dying process, especially
fear of pain.
- There is an increase in spiritual
interests. While NDErs may not become
more religious, they certainly do
have a profound increased interest
in spiritual matters.
- There is an understanding that our
main purpose on Earth is to learn
how to love better. Thus, there is
an increase in universal non-specific
- An increased feeling of connection
with nature and an increase in the
desire to be in nature is very common.
- There is often an increased interest
in learning just for the sake of learning.
- A decreased interest in materialism
is usually seen.
- There is a decreased interest in
success, especially in the form of
- Other changes may be noted by the person
who has had the NDE:
- An increased sensitivity to violence
may make watching the news and "action"
- Sensitivity to other people's emotions
is often enhanced, making it difficult
to be in crowds such as in the mall
and at large parties as the emotions
are experienced as a "bombardment."
- Psychic abilities may be enhanced
which is often experienced as very
disconcerting, especially at first.
- Common problems that occur after a NDE:
- Readjustment to the "real world"
often takes months and even years.
- The understanding that we are here
to learn to love well may not mesh with
the NDEr's previous lifestyle. His friends
and/or occupation may no longer be appropriate
- The increased sensitivity to emotions
and violence may create great tension
in situations that were previously interpreted
- There may be difficulties within the
family as family members try to adjust
to the changes in the NDEr and the NDEr
tries to find his place in the family
with his new values and sensitivities.
- The NDE generally occurs in the setting
of severe medical illness or a trauma
and the physical aspects of that need
to be dealt with simultaneously with
the adjustments after a NDE.
- Other assistance that might be useful
- Many NDErs find great comfort and
assistance from meeting other people
who have had NDEs. This can be done
on an individual basis or in a support
group setting. For information on
local support groups, contact IANDS
(International Association of Near-Death
Studies) at P.O. Box 502, East Windsor
Hill, CT 06028-0502, (860) 882-1211
or visit their web site at www.iands.org.
- Brief counseling with a minister
or psychotherapist that is familiar
with the after-effects of NDEs is
often quite helpful. It is crucial
to avoid therapists and counselors
who themselves are not well versed
- Books that might be useful include:
- Callanan, Maggie and Patricia
Kelley. Final Gifts: Understanding
the Special Awareness, Needs,
and Communications of the Dying.
New York, 1992: Posiedon Press.
- Kircher, Pamela M., M.D. Love
is the Link: A Hospice Doctor
Shares Her Experience of Near-Death
and Dying.New York, 1995:
- Morse, Melvin, M.D. Closer
to the Light.New York, 1990:
- Ring, Kenneth, Ph.D. Heading
Toward Omega.New York, 1984:
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