Florence sits at the kitchen table. Her husband is there, her daughter, too. They laugh together, share a meal — just as they used to. But there is one difference: both her husband and daughter have been dead for years. "As if we have never been separated," she says. Florence has never experienced dreams with such intensity before. She feels no fear — instead, a deep sense of calm, a certainty that she will see her loved ones again. Five days later, Florence dies.

This was no ordinary dream, but an encounter.

Many people have reported similar experiences in the final days of their lives.

Known as End‑of‑Life Dreams and Visions (ELDVs), they often occur as dreams during sleep, and sometimes as visions while a person is awake.

For those experiencing them, they can feel more vivid and real than ordinary dreams — and for those observing them from the outside, it can be unsettling.

Medicine long dismissed ELDVs as episodes of sudden confusion (delirium) or as side-effects of medication. But today, the thinking is shifting.

Nine out of ten people report End-of-Life Dreams and Visions

Christopher Kerr, a neurobiologist, palliative care physician and hospice doctor in the US, has been studying dreams and visions at the end of life since the late 1990s. The ELDV stories described in this article, such as Florence's, are drawn from Kerr's documented case reports in palliative care research.

Over a period of roughly ten years, Kerr and his team interviewed more than 1,400 hospice patients up until their death — provided they were cognitively intact and not experiencing delirium.

They found that about 90% of the patients reported at least one such dream or vision.

Kerr does not describe these people as confused — quite the opposite. "These are clearly patients with heightened acuity and heightened awareness," he told DW.

Psychologist Elisa Rabitti, lead author of an Italian study on ELDVs, emphasized a similar point in an email to DW: "End‑of‑Life Dreams typically occur in patients who are able to recount them with a coherent narrative, while maintaining preserved attention and awareness."

ELDV recurring themes: Journeys, reunions, belonging

The dreams are vivid and meaningful. Many involve encounters with deceased loved ones and pets, who appear to return to offer comfort.

They often revolve around journeys, preparation, and a sense of going somewhere. 

Relationships are revisited, conflicts addressed, guilt and regret surface.

"As they get closer to dying, there's an increased frequency. They become progressively more likely to include the deceased," said Kerr. Time and distance seem to lose their meaning.

Whether someone is religious appears to make little difference. According to Kerr, both religious and non‑religious individuals report ELDV experiences. What matters instead are these universal themes of love, connection and forgiveness — but not belief systems.

ELDVs are also distinct from near‑death experiences. Near‑death experiences tend to occur suddenly in acute, life‑threatening situations. End‑of‑life dreams, by contrast, develop gradually over days or weeks and are closely tied to a person’s life story. They are less dramatic — rarely involving tunnels or bright lights — and far more centered on relationships.

Comfort — or necessary confrontation

Most of these experiences are comforting. In Kerr’s studies, patients overwhelmingly described them as calming and meaningful. Some, however, found them distressing.

More difficult dreams may be especially transformative, said Kerr, because they bring unresolved issues to the surface — guilt, regret, unfinished business.

Sierra is in her twenties, has a young child, and is dying with a terminal illness. For a long time, she has struggled to accept her diagnosis. Conversations with her doctors fail to make an impression. But then, in a vision, her deceased grandfather appears. He tells her he is proud of her and that everything is okay. Something shifts. Sierra finds peace. One week later, she dies.

Rabitti said that while direct conversations about dying can be distressing for patients, dreams can provide a less threatening way of approaching death.

Why dreams become more intense near the end of life

There are biological reasons why these dreams become more frequent in the final days or weeks of a person's life.

Kerr described dying as a process of increasing sleep. "Nobody dies awake," he said.

And as sleep patterns change, our attention turns inward. External demands fade.

"You tend to reflect on the things that matter most, which tend to be our relationships," said Kerr.

But biology still cannot fully explain what the dreams mean — why they comfort, confront, or help people come to terms with their lives.

What these dreams mean for loved ones

While ELDVs do not predict death, they can have a lasting effect after death among loved ones left behind.

Studies suggest that relatives who hear about or witness such experiences often find it easier to cope with their loss and navigate their own process of grief.

This was true for Jennifer, who witnessed her late partner, Patrick, experience an ELDV. 

Patrick is severely ill when he dreams of his dead grandmother. She reveals a missing ingredient of a sauce Patrick feels he's never been able to recreate. She tells him he needs to add a teaspoon of sugar. Although already very weak, he cooks the recipe once more together with Jennifer. Soon after, Patrick dies.

When such experiences are explained properly, they have value, said Kerr. They can help people see death not only as a biological process marked by decline and suffering, but also as something that carries meaning and connection.

"Patrick was at peace," said Jennifer later. "If your last dream in life is about spaghetti sauce, there's nothing more peaceful than that." He was ready to go.

This article was originally written and published in German.