Dr Chris Kerr, a hospice physician who has spent 27 years caring for dying patients, has shared some of the key signs he's observed as someone nears the end of their life, speaking on an episode of Oprah's podcast.
The signs to look out for
Kerr said one of the clearest signs is the appearance of what he calls "visitations," where dying patients report seeing people who have already died. He explained these visions tend to grow more vivid and frequent the closer someone gets to the end, telling Oprah: "That's a sign you're very close to the end." He also noted that patients nearing death spend increasing amounts of time asleep, saying: "It's happening in the context of sleep, so you're sleeping more, and within the sleep state, more and more you're immersed in these experiences."
Why these aren't ordinary dreams
Kerr was clear that these experiences differ meaningfully from typical dreams, explaining: "They're not dream-like, and there's not symbolism, they're not metaphor." He said patients can become offended if a clinician suggests otherwise, adding: "Sometimes they actually get offended when you imply that it was a dream because it was a visitation for them." According to Kerr, the visions are strikingly literal, based on real people and real events, and recalled with total clarity, saying: "I've been doing it for 27 years. I've never had a patient ask me, 'What do you think this means?'"
How children experience it differently
Kerr said the picture changes significantly for younger patients, who typically haven't experienced the loss of a loved one in their own lives. He said children "don't distinguish between the imaginary and the real in the same way," and often lack the vocabulary for death itself. Rather than seeing a deceased relative, he said children more commonly picture a lost pet, or occasionally a family friend who has died, carrying the same comforting significance. He recalled one young patient who imagined herself inside a castle she had built, describing it simply as "a safe place." Despite these differences, Kerr said dying children, much like adults, often display a clear understanding of what's happening to them, saying: "They often have a very clear understanding that they are at the end of their life."
