The Terminal Event and NDA

Gustave Dore's depiction of the Highest Heaven

Gustave Dore

My uncle talks about the last few hours of my aunt’s life, when she suddenly became more alert and aware of her surroundings. While my uncle thought this increased awareness meant that she was going to be around a few more days, within a few hours she had died. “If,” he said, “I had known that this was the ‘terminal event,’ I would have had different feelings and reactions.”

What is known as the ‘terminal event’ is the hours that precede death itself. Hospice workers and deathcare caretakers know about this event, and they often talk about its repurcussions with family members. While some regard this brief period of rallying and alertness as a gift, other family members see the terminal event as a painful experience, since they know they have so little time left with their loved one.

Dr. Robert W. Buckingham wrote about this near-death awareness in his book, The Handbook of Hospice Care (1992), and he was speaking about children. So, it appears that this awareness is possible in many near-death experiences among people of all ages. This ‘terminal event’ awareness also is called NDA, or Nearing Death Awareness, and it may incorporate visions that are beyond the family’s ken.

Pamela M. Kircher, M.D., Maggie Callanan, RN, CRNH, and the International Association for Near-Death Studies, Inc. (IANDS) Board of Directors pulled together a handout about NDA that may help you deal with a dying loved one and/or the family of a terminally ill patient. The handout talks about the difference between NDA and NDE (Near Death Experiences), and offer suggestions about what a family can do to make the dying patient feel more comfortable.

The greatest difference, it seems, between the NDE and the NDA is that the NDE seems to teach the person how to live better, whereas the NDA seems to prepare the person for death. Additionally, the NDA differs from hallucinations in that the person who experiences NDA can stop speaking with a vision of a dead individual to talk with living people in the room. For the person who experiences NDA, meeting deceased relatives seems universal.

If the living support team surrounding the dying person is aware that this NDA event may happen, then support for the visions appears to reassure the terminally-ill patient.

But, the NDA doesn’t stop there. After the patient has died, it is common for surviving loved ones to sense that person’s presence. Some people may feel notified of the death by the person who has just died, and other people may feel the presence of the recently deceased through words, images or aromas. Some individuals have reported the departed warning the survivor about impending dangers.

While you may scoff at such ‘feelings,’ you may be surprised to learn that they are usual, or normal.

My uncle learned about NDA and the terminal event before my aunt died – the hospice he had enlisted had taught him about these experiences. But, his unending care for his wife and stress over her death had clouded his memory. After she died, he could recount everything that happened, and he was able to connect certain events in her last hours to both the terminal event awareness and NDA as she drifted between total awareness and a need to meet death head on.

As for the rest of the family, I can’t say whether any one of us experience my aunt’s presence after her death – at least not immediately. But, she has left her mark upon everyone who loved her, and we agree that we all feel that presence.

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