These experiences are sometimes called end of life hallucinations, visions or delirium. They can feel surprising or upsetting, but they aren’t always frightening for the person who is dying.

The most important thing is to notice how they seem. If they are calm, you can offer gentle reassurance. If they are frightened, restless, in pain or uncomfortable, ask a healthcare professional for help.

Are hallucinations normal at the end of life?

Seeing or hearing things can happen when someone is very unwell or nearing the end of their life. It may be linked to changes in the body, or to medication, infection, dehydration, pain, constipation, difficulty passing urine, lack of sleep or unfamiliar surroundings.

Healthcare professionals may call sudden confusion and changes in awareness delirium, you may also hear them use the terms terminal delirium, terminal agitation or terminal restlessness.

In most cases, it can feel peaceful or comforting to the person who’s dying. At other times, it may be a sign that they are distressed, confused, uncomfortable, or need support from the care team.

Why do dying people see relatives who have died?

Some dying people talk about seeing family members, friends or pets who have died. Others may talk about going somewhere or describe something that feels meaningful to them. We don’t always know why this happens, but it be peaceful or comforting to the person.

If the person is calm, you don’t need to correct them or ask lots of questions. Listen and respond to how the experience seems to make them feel.

You might say

• "I’m here with you."

• "You’re safe."

• "That sounds comforting."

You don’t have to pretend that you can see or hear what they can. Your calm presence is often enough .

What if they seem frightened or distressed?

Tell a nurse, doctor or another healthcare professional involved in their care if the person who is dying looks frightened and distressed . If they are being cared for at home, contact the community nursing, hospice or the out of hours team supporting them.

Ask for help if they

• seem scared, upset or unable to settle

• call out repeatedly or don’t recognise familiar people in the room

• try to climb out of bed or pull at bedding or medical equipment

• appear to be in pain or physically uncomfortable

The care team can check for possible causes and decide what support or treatment may help.

Should I correct someone who is seeing things?

Trying to correct someone who is confused may make them feel more frightened or alone. It’s usually kinder to respond to the feeling behind what they are saying.

You could say, “I’m here with you. You’re not on your own.” If they seem afraid, try: “That sounds frightening. I’ll get someone to help.”

How can I help them feel calmer?

By speaking slowly and calmly, reducing any background noise, softening bright lights and avoiding too many people talking at once, you will create a much calmer environment for the person who’s dying. Their favorite music, photographs or familiar objects may also help.

If they usually find touch comforting, you could hold their hand. Tell them before you touch or move them, even if you’re not sure if they can hear you, and give them space if touch seems to upset them.

It can be upsetting for you too

Seeing someone you love confused or hearing them talk about things you can’t see can be hard to watch. These changes aren’t your fault, and you don’t have to manage them alone.

If you’re worried, always ask the care team to explain what may be happening and what they/you can do to keep the person comfortable.