It’s a question I’m often asked on social media: ‘Is there an afterlife?’ As if by virtue of being a hospice nurse I’m some kind of an authority on what lies beyond.
And yet in some ways the people who ask me this are on to something. I didn’t have a formal religious upbringing, and until I became a nurse in my forties I had no concept of a life beyond our time on Earth. But working with the dying presented me with an opportunity that would change my beliefs: deathbed visions.
On duty in the hospice one day I was called into a side room by the daughter of one of my patients, Mrs Jones. ‘I think Mum needs some medication or something,’ said her daughter, worriedly. ‘She’s hallucinating.’
Mrs Jones was lying in her hospital bed, staring up toward the ceiling, pointing at the air, and uttering something quietly. I couldn’t quite make out what she was saying at first, but as I continued to watch and listen, I heard a name: Winnie.
I turned to her daughter. ‘Who is Winnie?’ I asked.
She looked at me, puzzled, and then, as if a light bulb turned on, she said excitedly, ‘Her sister… my aunt… Aunt Winnie!’ Her excitement turned back to confusion. Frowning, she told me Aunt Winnie had died last year.
Our conversation was interrupted by Mrs Jones, who continued to point and was now clearly calling out names: ‘Momma! Hi, Daddy!’ I explained to her daughter that we did not need to medicate her mother. These were deathbed visions.
‘Deathbed visions’ is a misleading misnomer because they can happen weeks before a person’s death. Sometimes this phenomenon is also called end-of-life visioning.
Hospice nurse Penny Hawkins Smith says we shouldn’t fear death – and it is the most normal experience humans have
It is very common that a dying person will say they see their deceased loved ones, or even pets. I once spent a fair amount of time helping a patient look for the cat she said she was seeing in her room before she realised it had been a childhood pet.
Witnessing this mysterious end-of-life phenomenon, or even just hearing about it, can be life-changing. These visions bring comfort to the patient who experiences them, as well as to the family who sees their dying person ‘reunited’ with their lost loves.
One evening, I was hammering away at my computer keyboard in the hospice, writing up notes, when I suddenly heard a voice cry out.
‘Ingrid! Ingrid!’
It was coming from the room next door to the nurses’ station, where I sat. My patient John was in his eighties. His wife had died of cancer the year before he landed in the hospice with an end-stage terminal heart condition.
John had been married to her for decades. They had no other family except for their caregiver Josie, who had lived with them for several years before his wife became ill, and to whom they had become very close.
‘Ingrid! Ingrid!’ I heard again as I stood up and hastily went to see what John was so upset about. He was lying in the hospital bed, reaching up toward the left corner of the room. Tears were streaming, no, pouring down his cheeks. ‘Ingrid! Ingrid!’ he cried out again.
I walked up next to his bed. ‘John?’ I said gently. ‘Was Ingrid your wife?’
He stared intently at the corner. ‘Yes!’ he yelled, almost startling me. ‘Yes! And she’s right there. I can see her!’
By this point in my experience with dying people and deathbed visions, I believed those they said they saw were indeed there. Curious to know if Ingrid had any insight into how soon John would die, I asked him if she was coming to get him.
‘Yes!’ he said again. Then he smiled and calmly added, ‘But not today. Tomorrow.’
Wow, I thought. That was very specific.
The next day was Monday, and – drum roll, please – Ingrid did not come to take her beloved husband to wherever it is we all end up. Instead, he died two days after he had seen her.
A week later, Josie came to pick up his belongings. I excitedly told her about John’s visitor and how Ingrid had said she would be coming to get him Monday, but then he didn’t die until Tuesday. Without missing a beat, Josie said, ‘It was always like Ingrid to be late.’
That certainly left me with plenty to think about.
As a baby with her father – whom she says visited her after his death
Before becoming a hospice nurse, Penny suffered from something known as death anxiety
Sometimes it’s not just families but patients themselves who can be caught off guard by their visions. They don’t always recognise the people they are seeing, or they might be reluctant to talk about them because they aren’t sure how people will react.
My patient Florence was in her eighties and dying of a lung disease called chronic obstructive pulmonary disease (COPD). My visits took place in her home, where we always sat at her kitchen table.
From time to time I like to check in with my patients about things that can help guide me to where I think they are in their dying process.
‘Have you had any falls, Florence?’ I asked.
‘No.’
‘How much are you sleeping?’
‘A lot.’
‘Eating?’
‘A little.’
‘Have you seen any unusual things you want to tell me about?’
Florence paused. ‘Seeing things like what?’ she asked.
‘Oh, like deceased relatives or pets?’ I replied.
‘Oh no!’ she said hurriedly. ‘Nothing like that.’
I explained to her that it wouldn’t be unusual to see something out of the ordinary. ‘It’s normal for people who are dying to have visions like that,’ I calmly told her.
‘It is?’ She sounded incredulous. ‘Well,’ she said slowly, ‘my Dad is standing over there.’ She pointed to a corner of the kitchen.
I knew without looking that there would be no one there, but I turned around to see an empty kitchen anyway.
‘I was afraid to say anything because I thought you might think I’m nuts!’ Florence exclaimed.
‘Nope,’ I told her. ‘It’s perfectly normal.’ And I knew that meant the end was near. Florence died about three weeks later.
Whether they believe in them or not, people are fascinated by stories of end-of-life visioning. Those who do believe don’t question that the dying person really is seeing their deceased loved ones.
Those who don’t believe love to toss out theories to rationalise and explain them away. Social media commenters will insist it’s just hallucinations from the medications, or their disease, or other explanations.
But in truth, I’ve seen time and time again patients so convinced they’re being visited by the spirits of their dead relatives that I’m also convinced. Who are we to say they are not?
Deathbed visions aren’t the only unexplained occurrence that happens at the end of life. People also often make motions with their hands that may look like they’re fishing, smoking, sewing, or other such activities.
Although the person can’t communicate, family members will usually excitedly state what they are doing. ‘My uncle was an avid fly fisherman – he’s tying flies!’ Or ‘Mum loved doing cross-stitch.’
One of the most common things we see people do with their hands is reach into the air. I’ve come to believe this has something to do with seeing those deathbed visions, as they are often above the person or in the upper corner of the room, like where Ingrid was when she was visiting with John.
I’m not trying to convince anyone that there is anything mystical or supernatural happening here, or even that there is an afterlife. We are all entitled to our own beliefs. The truth is, we can only know what happens after we’ve died.
Before I became a hospice nurse, I suffered from something known as death anxiety.
I thought about death constantly, even obsessively. I worried about it day and night, mostly at night, when I would lie awake, seeking solace from my then husband.
‘But what if there’s nothing after we die?’ I would cry in anguish. To which his unhelpful reply was, ‘Well, it won’t matter, because you won’t know!’ This might be why he is my then husband and not my now-husband.
Death anxiety is a fear that involves overwhelming and extreme feelings of dread and distress when thinking about one’s own death or that of others in a way that interferes with daily life. According to some studies it may affect around 10 to 20 per cent of people at some point in their lives.
Anecdotally, many have told me it started in their late twenties and thirties. My personal theory is this is the age when adults truly start thinking about death.
She says her father came to her in a dream, surrounded by bright light
It’s persistent and pervasive, and I believe it’s a direct result of our cultural failure to talk openly and honestly about death, especially to children.
I was nine years old when I had my first exposure to death. ‘Grandpa died,’ my mother told me and my sister. My brother was only four and was excluded from the conversation.
‘What does that mean?’ one of us asked.
‘It’s like he went to sleep, but he won’t wake up,’ she told us.
I had met my paternal grandfather just once, so I wasn’t particularly emotionally invested in his life or death. However, the news that a person could simply go to sleep and never wake up again was horrifying.
One night soon afterwards, I wandered into the living room where my mother sat watching TV.
‘I can’t fall asleep,’ I said meekly.
‘Why can’t you sleep?’ she said, slightly irritated. My Dad was deployed with the navy, leaving her to be tasked with all the fun questions.
I swallowed hard. Do I tell her? Do I say the word? If I say it, will that cause it to happen? ‘I just keep thinking – what if you die?’ I finally blurted out.
‘Well, stop thinking about it,’ she said, now more than slightly irritated. ‘Think about something nice instead, like flowers.’
I walked slowly back to my room and then appeared before her again just a short time later. ‘When I think about flowers, I think about cemeteries,’ I wailed. ‘And when I think about cemeteries, I think about you dying!’
For the life of me I can’t remember where the conversation went from there. My mum truly is a compassionate and loving person, though she was obviously misguided in how to approach conversations around death.
In her defence, most adults feel uncomfortable talking to other adults about death, let alone talking to children about it. And to her credit, she did use the actual word ‘died’ when she told us about our grandpa, so kudos to her for that.
Many people who are uncomfortable with the topic opt for euphemistic language, like ‘passed away’, ‘in a better place’, or ‘resting in peace,’ but in my experience, that doesn’t help anyone, especially children.
My death anxiety didn’t manifest itself fully until I was in my thirties myself, and it lasted a decade or so. Truth be told, from the onset of my teen years until well into my twenties, I didn’t fear death at all.
At various points I had even welcomed the thought of it. During a troubled few years in my life – the result of drug and alcohol issues and my propensity for finding men who abused me, combined with my inability to leave them – I had attempted to ‘unalive’ myself several times. (‘Unalive’ is social media-ese for the word ‘suicide’, because using that can get your video banned.)
Nevertheless, I’m fairly certain my mother’s reluctance to discuss death further than the ‘sleeping for ever’ explanation is what ultimately caused me to suffer from an overwhelming fear of dying.
At the age of 41 I finally grasped the nettle and did something about it. I applied to train as a hospice nurse.
I had never seen a real live – well, real dead, I guess – deceased person until that point. I thought being around dying and dead people could help. Like exposure therapy, it might desensitise me enough to allow me to get over my fear.
And that is, thankfully, exactly what happened. Learning about and seeing the dying process, especially those deathbed visions, gave me a proper perspective on what it actually means to die. Just as I had hoped, it made my death anxiety better
What I know for sure is that fear of death and dying is much more common than I ever realised. It was through my social media that I learned many other people suffer from death anxiety. As I began posting more and more death-related content, I noticed people commenting on my videos that I was helping them to get over their fears.
It was also through my social media and my followers’ comments that I realised you don’t have to work in hospice to get over it. For them, learning about the dying process from my education, or even just watching my silly videos with dark humour, was helpful.
The conclusion I have reached about getting over the fear of death is that there’s only one way: you have to find acceptance that it is going to happen, whether you are actively dying or just worrying about it.
It is crucial for those who are in the process of dying, because acknowledgment allows space for better quality of life at the end of life, conversations with the living, closure, and goodbyes.
For those with death anxiety, acceptance of death’s inevitability seems to suck the power out of it. You don’t have to like it, but if you can accept it, you can put it in the back of your mind and move on to other, nicer thoughts.
Ultimately, it was my very own spiritual encounter that finally brought me to my personal belief about what lies beyond.
I don’t know if my Dad had dead relatives visit him, because he died so fast, of a respiratory disease 12 years ago. But I had a visit from him after his death.
About a week after he died, my family and I went to my sister’s house for a night. As I lay sleeping, I dreamed of my Dad.
Although I can only describe it as dreaming, it was much, much more. My Dad came to me surrounded by bright light, smiling his famous smile, and I could feel his love embracing me. And he was so happy, he radiated joy. He told me it was time to go.
‘OK,’ I told him. ‘I’m ready to go.’ Then I thought for a second and told him I would need to see my kids again before I went. ‘They’re going to miss me,’ I said.
‘No, it’s not your time to go yet,’ he replied. Then he told me he would always be with me and he wrapped his arms around me. ‘I love you. It’s all right, honey. I love you, it’s all right.’ I was crying tears of happiness and sadness at the same time.
As I awoke, still sobbing, my husband Randy had his arms around me. ‘I love you, it’s all right, honey. I love you, it’s all right, honey,’ he comforted me.
Strange, I thought. Neither my Dad nor my husband have ever called me honey before.
‘You were talking to your Dad,’ Randy said to me.
‘No,’ I insisted. ‘My Dad was talking to me! I was answering him.’
I will never be convinced that what happened that night was only a vivid dream. It was my reality, and I’m so grateful to have experienced it.
So is there an afterlife? As far as I’m concerned, yes. Because my Dad told me there is.
- Adapted from Influencing Death: Reframing Dying For Better Living by Penny Hawkins-Smith, available from Amazon, £12.99
- Instagram, TikTok, YouTube and Facebook: @hospicenursepenny
