by Pamela M. Kircher, M.D., Maggie Callanan, RN, CRNH, and the IANDS Board of Directors

This page is also available as a brochure (PDF) suitable for printing and distribution, though generally this page is kept more up-to-date.  (If you have trouble reading the PDF file, the Adobe Acrobat Reader is available for free download.)


People who are terminally ill may have a near-death experience (NDE) just before the final phase of their illness, but the remarkable experiences that are more common as death approaches are called Nearing Death Awareness (Callanan & Kelley, 1992), or NDAs.  

Nearing death awareness is part of the dying process. The dying person may seem to look into the distance and talk with people who are not physically present, or may make friends and family members uncomfortable by talking about their plans for going on a trip. What they see and experience is often expressed by what appears to observers to be confused ramblings, incoherent statements, unusual behavior, or references with no personal context. They may use symbolic language to describe an inner experience or event. For instance, one woman insisted that she dress in her best clothes because her long-dead husband was coming to take her dancing; a young person claimed to need a map so he would know which way to go on his trip; people very often say that someone they loved but who has died is coming for them, or is in the room. These statements, once they are understood, show what the person needs in order to die peacefully. It is not uncommon for them to tell of the time of their death or to let go only after a certain event or condition takes place.

As people approach death, they often participate in several tasks.

Things to consider when communicating with the dying.

After the person has died, it is common for surviving loved ones to sense their presence.

Books about NDEs, NDAs and dying that might be helpful:

Tuesdays with Morrie: An Old Man, A Young Man, and Life’s Greatest Lesson by Mitch Albom. New
York: Doubleday, 1997. (Also available as a video with Jack Lemmon.)

Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying by Maggie Callanan and Patricia Kelley. New York: Poseidon Press, 1992.

Grace in Dying: How We Are Transformed Spiritually As We Die by Kathleen Dowling Singh. San Francisco: Harper, 1996.

Hello from Heaven: A New Field of Research Confirms that Life and Love are Eternal by Bill Guggenheim and Judy Guggenheim. Longwood, FL: The ADC Project, 1995.

Love is the Link: A Hospice Doctor Shares Her Experiences with Near-Death and Dying by Pamela M. Kircher, MD. New York: Larson Publications, 1995.

On Death and Dying by Elisabeth Kubler-Ross, MD. New York: Macmillan Publications, 1997.

One Last Hug Before I Go: The Mystery and Meaning of Deathbed Visions by Carla Wills-Brandon, PH.D. Deerfield Beach, FL: Health Communications, 2000.