Hallucinations in Intensive Care Patients

On Thursday 8^th March I spoke at The Welsh Intensive Care Society conference. Although my paper was about my research into NDEs, part of my paper discussed the hallucinations that patients reported. This aspect sparked a lot of discussion and it is apparent that many healthcare workers in the audience were aware of many patients who continued to have very vivid and disturbing hallucinations after being discharged home. So I have decided to write a post specifically about hallucinations as opposed to NDEs.

Hallucinations are very common in patients who have been in intensive care. I nursed thousands of patients in intensive care, in the 17 years that I worked there, who reported such hallucinations. My colleagues knew of my interest in hallucinations and death and dying so I was predominantly allocated patients who were dying or hallucinating.

 When I undertook my research, during the first year of data collection I interviewed every patient who survived their admission to ITU. Out of this sample only two people reported a NDE yet I came across 12 patients who had clearly been hallucinating. These patients were entered into the study so that I could compare the hallucinations with the NDE. By the end of the 5 years data collection I came across 15 patients who had a NDE. I then compared the hallucination group with the NDE group.

 The full interviews with the patients who hallucinated and those who reported a NDE are in my first book The Near-Death Experiences of Hospitalized Intensive Care Patients: A Five Year Clinical Study published by The Edwin Mellen Press in 2008.

There were differences between the hallucinating patients and the NDE group. The NDE followed a specific pattern whereas the hallucinations were random and bizarre often with no logical sequence of events. On follow-up after a few months the NDE remained vivid and the patients remained adamant that it was ‘realer than real’ whereas those who had been hallucinating could rationalise that they had been hallucinating. Also Patient 10 had a very deep NDE but had also experienced hallucinations at a different time. He stated that there was a difference between the hallucinations and the NDE and the NDE remains as vivid now as it did when it occurred over 10 years ago whereas the hallucinations have faded and he can’t recall them in as much detail.

When I investigated the hallucination group it became apparent that the patients were predominantly reporting experiences which were actually occurring at the time they were recovering and their sedation had been discontinued. They could hear what was going on around them, they could feel what was being done to them, they could feel the equipment attached to their body and could partially see things in their line of vision as they were regaining consciousness.

For example one patient thought she was on the Swansea to Cork ferry. All patients in intensive care are on pressure relieving air mattresses. If you lie on one it feels as though you are on a boat swaying from side to side – further to this when her sedation had been discontinued she was being cared for by a nurse with a thick Irish accent. 

Even after sedation had been discontinued it appears that it remained in the patient’s body for some days especially if the patient had been in renal failure. The patient’s bizarre behaviour was also clearly observable by the nurses looking after them. Many patients tried to get out of bed or remove the tubes etc connected to their body; some even became aggressive towards the nurses. Many of the patients were later quite embarrassed about their behaviour.

However, it has also become apparent that some patients, especially those who are ventilated and sedated for a prolonged period of weeks and months, have intense hallucinations which can’t always be attributed to background noise etc. Some people report experiences that parallel post traumatic stress disorder (PTSD).

I frequently get contacted via my website by people who have had very vivid hallucinations that have a very disturbing effect on their lives and interrupt their sleep pattern. In some cases people are even afraid to go to sleep or close their eyes because they fear the hallucinations coming back and being re-experienced. One man was so disturbed by his stay in intensive care that the only way he could get any rest was to try to sleep on the sofa in his living room with all of the lights on and the white noise of the TV buzzing in the background.

This highlights the importance of providing good follow-up care for all intensive care patients who have been sedated and ventilated for a successive number of days. There are follow-up clinics in many intensive care units and there is usually a psychologist involved in extreme cases for patients who continue to experience vivid hallucinations.

In extreme cases, it would also be helpful for any patients who suffer with disturbing hallucinations after discharge from ITU, to return to the intensive care unit where they were a patient and speak to the nurses, doctors and physiotherapists who actually participated in their care. I did this with a patient in my study and it helped the patient immensely. I had actually looked after him while he was sedated and when I explained the various treatments that were given and showed him some of the equipment used he was able to make more sense of what he had been through. Due to the nature of their role, nurses usually spend most time at the patient’s bedside in intensive care and are a very useful resource when patients are trying to make sense of their experiences while in intensive care. Unfortunately, the reality of our current healthcare system with increased and often excessive workloads, nurses and other healthcare workers seldom, if ever, get the luxury of being able to spend time explaining these very important aspects with patients who have been discharged from intensive care. This has a double sided effect because the patient misses out on important support and the healthcare workers miss out on the opportunity to learn from these patients and use what they have learned to benefit future patients.

 

NICE recommends that when you have left the hospital:

“If you needed structured support while you were in hospital, you should have a meeting with a member of your healthcare team who is familiar with your critical care problems and recovery. The meeting will be to discuss any physical, sensory or communication problems, emotional or psychological problems and any social care or equipment needs that you might have.

If you are recovering more slowly than anticipated, or if you have developed any new physical or psychological problems, then you should be offered referral to the relevant rehabilitation or other specialist service.” (NICE CG83)

 

Below are some links which maybe helpful for people who are experiencing hallucinations after being a patient in intensive care:-

http://www.healthtalkonline.org/intensive_care/Intensive_care_Patients_experiences/Topic/1264

 http://www.sciencedaily.com/releases/2006/09/060925083003.htm

 http://www.healthtalkonline.org/intensive_care/Intensive_care_Patients_experiences/Topic/1369

 

 

Update on Anita Moorjani’s Case

Today I received an email from Regina Khan who is Anita’s assistant. She has directed me to another video clip of a lecture that Anita gave which also includes the testimony of Dr Peter Ko, the doctor who examined all of her medical notes and verified her case.  The video clip is approximately 20 minutes long – again this includes Anita’s very interesting and inspiring information about what she experienced and it also includes a clip of Dr Peter Ko speaking about her remarkable case. To view the clip visit Anita’s website, it’s the clip on the front page:

www.anitamoorjani.com

Anita Moorjani’s NDE on Youtube

This week I was alerted to Lilou Mace’s 47 minute interview with Anita Moorjani on Youtube. If my memory serves me correctly, Anita’s case is referred to in an article written by Dr Larry Dossey and published in Explore journal:

(Dossey, L. (2011). Dying to Heal: A Neglected Aspect of NDEs. Explore, March / April, Vol., 7, No. 2, pp. 59-62.)

On February 2^nd 2006 Anita, who had been suffering with lymphoma cancer for four years, was admitted to Intensive Care in Hong Kong. She was critically ill due to a relapse of her lymphoma. She was not expected to survive and her family were told that she would be lucky to survive another 36 hours. In fact, during the interview, Anita stated that she was actually pronounced dead by the doctor. Not only did Anita regain consciousness but miraculously her lymphoma cancer disappeared too.

Anita has reported a very deep NDE which incorporates many of the components that make up the NDE. There are many interesting points made by Anita including how she didn’t realise that she was in a coma when she was admitted to the hospital because she was still very much aware and could see everything that was going on around her. Also, as is commonly reported, her perception of time was greatly altered and everything seemed to be happening at once. Therefore making sense of the experience and trying to relate it to linear time was quite difficult as is reported by many NDErs.

A prevalent part of her experience was the realisation that we are all interconnected and when she was not in her body she was able to connect with those around her, even the nurses whom she did not know.

What was interesting to me was the fact that she was very much aware of her brother being many miles away and not being present at her bedside. She did not want to die because she did not want him to arrive at the hospital only to see her dead body. The possibility that patient’s have control over the time of their death is one thing I write about in my forthcoming book. As a nurse I have witnessed so many patients die either when their family leave their bedside to have a break or after the arrival of a person or after a particular event such as a family wedding has passed. Anita’s testimony supports the possibility that we have more control over our deaths than we realise.

Maybe the most important message that Anita has to share is how it made her realise that (like many of us, myself included!) she had previously been living her life out of fear of the consequences of her actions. However, her NDE taught her to live her life out of love for herself.

 Anita’ Moorjani’s forthcoming book Dying to be Me is released at the beginning of March.

 Thank you Anita and Lilou for the interview. What a great message Anita has to share with the world. I encourage everyone to watch the interview and listen to and hear what she has to say.

 To watch the interview click the link below:

http://www.youtube.com/watch?v=tjLouLHH-_I

Update of this Post

Today I received an email from Regina Khan who is Anita’s assistant. She has directed me to another video clip of a lecture that Anita gave which also includes the testimony of Dr Peter Ko, the doctor who examined all of her medical notes and verified her case.  The video clip is approximately 20 minutes long – again this includes Anita’s very interesting and inspiring information about what she experienced and it also includes a clip of Dr Peter Ko speaking about her remarkable case. To view the clip visit Anita’s website, it’s the clip on the front page:

www.anitamoorjani.com

In The News…

On Wednesday 1^st February The Guardian published an interesting article called the Top Five Regrets of The Dying.

Australian Palliative Care nurse Bronnie Ware recorded her observations of looking after patients who were in the last few weeks of their life and has written a book on the subject. She also has a blog called Inspiration and Chai:

http://www.inspirationandchai.com/Regrets-of-the-Dying.html

When I read the article I couldn’t help but agree with her observations and I too have mentioned some of these things in my forthcoming book.

Undertaking my research had a very profound effect on me and changed me in many ways. In fact because I learned so much from the patients I looked after I too completely re-evaluated my life. It’s almost as if I was faced with my own death through studying the deaths of my patients. It made me realise the importance of seizing the moment and living in the now! So it was no surprise when the number one on the list of regrets was:

I wish I’d had the courage to live a life true to myself, not the life others expected of me.

On reflecting on their lives many of the patients realised that they had never fulfilled their dreams. Health brings a freedom that few realise until they no longer have it.

Are you fulfilling your dreams?

For the full article click the link below:

http://www.guardian.co.uk/lifeandstyle/2012/feb/01/top-five-regrets-of-the-dying?INTCMP=SRCH

 

Forthcoming Events

This year has got off to a busy start. I’ve been asked to do several lectures in the space of just two weeks!

On Thursday 2nd February I will be taking part in The Wellcome Trust exhibition in London called Leap of Faith where I will be doing a brief presentation of my NDE research and then participating in a panel discussion. The link to the event is below:

http://www.wellcomecollection.org/whats-on/events/leap-of-faith.aspx

I am also really excited about another talk I’ve been asked to do in April. I have been invited to be a key speaker at the BTC Institute Bioethics Forum in Madison, Wisconsin, USA on April 26th – 27th. The title of the forum is Final Passages: Research on Near-Death and the Experience of Dying.

Other speakers at the event so far include Dr Raymond Moody, Dr Peter Fenwick, Professor Stanislav Grof, Professor Jeffrey Guss, Dr Marilyn Schlitz, Dr William Richards, Dr Pim Van Lommel and Dr Eric Weiss. The conference will be moderated by Steve Paulson of Public Radio International.

I’m really looking forward to participating in this conference and learning from all of the other papers that will be presented. I will post an update of the outcome of the conference.

The link to the conference is:

http://www.btci.org/bioethics/default.html

In The News… Teenager posts video on YouTube which describes his NDE three weeks before his death on Christmas Night

Yesterday The Mail Online reported the story of inspirational teenager Ben Breedlove’s death which happened a few days ago on Christmas night. 18 year old Ben had suffered with a life threatening heart condition for his whole life.

Ben posted a video describing his close brushes with death using flash cards. The video gives some insight into what it must be like to live with the constant threat of death.

A few weeks ago on December 6^th Ben suffered a cardiac arrest. On December 18^th Ben uploaded a video to youtube which described the NDE that he experienced while undergoing the cardiac arrest. Part of the NDE describes an encounter with his favourite rapper Kid Cudi. One of his last comments on the video was ‘I didn’t want to leave that place’.

What a truly inspirational young man. RIP.

To watch Ben’s video click the link below:

http://bcove.me/ygiiepao

 To read the full newspaper report click the link below:

http://www.dailymail.co.uk/news/article-2079098/Ben-Breedlove-Video-sick-teenager-life-1-week-died.html

 

 

In the News… Scientists at Cern Discover ‘The God Particle’

There was an interesting article in the news this week about research carried out at the The Cern physics research centre inSwitzerland. Awaited results of experiments undertaken in the Large Hadron Collider are expected to show that signals have been produced that provide the clearest evidence yet that the sub-atomic particle exists.

 For the full article reported in The Daily Telegraph click the link:

 http://www.telegraph.co.uk/science/large-hadron-collider/8947263/Higgs-boson

 According to Sky News report:

‘If the Cern experiments confirm the Higgs boson exists it would fix the biggest hole in the Standard Model – and give credence to what has been a largely mathematical model of how the Universe works.

 But if they showed it does not exist it would shake the foundations of modern physics and force a massive rethink on the forces that glue the Universe together.’

 Again this appears to be more research to indicate that our current science is at the tipping point. We live in very interesting and exciting times.