End-of-life dreams and visions in a patient with delirium: A Brazilian case report and narrative review.
Palliative & supportive care December 26, 2025 Taís Oliveira Silva, Bruno Angeli-Faez, Lorena Cândida Ferreira Paixão et al.
Near death, end-of-life dreams and visions (ELDVs) and delirium often overlap, making them hard to tell apart. This case report describes an elderly Brazilian woman with metastatic cancer who experienced both. ELDVs involved vivid encounters with deceased relatives and biographical themes, but many were distressing and occurred alongside fluctuating attention typical of delirium. The Confusion Assessment Method (CAM) identified delirium but could not distinguish ELDVs within delirious states. ELDVs often emerged during lucid windows with preserved recall and insight. Distress alone did not differentiate the two. Supplementing CAM with qualitative criteria—content, vividness, biographical meaning, insight, cultural fit, and recall—may prevent misclassification and support holistic palliative care.