— An increase in a certain kind of high-frequency wave in dying brains might be associated with last-minute conscious experiences, but scientists don’t know for sure.

In a new study, researchers recorded comatose patients’ brain activity as they died.

In their last minutes of life, some people’s brains generate a surge of surprisingly organized-looking electrical activity that may reflect consciousness — although scientists aren’t entirely sure.

According to new research, published Monday (May 1) in the journal PNAS (opens in new tab), this surge can sometimes occur after a person’s breathing stops but before the brain stops functioning. The activity pattern is somewhat similar to what is seen when people are awake or in dreamlike states, leading to speculation that perhaps these electrical surges reflect the otherworldly experiences reported by people who’ve had close brushes with death: A sense of looking at the body from the outside; a tunnel and white light; or a sense of reliving important memories.

However, since all the patients in the new study ultimately died, it’s impossible to know if they had such experiences.

“If you talk about the dying process, there is very little we know,” said Jimo Borjigin (opens in new tab), a neuroscientist at the University of Michigan Medical School who led the study. It’s rare for patients to have their brains continuously monitored as they die, Borjigin told Live Science. “This is maybe the first study to really show second-by-second how the brain dies.”

Near-death experiences

Some people who are brought back from the brink of death report seeing or hearing unexplained things during resuscitation or when they seem to be unconscious. The reason for these near-death experiences is unknown, and it’s not clear if they’re even specific to death.

International surveys suggest that only about half of what people call “near-death experiences” actually occur in life-threatening situations, said Daniel Kondziella (opens in new tab), a neurologist at the University of Copenhagen who was not involved in the new research. The other half occur during meditation or in scary situations that don’t endanger one’s health or impact the brain’s metabolism, Kondiziella told Live Science.

“The thing is, from the experience itself you cannot say if someone has had a cardiac arrest or syncope [a brief loss of consciousness] or near-miss traffic accident,” Kondiziella said.

Because the people who survive to report a near-death experience are inherently different from the people who die — their brains don’t permanently lose function, for one thing — it’s hard to determine whether those who actually die also have these subjective experiences.

In 2013, Borjigin and her colleagues measured electrical activity in the brains of rats (opens in new tab) that they euthanized via cardiac arrest. They found that for about 30 seconds after the heart stopped, the brain showed a surge in what are called gamma waves, which are the highest-frequency electrical oscillations in the brain. Gamma waves are correlated with conscious experience, but don’t necessarily prove that someone is conscious; they’re just one of many indicators that someone might be aware and alert.

In 2022, a separate group of doctors happened to be monitoring the brain of an 87-year-old man with an electroencephalogram (EEG), which detects electrical activity on the surface of the brain, when the man unexpectedly died. Similar to Borjigin’s rats, the man’s brain showed a surge in gamma activity in the 30 seconds before and after his heart stopped.

‘Reading’ the dying brain

In their new paper, Borjigin and her team made a deliberate effort to use EEG to capture what the brain looks like during death.

The researchers got permission to monitor dying patients in intensive care whose breathing support had been removed after treatment proved futile. The study included four patients total, all of whom were comatose after cardiac arrest.

In the 30 seconds to two minutes after their ventilators were removed, two of the four patients’ brains showed surges in gamma waves. Interestingly, this gamma activity seemed organized, in that the gamma waves in one portion of the brain were associated with predictable activity patterns in other regions.

The temporoparietal junction, a brain region where the temporal and parietal lobes meet, toward the back of the brain behind the ear, was particularly active with gamma waves. This region is known to be activated when people have out-of-body experiences or dreams, Borjigin said.

The new findings echo what was seen in the 87-year-old patient who unexpectedly died, said Raul Vicente (opens in new tab), a neuroscientist and data scientist at the University of Tartu who co-authored the 2022 study but was not involved in Borjigin’s work. “It’s very nice to see a confirmation,” he told Live Science.

“The more consistent findings we have, the more evidence it is that this likely is a mechanism happening at the time of death and if we can pinpoint this down to one location, even better,” said Ajmal Zemmar (opens in new tab), a neurosurgeon at the University of Louisville Health who also co-authored the 2022 study.

Zemmar and Vicente are optimistic that these signals could be signs of conscious experience at the moment of death. But reflecting the debate in the field, Kondziella is more skeptical.

“We know when you die a cardiac death as opposed to a brain death, that takes time,” he said. Minutes pass between the heart stopping and brain cells dying, he said. “It shouldn’t be a big surprise during those minutes, you will see aberrant electrophysiological activity in the brain.”

Some people may experience something like near-death experiences in these moments, Kondziella said, but we may never know for sure. And again, these experiences may not be unique to death — a more likely explanation for near-death experiences that encompasses both life-threatening experiences and non-life-threatening experiences, he said, may be “REM sleep intrusion into wakefulness,” a situation in which the brain blends waking and dreaming states. (REM sleep is marked by dreaming and brain activity patterns that are very similar to waking, including gamma waves and other, lower-frequency waves.)

Borjigin’s team is still collecting end-of-life data, hoping to add to the evidence that the dying brain may generate predictable gamma-wave patterns. Already, other research groups have attempted to use artificial intelligence to identify objects that people saw in their dreams (opens in new tab) based on their brain activity — similar mind-reading may be possible with unconscious and dying patients, Vicente said.

“This opens an opportunity at some point, if we gather enough data, to be able to decode what people in different coma states are thinking,” Vicente said.

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— How to protect your psychological health

By Bianca Iovino

Aged care staff face a variety of challenges that come with their work and dealing with death, dying and grief is an unfortunate reality of the job.

When frequently dealing with the death of people you are caring for, particularly if you have a strong relationship with them, intense feelings of grief and loss often arise which can be harmful if not dealt with.

Grief is a common response to death. Everyone expresses grief differently and no one can tell another how they should grieve, but it is important to know where to turn to when you are in a state of bereavement and still need to work in the industry.

The Australian Psychological Society acknowledged that aged care workers should be trained to deal with the challenges of their job properly, particularly in areas where trauma or workplace injury may occur, such as the death of a client. But access to psychological services, particularly through your workplace, can be limited as the country faces a shortage of psychology professionals.

Just yesterday, The Medical Journal of Australia released findings that evidence‐based mental health and wellbeing programs are needed for workers in health and aged care organisations to alleviate the ongoing mental health and wellbeing effects of workplace shortages, considerable physical and psychological demands of the job as well as the COVID‐19 pandemic.

As it is in the nature of a carer to do just that – care for others – it is also important for you to care for yourself when you’re feeling weighed down from bereavement.

So what can be done to protect your psychological health?

Heightened exposure to grief in aged care

Exposure to repeated instances of death and grief has been linked to burnout and overwhelming stress in many aged care workers.

Aged care workers are battling staff shortages, increased responsibilities and are still feeling the impacts of the COVID-19 pandemic, increasing the likelihood of experiencing burnout even more.

Grief can also be complicated or prolonged which can be persistent, debilitating and lead to serious psychological distress.

Aged care staff can experience grief more intensely after a resident’s death if:

They were particularly close to the person who passed
They have limited confidence in caring for people at the end of life, or in talking about death
They are facing other stressors, such as heavy workload demands or conflicts and pressures at home
COVID-19 can also add to the grief experienced by aged care staff as they are under increased pressure to provide end of life care when family and volunteer visits are limited

Managing grief and bereavement at work

After experiencing death and loss, you may feel the need to start distancing yourself from clients in the name of self-preservation.

You’re not alone. Since the pandemic, many working in the health and aged care field have said they are experiencing compassion burnout – putting the care of vulnerable older Australians at risk. But this strategy probably won’t help you and learning ways to cope with grief can help you build the emotional resilience needed to be the best carer you can be. You can grieve and still care well.

As a first step, it is important for you to acknowledge your feelings of loss and grief. Think about how you are feeling, why you may be feeling it and identify if you think you need to take more steps to help you mitigate these, often intense, feelings.

If you have decided you need more help and support, you can lean on your workplace and fellow colleagues to talk out your feelings and experiences.

Aged care supervisors and staff can support each other by debriefing after a client dies and listening in a non-judgmental way. You may also decide to organise a memorial or attend the client’s funeral if you wish.

Staff should be given time and a private space to debrief after a resident’s death to honour the loss, sign condolence cards for the family and share information about the end of life caring experience. You can ask to know your organisation’s support policy by talking to your supervisor as this should be outlined in an Employee Assistance Program.

Managing grief and bereavement at home

When something happens at work, it’s not easy to simply leave it at the door.

Developing self-awareness is an important step in mitigating the feelings and experiences associated with bereavement and grief. By identifying your strengths and weaknesses as well as understanding why you react the way you do in certain situations, you can better manage your emotions rather than being overwhelmed by them.

If grief and bereavement are becoming unmanageable and starting to impact your home life, maintaining self-care practices is paramount to getting through.

Taking time to rest and relax is key to avoiding burnout and keeping stress levels under wraps.

Where possible, spend time with friends and family so that you have opportunities to talk about your feelings and experiences and also maintain your sense of community support and social connection.

As always recommended, maintaining a healthy diet and exercising in some capacity helps with feelings such as sadness and loss. But you may find you still need a bit more support to help you through.

Seek help by talking to a General Practitioner (GP), a counsellor, a psychologist or other source of professional support.

There are specific bereavement services to help you with grief and loss which may even be available to you through your employer, given the nature of the job.

Dealing with death and dying is no easy feat. We all experience grief loss in our lives but for aged care staff, this reality is constant.

Knowing what to do, where to turn and what supports are available to you when you lose a resident are important pieces of information that can help you grieve healthily while still caring.

Complete Article ↪HERE↩!