NDE subjects often report long-term after-effects, and changes in worldview, such as increased interest in spirituality, greater appreciation for life, increased interest in the meaning of life, increased empathic understanding, decrease in fear of death, higher self-esteem, greater compassion for others, heightened sense of purpose and self-understanding, desire to learn, greater ecological sensitivity and planetary concern, a feeling of being more intuitive or psychic (Mauro, 1992; van Lommel et.al, 2001). Greyson (2003) notes that Near-death experiences are associated with enhanced purpose in life, appreciation of life and with reduced fear of death, but also with adverse effects, such as posttraumatic stress symptoms. Some subjects also report internal feelings of bodily energy and/or altered states of consciousness similar to those associated with the yogic concept of kundalini (Greyson, 2000).

Greyson (1983) developed The Near-Death Experience Scale in order to measure the after-effects of a near-death experience. Researchers have pointed out that the aftermath of the experience can be associated with both positive and healthy outcomes related to personality and appreciation for life, but also a spectrum of clinical problems in situations where the person has had difficulties with the experience (Orne, 1995). These difficulties are usually connected to the interpretation of the experience and the integration of it into everyday life. The near-death experience as a focus of clinical attention, and the inclusion of a new diagnostic category in the DSM-IV called "Religious or spiritual problem" (American Psychiatric Association, 1994 - Code V62.89), is discussed more closely by Greyson (1997) and Lukoff, Lu & Turner (1998).

Simpson (2001) notes that the number of people that have experienced an NDE might be higher than the number of cases that are actually reported. It is not unusual for near-death experiencers to feel profound insecurity related to how they are going to explain something that the surrounding culture perceives as a strange, paranormal incident.

Near-death experiences has many clinical implications for health professionals, for the dying patient and for family and friends.

Implications for health care professionals

For health care professionals, it is not necessary to take sides in the debate concerning the objective reality of these spiritual experiences. Simply the knowledge that they are a normal and natural part of the dying process has profound implications for those who work with death and dying. The ability to feel at ease in discussing the paranormal is an essential element of the bedside manner of all those who work with critically ill patients.

Death-related visions can play a role for health care professionals in alleviating their own guilt, lack of control, and spiritual/social isolation when dealing with death and dying. They can also can relieve health care personell of responsibility and the need to always be in control, always have the right answer, the right dose of medicine, etc. when confronted with the deaths of patients. Death-related visions or the use of guided imagery with the dying can result in increased bedside related activities, conversations about death and dying, touching, holding, and simply sitting: all of which can reverse the social isolation of the dying. Ultimately, health care personell may see a decreased need for irrational adherence to rules and policies that reflect their own need to impose control and order on the process of dying, instead of focusing on patient care needs.

It might be suitable for health care professionals to analyze their own spiritual beliefs and feelings about death. Dismissing a patient’s vision of the afterlife as “hallucinations” can often reflect their own religious beliefs and values. It might also be important to recognize that most death-related events are not dramatic visions of an afterlife, but might be simple feelings and intuitions. Patients are often troubled if they don’t have a dramatic vision of another life. It might also be suitable to encourage discussion among family and friends. Often death-related visions and their significance only become evident when several family members report having the same experience at the same time. A professional, being willing to validate the experience as normal and natural, can often give the family permission to trust their instincts and beliefs. Family members often perceive comatose patients as “stuck in the tunnel”. Others want to know why their child or spouse did not “choose” to return to them. These issues must be addressed in an individual manner (Morse, 1991; Morse & Perry, 1992).

The near death experience validates the patient’s own psychical experiences and can restore control and dignity to the process of dying. The implication that the process of dying is not painful or scary, but spiritual and wonderful, can be comforting. Comatose patients often are able to hear and see what is going on around them and can emotionally process conversations. Often they subjectively perceive themselves to be floating on the ceiling and perceive themselves to have a bird’s eye view of their own deathbed or resuscitation. If the dying patient has had spiritual visions, these can be used to interpret the process of dying for them. For patients who have not had death-related visions, guided imagery or fantasy can often serve the same purpose. Knowledge of near-death experiences can reverse the isolation and neglect of the dying. People might want to visit to hear about pre-death visions or to work with guided imagery with the dying. The old-fashioned deathbed scene crowded with friends and relatives may be resurrected (Morse, 1991; Morse & Perry, 1992).

Research on near-death experiences validates a variety of death-related visions. The knowledge that NDEs are being studied as "real" phenomena can bring new meaning to a peaceful smile before death, a faraway look in the eyes, or simple and brief statements such as “the Light, the Light” that might otherwise be missed. Frequently, friends and family members have post-death visions and intuitions that can be properly interpreted in light of this new scientific information. For example, Dr. Therese Rando states that 75% of grieving parents have post death visions of their deceased child. Simply restating that most parents will see their child again after death, without using a medical term such as “hallucinations,” can bring enormous comfort and can give parents “permission” to interpret the event in their own way. Death related visions can serve to restore a sense of control and order to the universe, which is particularly important in dealing with untimely deaths or the death of a child. They can also promote healthy grieving and decrease the incidence of pathological grief, by decreasing guilt and a sense of personal responsibility that can interfere with normal grieving. Also, death related visions generate a sense of meaning for death, even if that meaning is elusive. For example, a pre-death vision of a child’s accidental death can allow parents to feel there is some meaning to the death. This can convert a senseless tragedy to a “senseful” one, which is helpful in preventing pathological grief. Family and friends can find comfort in knowledge that those last moments of life may be serene and peaceful. Knowledge that it is now scientifically possible to entertain the survival hypothesis can give hope for eventually being reunited with the dying. This can be extraordinarily comforting to many. Death-related visions can give faith and confidence to survivors to trust their own spiritual intuitions and reaffirm their religious faith (Morse, 1991; Morse & Perry, 1992).