A two-year-old cat has become a telltale sign of death at a Rhode Island nursing home, curling up beside dying patients in their final few hours, says a touching essay in the New England Journal of Medicine.

Dr. David Dosa, a geriatrician at the Steere House Nursing and Rehabilitation Center in Providence, detailed the phenomenon Thursday in a brief essay titled "A Day in the Life of Oscar the Cat."

Oscar strolls down a hallway at the Steere House nursing home on Monday.
(Associated Press/Stew Milne)

Since he arrived at the centre two years ago, Oscar has been at the side of 25 patients who have died, according to the article.

"He doesn't make too many mistakes. He seems to understand when patients are about to die," Dosa said.

"Many family members take some solace from it. They appreciate the companionship that the cat provides for their dying loved one."

Oscar was adopted as a kitten and grew up on the centre's third-floor dementia unit, which treats patients with Alzheimer's, Parkinson's disease and other illnesses.

Oscar makes his daily rounds, waiting patiently outside rooms if the doors are closed, wrote Dosa. Once inside, the grey-and-white cat jumps onto beds and appears to inspect patients by sniffing the air.

If Oscar leaves the room, the patient isn't likely to die that day, said Dosa.

But when the cat curls up on the bed, staff notice. They start phoning family members because the patient usually dies within four hours.

Usually indifferent and sometimes unfriendly to staff and visitors, Oscar purrs and nuzzles the patients during their final hours, Dosa said.

He recounted the hours before the death of a patient called Mrs. K.:

"A nurse walks into the room to check on her patient. She pauses to note Oscar's presence," writes Dosa.

"Concerned, she hurriedly leaves the room and returns to her desk. She grabs Mrs. K.'s chart off the medical-records rack and begins to make phone calls. Within a half hour the family starts to arrive."

When asked why the cat was in the room, the woman's daughter told her young son: "He is here to help grandma get to heaven." 

For his efforts, a plaque mounted on the wall reads: "For his compassionate hospice care, this plaque is awarded to Oscar the Cat."

Experts have speculated about Oscar's behaviour, saying he could be responding to scents given off by the patient or the behaviour of the nurses.

"I do think there is some biochemical reason, some odour or smell is helping the cat sense," said Dr. Joan Teno, a physician at the Steere House nursing home.

"Those behaviours have really won me over to this cat."

With files from the Associated Press