Coming from a completely different perspective than dutchraptor, since I am a person who finds dream interpretation quite useful.
I would say that the dream indicates that something is wrong. The dreamer first assumes that what is wrong is external to him (ie: the other's hand is wrong), but then is assured that the problem is with him (the dreamer). In dream interpretation it is common to keep in mind that all dream characters may represent the dreamer also, so it could be said that part of his own mind realizes that something is wrong with himself. He also finds a part of his own mind scary. It makes him think of a skelteton or death. Now thinking about death happens, and I think it happens more often to people with issues than for carefree people. When I am depressed, for example, I tend to think and dream about death more often. Of course, death in dreams can also at times not be literally about death, but symbolize an end of some other sort, for example.
I would say that this dream in and of itself is harmless or even potentially a useful dream in that it encourages the dreamer to greater self awareness that something is wrong within him and he should try to figure out what it is. However, what has happened is that the young man has obsessed so much with this dream in a negative way and with his emotion of being scarred of it and that has perpetuated the dream as a scary experience. The way it works with dreams is that if we obsess with some thoughts and have strong emotions such as fear, we are more likely to have that as a nightmare. Kind of a negative reinforcement dream incubation: planning out one's future dreams in one's mind unintentionally by not letting go of the idea we fear.
Or another way of looking at it, perhaps whatever issue prompted him to have this dream in the first place is still there. A healthy mind would use dream time for creative problem solving through random associations of recent events and issues with other memories to try to come up with a creative solution. Sometimes this process is broken though and instead of searching for new ideas about an issue, our mind gets stuck on one way of looking at it which is not very useful: a recurring nightmare. Now a recurring nightmare is not necessarily a sign of mental illness or trauma: recurring nightmares happen to normal people sometime.
How to resolve a recurring nightmare like this? Try to focus on the dream less in daytime, think about it less, go over it in one's head less, to not reinforce this dream by repetition. If the dream occurred to begin with because there was some kind of issue, try to figure out what are the issues that are on your mind and try to resolve them. Recurring nightmares do ultimately go away with time. If the issues are too troubling and are interfering with life, seek professional help such as counseling but sometimes just talking to someone who is a well meaning good listener and telling them one's issues may suffice - since the young man is religious, if a priest/pastor is a good listener, that may be a good choice.
Edit: upon rereading, you say the young man has experienced much loss and hardship in life. This dream may just be a reflection of that. It may be that he has just been focusing on the losses, and is unable to get past them. Anyway it is good that you are seeking professional help for him because it certainly sounds like his issues are interfering with his life in a major way. Hopefully, he will get someone who can help him.
Oh and the final part of the dream, I would interpret as, no matter how he tries to run away from his issues, they catch up with him. Which makes sense because the way to solve issues is to face them, not to run away from them.
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