End-of-Life Rallying: What is Terminal Lucidity?

As patients reach the end of life's journey, there are many unexpected feelings and occurrences that can arise for them, their caregivers, and their loved ones. Terminal lucidity is an end-of-life phenomenon that has left many families and caregivers puzzled.

Though there is still much mystery around the abrupt return of mental clarity for patients shortly before their death, it’s not an uncommon circumstance. An article in The New York Times discussing the topic also referred to it as an “end-of-life rally.”

Seeing a loved one become more lucid after a long battle with dementia or other illnesses can be confusing and instill loved ones with a false sense of hope. Although the exact cause of terminal lucidity remains unknown, it’s important for families and caregivers to be aware of this phenomenon in order to assist and prepare for the possibility of a patient or loved one experiencing it.

Understanding Terminal Lucidity

Before accepting a patient’s renewed vigor as a sign of healing, should this end-of-life rally occur, it’s important to understand the definition of terminal lucidity and how it can materialize. While there are no definitive answers, the previously mentioned article in the New York Times explains that the mind becomes more responsive without the extensive fluids and medications of certain curative treatments like chemotherapy that have toxic effects. Given that hospice patients have elected to forgo such curative treatments, these moments of clarity can become more frequent.

This abrupt change in a patient can occur through a burst of energy or a return of lost memory. Beyond understanding the basic experience, it’s crucial to know that experiencing this is far from uncommon. The article also states, “doctors and nurses interviewed for this article said that a striking number of their dying patients had experienced a rally.”

As with most life experiences, not every case is the same: “bounce-backs generally last only a couple hours, but some go on for so long that the patients can take a break from a hospice for a few months."

However long the rally lasts, many patients are searching for the same types of things in these lucid moments. Some palliative care experts report patients requesting odd meals or the presence of someone to pay their last respects — these specific requests show the patient’s awareness of their state.

Fulfilling Requests and Staying Present

Whether it’s an ice cream flavor only found at their childhood parlor or a visit from their eldest son, it is not unlikely that a patient will ask for a specific food, object, or presence of a person in their final days. This rush of lucidity can cause them to seek closure or feelings of joy from their past.

No matter how odd a request may seem, it’s important to try to help fulfill these final wishes however possible. While these small actions don’t have the power to heal the patient physically, objects and people that evoke cherished memories can help to heal them spiritually and make them to feel more at ease in their final days. 

Maintaining Realistic Expectations

As these last flickers of vitality can be surprising and even heartbreaking, knowing the possibility of these lucid and sudden moments can help caregivers and loved ones maintain the proper expectations. Above all else, it is important to be present for a patient in their moments of terminal lucidity.  With the added support of hospice care, both families and patients are equipped with the resources necessary to be more present in a variety of ways.

Crossroads Hospice & Palliative Care is committed to the philosophy that no one should go through these final moments alone. With Crossroads, a team of nurses, hospice aides, social workers, chaplains, volunteers, and bereavement coordinators visit the patient and supplement the care provided by their family. This team of end-of-life-care professionals provide physical, emotional, and spiritual care, so that the patient can live their final days to the fullest with their loved ones at their side.

By adding the presence of professional guidance and by freeing loved ones of their caregiving duties, allowing them to be there physically and emotionally, patients can feel supported and fulfilled in moments of terminal lucidity. Additionally, Crossroads offers grief support, which help those suffering to understand and navigate life before, during, and after times like these.

Crossroads’ bereavement coordinators offer opportunities for those grieving to communicate with other individuals who understand their pain. For more information about Crossroads grief support services, please visit our website or give us a call at 1-888-564-3405.

If you found this information helpful, please share it with your network and community.
Copyright © 2019 Crossroads Hospice & Palliative Care. All rights reserved.