Terminal lucidity

Terminal lucidity (also known as rallying, terminal rally, the rally, end-of-life-experience, energy surge, the surge, or pre-mortem surge)[1] is an unexpected return of consciousness, mental clarity or memory shortly before death in individuals with severe psychiatric or neurological disorders.[2][3] It has been reported by physicians since the 19th century. Terminal lucidity is a narrower term than the phenomenon paradoxical lucidity where return of mental clarity can occur anytime (not just before death).[4][5] However, as of 2024, terminal lucidity is not considered a medical term and there is no official consensus on the identifying characteristics.[6]

Terminal lucidity is a poorly understood phenomenon in the context of medical and psychological research, and there is no consensus on what the underlying mechanisms are. Its existence challenges the irreversibility paradigm of chronic degenerative dementias.

Studying terminal lucidity presents ethical challenges due to the need for informed consent. Care providers also have ethical challenges of whether to provide deep sedation, which might limit terminal lucidity, and how to respond to requests for a change in care plans from family members.

  1. ^ Julião, Miguel; Wholihan, Dorothy J.; Calaveiras, Patrícia; Costa, Elisabeth; Sousa, Paulo Faria de (April 2023). "Energy surge: A deathbed phenomenon that matters". Palliative & Supportive Care. 21 (2): 371–375. doi:10.1017/S1478951522001754. ISSN 1478-9515. PMID 36700451. S2CID 256273070.
  2. ^ Mendoza MA (October 10, 2018). "Why Some People Rally for One Last Goodbye Before Death". Psychology Today (blog). Retrieved 26 August 2019.
  3. ^ Bursack CB. "When Loved Ones Rally Before Death". AgingCare. Archived from the original on 26 August 2019. Retrieved 26 August 2019.
  4. ^ Peterson A, Clapp J, Largent EA, Harkins K, Stites SD, Karlawish J (March 2022). "What is paradoxical lucidity? The answer begins with its definition". Alzheimer's & Dementia. 18 (3): 513–521. doi:10.1002/alz.12424. PMC 8807788. PMID 34338400.
  5. ^ Eldadah BA, Fazio EM, McLinden KA (August 2019). "Lucidity in dementia: A perspective from the NIA". Alzheimer's & Dementia. 15 (8): 1104–1106. doi:10.1016/j.jalz.2019.06.3915. PMID 31422799. S2CID 199577248.
  6. ^ "Terminal lucidity and dementia: Definition and causes". www.medicalnewstoday.com. 2022-08-30. Archived from the original on 2023-08-04. Retrieved 2023-08-04.