Dementia is commonly described as “the long goodbye”. Though the particular person remains to be alive, dementia slowly and irreversibly chips away at their recollections and the qualities that make somebody “them”.
Dementia ultimately takes away the particular person’s capacity to speak, eat and drink on their very own, perceive the place they’re, and recognise relations.
Since as early because the nineteenth century, tales from family members, caregivers and health-care staff have described some individuals with dementia all of the sudden turning into lucid. They’ve described the particular person partaking in significant dialog, sharing recollections that have been assumed to have been misplaced, making jokes, and even requesting meals.
It’s estimated 43 % of individuals who expertise this transient lucidity die inside 24 hours, and 84 % inside per week.
Why does this occur?
Terminal lucidity or paradoxical lucidity?
In 2009, researchers Michael Nahm and Bruce Greyson coined the time period “terminal lucidity“, since these lucid episodes usually occurred shortly earlier than demise.
However not all lucid episodes point out demise is imminent. One research discovered many individuals with superior dementia will present transient glimmers of their outdated selves greater than six months earlier than demise.
Lucidity has additionally been reported in different circumstances that have an effect on the mind or pondering abilities, equivalent to meningitis, schizophrenia, and in individuals with mind tumours or who’ve sustained a mind harm.
Moments of lucidity that don’t essentially point out demise are typically known as paradoxical lucidity. It’s thought-about paradoxical because it defies the anticipated course of neurodegenerative illnesses equivalent to dementia.
But it surely’s essential to notice these episodes of lucidity are short-term and sadly don’t symbolize a reversal of neurodegenerative illness.
Why does terminal lucidity occur?
Scientists have struggled to clarify why terminal lucidity occurs. Some episodes of lucidity have been reported to happen within the presence of family members. Others have reported that music can typically enhance lucidity. However many episodes of lucidity shouldn’t have a definite set off.
A analysis workforce from New York College speculated that modifications in mind exercise earlier than demise might trigger terminal lucidity. However this does not absolutely clarify why individuals all of the sudden get better talents that have been assumed to be misplaced.
Paradoxical and terminal lucidity are additionally very troublesome to check. Not everybody with superior dementia will expertise episodes of lucidity earlier than demise. Lucid episodes are additionally unpredictable and sometimes happen with out a explicit set off.
And as terminal lucidity generally is a joyous time for individuals who witness the episode, it could be unethical for scientists to make use of that point to conduct their analysis. On the time of demise, it is also troublesome for scientists to interview caregivers about any lucid moments that will have occurred.
Explanations for terminal lucidity prolong past science. These moments of psychological readability could also be a method for the dying particular person to say last goodbyes, achieve closure earlier than demise, and reconnect with household and mates. Some imagine episodes of terminal lucidity are consultant of the particular person connecting with an afterlife.
Why is it essential to learn about terminal lucidity?
Individuals can have a wide range of reactions to seeing terminal lucidity in an individual with superior dementia. Whereas some will expertise it as being peaceable and bittersweet, others might discover it deeply complicated and upsetting. There may additionally be an urge to switch care plans and request lifesaving measures for the dying particular person.
Being conscious of terminal lucidity may help family members perceive it’s a part of the dying course of, acknowledge the particular person with dementia won’t get better, and permit them to take advantage of the time they’ve with the lucid particular person.
For individuals who witness it, terminal lucidity generally is a last, valuable alternative to reconnect with the individual that existed earlier than dementia took maintain and the “long goodbye” started.
Yen Ying Lim, Affiliate Professor, Turner Institute for Mind and Psychological Well being, Monash College and Diny Thomson, PhD (Scientific Neuropsychology) Candidate and Provisional Psychologist, Monash College
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