Terminal Lucidity: What It Is And What Are Its Causes
Nowadays, rare is the person who has not had or will have a loved one who suffers from dementia. Today, more than 55 million people have this “disease” (I’ll explain the quotes later), increasing in recent years almost 10 million cases per year.
Dementia is very emotionally painful, both for the person who suffers from it and sees how they gradually lose abilities and autonomy, and for those close to them, who see how they lose their loved one over time.
However, there have been many cases in which, suddenly, the person with dementia returns to showing the cognitive abilities of yesteryear, as if they did not have a neurodegenerative disease. What does this mean? Keep reading this article to find out what it is terminal lucidity and what you can get out of it.
Dementia is a general term that encompasses symptoms of severe cognitive and executive impairment, caused by various neurodegenerative diseases. This deterioration is progressive, starting slowly, and occurs due to the damage and gradual loss of neurons.
This set of symptoms entails many physical, psychological and economic consequences for the person who suffers from it and their caregivers. This disease usually has a series of associated stigmas and prejudices, which impact the care of patients suffering from dementia.
Currently, it is the seventh cause of death in the world, and one of the most common causes of disability and dependency among older people. This term is a bit of a mixed bag, because it is usually understood that it is a disease as such, but in reality it is not, but rather represents a set of symptoms of other brain diseases.
The symptoms vary, depending on the disease, its severity and the person who suffers from them, but they are always conditions in different cognitive and executive functions:
Causes of dementia
Dementia is usually associated with age and aging, but it can also be caused by vascular problems, excess blood sugar, vitamin B12 deficiency, overweight or obesity, physical or mental inactivity, or substance addictions. In turn, dementia can occur in the case of different neurodegenerative diseases, such as:
What is terminal lucidity?
Michael Nahm and Bruce Greyson created the term “terminal lucidity” to refer to those episodes in which A person with dementia suddenly recovers cognitive abilities, as if returning to themselves; however, these episodes occur shortly before death as if they were foreshadowing it.
Studies have estimated that 43% of people who have experienced an episode of terminal lucidity die within 24 hours, while 84% of these people die a week after the event.
These episodes are unpredictable as they cannot identify the specific triggers that cause them. During terminal lucidity, the person suffering from dementia can have fluid and meaningful conversations, joke, remember old moments…
Terminal lucidity can cause various reactions in the family members and caregivers of the person with dementia. There are those who experience it as really disturbing and confusing, and others who interpret the situation as an indication that something is even worse, and the patient must be cared for to prevent him from dying.
However, there are people who manage to take this episode as a last opportunity to enjoy the company of the person with dementia and make the most of time with him/her. In this way, they are able to reconnect and say goodbye to their loved one, in a peaceful but bittersweet moment.
As for the question of whether all episodes of lucidity during the course of dementia are an indicator that death is near, I answer no. There are cases in which brief periods of lucidity appear, but not shortly before death, but more than six months before death.
On the other hand, not all people who suffer from dementia will experience an episode of lucidity. What’s more, they are not exclusive to dementia either, They are also experienced in other brain diseases or in which there is considerable brain damage such as in meningitis, schizophrenia and in cases with brain tumors or lesions.
All of these situations in which there are episodes of lucidity, but without being a sign of imminent death, are called paradoxical lucidity. It has been coined with this name, because these episodes go against the expected course of these diseases. However, it is important to remember that, in all cases, these episodes are only temporary and, sadly, do not represent an improvement or reversal of the disease.
Why do terminal or paradoxical lucidity occur?
Unfortunately, it is not known why episodes of lucidity occur, neither in the case of terminal nor in paradoxical lucidity, despite being studied. It is known that they usually occur in the presence of loved ones, as well as in some cases they have happened as a possible response to the music that their caregivers have played for them.
A New York research group also found that Terminal lucidity may be partly caused by changes in brain activity that take place before dying. However, this research does not fully explain why these people with dementia can suddenly regain skills.
Why isn’t more known about terminal or paradoxical lucidity?
First, because of its unpredictable nature. If you don’t know when it will happen, how can you study its cause? At most it can be done a posteriori, or dementia patients would have to be continually evaluated, which would entail a lot of financial and energy expenditure, both for patients and researchers.
And why isn’t the analysis done during the moment of lucidity? Well, simply because it would not be ethical to investigate it, taking into account that terminal or paradoxical lucidity are events that the loved ones of the patient can take advantage of to enjoy a last conversation with this person, to laugh together again and to say goodbye.
Sometimes it is necessary to remind ourselves and keep in mind that the objective of science is to discover relevant information and phenomena, in order to apply them to achieve the well-being and development of people. If to do so, we have to harm people’s lives or prevent them from taking advantage of such special circumstances, there is no point in conducting an investigation. The end does not justify the means.
