INFORMATION AND SUPPORT TO CARE FOR YOUR AGING PARENT

Deathbed Rally

You’ve probably heard the stories: a hospice patient experiences bright upturns in health right before their body finally shuts down or an Alzheimer’s patient who has not spoken in months suddenly becomes completely lucid and recognizes those around them.  These stories can feel improbable, but there is actually some official documentation to their authenticity. This process of end-of-life upturns is often known as a “deathbed rally,” or, more formally, “Terminal Lucidity.” This strange, last burst of strength can allow a family a final goodbye. If unexpected, though, it can also trigger a false spark of hope for both a terminal patient and their family. Read on to discover the signs and signals to look out for in a deathbed rally.

What Is a Deathbed Rally, or Terminal Lucidity?

When someone on their deathbed “rallies,” it means a sharp uptick has occurred in their health. While health status can be a nebulous concept, AgingCare describes the traits of a rally to be a shift in energy and abilities before death. These traits include:

  • Vital sign stabilization where there was once fluctuation.
  • An insistence to eat or drink where desire previously lacked.
  • A sudden talkative drive.
  • Physical restlessness.
  • Improved mental clarity.
  • Improved motor function.
  • A backslide of symptoms associated with dementia and Alzheimer’s.

These signals grind up against what you may have been informed the end-of-life process will look like, and may be mistaken for recovery. Hospice patients will engage in meaningful conversation with others and even ask for food or drink. Their sense of humor might return. Any dementia they may experience will appear to lessen its hold on their mind. As their caretaker, you might note that your loved one feels like their “old self.” All too tragically, rallying is usually a final road sign at the end of one’s life journey.

How is a Deathbed Rally Defined?

Michael Nahm, a German biologist and medical researcher, coined these deathbed upticks as Terminal Lucidity. Terminal Lucidity is not considered a formal medical diagnosis. Rather, deathbed rallies are considered a noted end-of-life experience more in line with an observable psychological phenomenon than disease. As noted in Psychology Today, Nahm defines Terminal Lucidity as one of the more common, but lesser known, end-of-life experiences. Other experiences include visions, ghost visitations, out-of-body experiences, telepathic impressions, and other, seemingly supernatural occurrences that manifest in the mind as it attempts to process its mortality.

Medical documentation for the phenomena dates back 200 years. For many doctors, nurses, and hospice workers, firsthand accounts of rallies are so commonplace they are simply seen as an innate part of the death process. According to Scientific American, one study showed that 70% of caretakers in a British nursing home had personally observed elderly patients with dementia becoming lucid shortly before their deaths.

Are Deathbed Rallies Related to Dementia?

While a deathbed rally is not uncommon, the mystery of why it affects some terminal patients over others remains unsolved. Some have attempted to connect its shift to being more prominent in those suffering with dementia.

Researcher Alexander Betthyany reported that out of a total of 227 dementia patients observed, approximately 10 percent exhibited terminal lucidity. He reported this number as significantly higher than the number of occurrences in patients with no cognitive issues. One answer provided for this disparity is that the uptick is significantly more apparent in those suffering from dementia, as their downturn in mental clarity is more apparent before their deathbed rally. Regardless, there is simply too little formal information to acknowledge a root cause for deathbed rallies.

Do Deathbed Rallies Reverse Dementia?

Because of deathbed rallies’ link to temporarily “curing” dementia, some see it as holding the key to reversing its tragic effects. While recent studies, such as a 2020 report on the “spontaneous remission” of dementia patients, detail terminal lucidity in more firm scientific terminology, the vocabulary used by these studies is deliberately hesitant. There is clear care to not imply the reversibility of dementia.

While these long, winding scraps of information might seem dense, the simple explanation is that much of the human brain remains unmapped. For now, terminal lucidity remains a documented but ultimately under-known sector of scientific research.

When does a Deathbed Rally Happen?

Nahm divides terminal lucidity into two, distinct subtypes: a rally that comes gradually (a week before death), and a rally that comes rapidly (hours before death). The former is reported to occur more often than the latter. While some outlier cases were reported to have rallied across weeks or even months before death, a one-week window was marked as precedent for most cases.

How Long Does a Deathbed Rally Last?

A rally can last days, weeks, or for a few short, unexplainable minutes.

However, every end-of-life experience is as unique as the person who lives it. If you suspect your loved one may be experiencing a rally, do not attempt to mark their time left with statistics. I encourage you to spend as much time as you can at their side, for however long or short it might last.

What Should I Do If My Loved One is Rallying?

While a deathbed rally might trigger a spark of doomed hope, do not see it as some looming reaper. A deathbed rally can be a span of moments where your fading loved one’s life can be celebrated alongside them for a final time. Their memories, awareness, and sense of self can temporarily return, marking a welcome moment of normality in what is surely a difficult time for everyone involved. Many families find relief in their elderly kin’s sudden return to form, however fleeting, and embrace the short span of time to grant their affections and say their reciprocated final goodbyes. Deathbed rallies can be a sign of closure as much as they might be a sign of the end. They can be a gift, in some ways. If your parent is experiencing a rally, I encourage you to seize the span of it for all it might be sentimentally worth.

If you’re unsure, or are otherwise simply grappling with what might be your final months with your parent, feel free to share your experience within our Facebook Group. I’m certain you will be able to find support there, and discover fellow members that can empathize with your story.

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Older woman lying in bed, holding hand of loved one. Cover image for article about a deathbed rally.

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