• Mitch Ware

The 7-Minute Scoop: Understanding the 'Rally' Before Death

In this 7-Minute Scoop, Mitch discusses the phenomenon of "Terminal Lucidity", or the unexpected return of mental and physical ability that sometimes occurs before death.  He explains what can happen when this occurs, and relates his own personal experience with this how this can be a remarkable gift.  



"So how is it possible for someone's brain to be destroyed by a disease like Alzheimer's or dementia or whatever cancer and yet the same person can become lucid and engaging this close to death? And why doesn't everybody who's dying have this wonderful moment? "


Transcript:

Hello. My name is Mitch Ware and this is the Seven Minutes scoop. We're trying something new here at Living with Hospice.  We're answering some of your questions in a short seven minute episode. This is the second of what I hope will be many of these seven minutes groups to come. And with this one, we're going to address the question. Do people rally before they die?

Many of us have heard of the term the last minute rally, and many of us have experienced this firsthand. So what is the last minute rally? And is it common for people to do that before they die? While the medical term for this is terminal lucidity, whatever you want, call it. This experience refers to an unexpected return or regained consciousness and mental clarity. And this, of course, occurs in a time period shortly before death. Now, many palliative care experts say it's not uncommon for people in hospice care to perk up briefly before they die. And it's not uncommon for them to ask for food or what day is it or how is the weather or maybe asking about a particular friend or loved one. Some just smile and say hello. And by the way, the last minute rally can last for a few minutes or as long as a couple of days.

There's been relatively little scientific research into this phenomenon, and it's only been named terminal lucidity since 2009. Those who work with dying are very familiar with this phenomenon and and experience it. Every once in a while. I personally have witnessed the last minute rally in individuals with dementia as well as well, brain tumors and strokes and even mental illness. Mind you, these are the people that one would think would be the least likely to have this sort of experience. Yet they do. So how is it possible for someone's brain to be destroyed by a disease like Alzheimer's or dementia or whatever cancer? And yet the same person can become lucid and engaging this close to death? And why doesn't everybody who's dying have this wonderful moment?

Sadly, there is, as of yet no scientific answer to this medical mystery. There just is not enough information to postulate a definitive mechanism for terminal lucidity. The fact that it occurs in people with different diseases suggest that there may be different processes occurring. Some speculate that what we're witnessing or experiencing is a spiritual thing. a spiritual experience. It's a divine gift. It certainly is a gift for family members and friends present. They get one last opportunity to be with their loved one and to say their last goodbyes. I will forever be grateful for the opportunity to close the books with my 28 year old son, who had brain cancer. Hopefully, there will come a day when we can have the answers to these unusual experiences. Until then, if you're with your loved one at the end of their life and you're lucky enough to be around them when they're having this experience, consider it a blessing and a final gift and savor that moment.

I remember it was a Friday night, it a local hospice inpatient facility where my son Matt was and I was feeding him some Arnold Schwarznegger pudding with a syringe through his closed teeth.  As I've mentioned before, he had brain cancer, and as a result of extensive radiation, he had had a stroke. His ability to chew was seriously diminished. He'd lost the most of the use on the right side of his body that combined with the medicine that he was on, we would have to remind him to chew and then swallow.  Anyway. I just placed the pudding in his mouth and said, "OK, Matt chew, chew, chew." and I turned to look at the TV as the Tigers were playing at the time.   and I heard him saying a very clear voice. "Dad, please stop saying that it's extremely annoying."

Man I hadn't heard that voice in weeks!! I was well aware of this thing called the last minute rally. So I said, "Matt, you're speaking? "And he said, "Yes, I am And please stop with the chew, chew, chew thing." I said, "Okay!", I dropped the pudding and said, "Matt, please forgive me for not being a better dad. I worked day and night and I should have..I should have stood up to your mom when she wouldn't let you play hockey. She was afraid you're gonna get hurt." 

Tears were running down my cheeks and I laid my head on his chest and he took his good hand, his left arm hand, and patted me, said. "Dad, You were a very good dad."

About that time my wife walked in and together she, Matt and I went on to talk about the important things... love, life, the joy of us being a family, the joy of knowing we're going to see each other soon in heaven. And we were able to close the books. We were so blessed. This was our last hurrah, his last minute rally. We woke up the next morning and he'd lost that mental clarity. And four days later, on Tuesday at 4:23 PM, Matt passed away.

My wife and I are eternally grateful for those few hours we had with him on that Friday night, and I'm sure it was a gift from God. I could share many other stories like this one with you, but time doesn't permit.

I do want to thank you for listening today. Please subscribe to our podcast and share this with your friends and family. If you have any questions or comments, please visit our website at www.livingwithhospice.info.  Click on the comments icon. Let us know what's on your mind.  Until next time. This is Mitch Ware for Living With Hospice and this has been your 7-minute scoop!

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