terminal or paradoxical lucidity

loveskitties

I was wondering if any of you have heard of this in dementia patients.

I have heard of this in coma patients, and those who have been severely ill for other reasons.

From what I have read it can occur for hours, days or even a month before death in dementia patients.

The reason for my asking is that my father has had a week of increased lucidity and improved walking ability.  It is as if we are back to a year ago with his status.

There has been no medication or physical heath change to explain it.

harshedbuzz

We did not have this with either of my aunts who died on hospice and well medicated- one of them sort of faded out while the other had obvious terminal agitation. The same for the mother of a dear friend, she just sort of went to sleep; mom was running a race between stage 7 dementia and untreated breast cancer so her pain meds were likely at higher doses.

My dad and I had an unusually pleasant visit the day he died. He was chattier than usual and a bit more animated which I put down to showtiming. He flirted shamelessly with the SLP who was trialing foods and telling us conflated tales of spending the afternoon drinking beers with his brother in the lounger downstairs (1 story building) and visiting with my sister (who died in 1994). Going into the visit I had been struck the previous week about a sudden change in dad's manner and appearance- he'd lost 20 lbs in 8 weeks, the weight he carried was distributed differently and his face and affect were physically changed all of a sudden. I even dragged my poor DH to visit to confirm that my eyes weren't playing tricks on me; DH was shocked at the difference in his physical appearance. We talked with the DON who validated my concerns and ordered bloodwork, an X-ray and feeding eval to get a sense of what was going on. 

He looked perkier at the visit. The SLP explained he was aspirating and expressed surprise that  his speech was as good as it was compared to his swallowing. She was a little surprised when I explained that my sister was dead and said that could be worrying. On my way home, I stopped by my mom's to encourage her to visit (she said "tomorrow") and let her know about the SLP visit and scheduled hospice eval. Then I went home and debriefed my DH who agreed this all sounded like progression (previously dad was confused about my sister- some days he suspected she was sick or dying and would ask for confirmations saying "she's dead, isn't she?") and insisted I update my dad's brother. My uncle played devil's advocate at every turn which felt like judgment from one of those drive-by type of people. But I called. I told him about the swallowing issues, the weight loss and warned him that dad looked quite different than he might have when bro last visited. Uncle said he'd been meaning to visit and promised to get there the next day. I went to bed early with my ringer on and the phone next to the bed- the call came before 11. 

I asked the night nurse who was brand new- poor thing to have someone die on her first shift alone- and she said dad had had a quiet night but that he'd asked her at each bed check what time it was which I'm told is a common active dying thing.

My BIL did report that my sister had terminal lucidity but he's a lying rat bastard and was a cocaine addict at the time, so I don't know whether I believe him or not. My sister died from complications of AIDS. She was on hospice at home with him as caregiver enjoying access to his estranged wife's bank account and medications. BIL claims she was like her old self, laughing, joking, asking after her kids and parents. If this actually happened, it's another reason for me to loath this turd of a man for not getting his kids and her parents to her bedside and if it didn't why would he let his kids think they missed a last chance to connect with their mom? 

Like many with HIV/AIDS she developed a form of dementia- likely Korsakoff's which was one of her dad's mixed dementias. Conflated stories are their stock and trade. I was hugely pregnant when my sister was last hospitalized for infection. Most afternoons I would stop in for an hour or so bringing a pint of ice cream from a local guy who would create random combos for me to pique her appetite. The nurses were always quite professional but they never engaged with me which struck me as odd. One day a new nurse asked about where I was going to deliver and the others shot her a look. Seems my sister had told them all that I was intellectually disabled, no one knew who the father was and that I wouldn't be keeping the baby. I only found this out because the newbie spilled the beans.

HB

Hal42

loves kitties, I had never heard this term before you posted. I looked it up and thought perhaps that was what transpired with my mother many years ago. She had advanced Alzheimer’s, in the hospital with a broken hip and could not talk. Her vocalization were “Da, da, da, da…..”. My wife and I visited her in the hospital one day. When we approached her bed I said my name and “Mom, I love you”. Mom speaks in a voice as clear as a bell and said “Well, you better!” My wife said “I’m ….. and I love you too, Mom.” Mom says, again in a clear voice, “I know who you are and I love you too!”  Those were the only coherent words she had spoken in months and also the last. She passed away about a week later. 

That visit is one I keep in my Happy Memories collection.