Nurses and caregivers often witness terminally ill patients in their final days, giving them insight into the signs that indicate the end is near. Terminal lucidity, a surge of energy before passing, is one such sign. Nurse Ruby Gramlow shared her experiences with patients in their final days and the importance of recognizing these signs. This surge of energy, although short-lived, can mislead loved ones into thinking the patient is recovering. Understanding these signs can help families prepare emotionally for their loved one’s passing.
A Nurse’s Warning About the End-of-Life Surge of Energy

Individuals nearing the end of life may experience a surge of energy before passing, including increased appetite, communication, and wakefulness. This phenomenon, known as terminal lucidity, is observed in some dementia patients and can be a confusing sign for families. It’s essential to recognize these signs as indicators of the approaching end and emotionally prepare for the inevitable.
More Signs of an End-of-Life Surge

In addition to an energy surge, patients may exhibit behaviors like sitting up in bed, clear communication, and engaging in specific topics or activities. However, these signs can also include agitation, nonsensical speech, and hallucinations of deceased individuals. Understanding these signs can help families navigate the complexity of the end-of-life process.
The Causes of Terminal Lucidity

Terminal lucidity is a medical phenomenon that is not fully understood, particularly in conditions like dementia. Researchers believe studying terminal lucidity can provide insights into neurological mechanisms and potentially lead to therapies for conditions like dementia. Recognizing and understanding terminal lucidity can help healthcare providers and families support patients in their final moments.
How Long Does an End-of-life Surge Last?

Studies have shown that most severe dementia patients who experience terminal lucidity pass within days of experiencing it. Understanding the timeline of these surges can help families prepare for the inevitable and make the most of their remaining time with their loved ones.
The Bottom Line on End-of-Life Surges

Recognizing the signs of an end-of-life surge of energy can help families navigate the emotions and complexities of the dying process. Understanding that this surge may signify the end can allow loved ones to cherish their final moments with the individual. Additionally, further research into terminal lucidity can provide valuable insights into end-of-life care and conditions like dementia.
Sources
- “Hospice Nurse Explains the Surge of Energy Often Seen at End of Life.” HRRV. Ruby Gramlow, RN, CHPN
- “A Review of Clinical Signs and Symptoms of Imminent End-of-Life in Individuals With Advanced Illness.” NCBI. June 26, 2023.
- “How to Explain the Surge Before Death to a Patient’s Family.” AMN Health Care. October 4, 2023