A Case Series Recognizing Terminal Lucidity in Non-Dementia Hospice and Palliative Care Patients.

1. Describe the signs and symptoms of terminal lucidity. 2. Integrate knowledge of terminal lucidity to guide prognostic expectations and advance care planning counseling. Terminal lucidity is the phenomenon wherein dying patients have a brief hyperactive period right before their passing. It is an unpredictable end of life experience predominantly researched in the dementia and neurologically impaired population. We present 3 cases of non-dementia patients with end stage cancer or advanced illness demonstrating this "last hurrah" period of clarity imminently before their death. "Terminal lucidity" describes a period of sudden mental clarity in the terminally-ill that is often fleeting. Also referred to as the "end of life rally" - it is a phenomenon wherein dying patients who have been encephalopathic or non-communicative unexpectedly regain neurobehavioral capabilities in the form of improved wakefulness, cognition, and even physical activities. While loved ones and even providers may consider this as a sign of clinical recovery, patients often die soon after the terminal lucidity event. Despite the term dating back to more than 250 years, there has been little research on the subject in the hospice and palliative care field, as it has typically been studied within the geriatric field in patients with dementia and other neurological conditions. We present a case series within the hospice and palliative care field among patients with non-dementia related advanced illnesses, such as malignancy, who experienced terminal lucidity. Not all patients experience terminal lucidity; moreover, it cannot be predicted which patients will. However, by recognizing this phenomenon, we hope to better identify potential shared risk factors as well as approaches for coping and managing prognostic expectations among caregivers/family and medical teams. Models of Palliative Care DeliveryManagement of Medical Interventions [ABSTRACT FROM AUTHOR]