Sudden improvement before death?

Specialties Hospice

Published

Have you had experiences with pts having a marked sudden improvement just before death? I have a friend whose mother went unresponsive (they were unable to wake her) for most of the day yesterday. She is in end stage Parkinson's and recently had a second CVA. That was the first time she has been unresponsive.

They were finally able to wake her last night for very brief periods where she would say one or two words, then go back to sleep.

My friend prepared herself for a death vigil. Before her mother became unresponsive and since her last stroke, she has been very weak, not able to speak loudly enough for anyone to hear her, and not "brightly" alert.

Today, her mother has awakened and is bright-eyed, alert, and talking better than she has in months. My friend is wondering if this could be the phenomenon of getting much better just before death. Since I am a nurse she asked me that question.

I told her I just don't know. I've been a nurse since 1998, and I've seen a few people improve a little just before death, but not that much. I would be interested in hearing your experiences on this.

That happeened to my mom. She suddenly gotten better, sat up, ate some of her favorite jello, took a sip of juice, and then she just drifed away and died.

-Dan

1 Votes
Specializes in LTC, assisted living, med-surg, psych.

I can't count the number of times I've seen this phenomenon. The most recent was a couple of weeks ago, when a comatose patient I'd cared for several times suddenly woke up, looked at his wife and family gathered round, smiled and said a few words. They thought it was a miracle. I tried gently to discourage this thinking, but to no avail, and they were genuinely shocked when he slipped back into the coma and died an hour later.

1 Votes
Specializes in ICU, CM, Geriatrics, Management.
txspadequeen921 said:
... happens in about 97% of the patients I deal with.

Knew it was common. But didn't think it was that high a proportion.

Thanks for quantifying your experience.

1 Votes
Specializes in Geriatrics, LTC.

Been there....seen that! Over and over again.

1 Votes
Specializes in Geriatric Psych.
txspadequeen921 said:
I work in hospice often ,it happens in about 97% of the patients I deal with.

Wow! 97%? I didn't realize it was that common.

1 Votes
Specializes in NICU- now learning OR!.

Absolutely. I have heard it many times and I have seen it personally.

On the personal side, it can be a wonderful way to say goodbye.

On the professional side....when they "perk up" like that - I was told to get the family in ASAP!

Jenny

ADN Dec 2005

1 Votes

Worked in hospice for few years and this was a very common thing.

1 Votes
Specializes in Educator.

My grandfather hd been placed in a nursing home (his choice, he wanted nothing to do with care of his colostomy--long story). Anyways, right before he died he perked up and ate lunch with my Dad. Within the next couple of days he died. I view it as a lovely gift to my Dad, from Grandpa. :)

1 Votes
Specializes in LTC.

I've seen it too. They "glow before they go."

1 Votes
nursnancy said:
Have you had experiences with pts having a marked sudden improvement just before death? .

Yes seen this several times. A remarkable 'recovery' from almost comatosed states. And someone who has not spoken a word for a long time suddenly sitting up and holding a conversation. Yes, it happens.

Mr.C.

1 Votes
Specializes in LPN.

Two days before my mom died, she became very alert. She knew she was dying, because she had made the decision to refuse a blood transfusion that would extend her life. It was her birthday, she hadn't eaten decently for months. She ate a sub sandwitch from subway, then a large piece of birthday cake, and ice cream. She laughed and joked. Then got down to buisness. My sister had a brain storm and had brought a tape recorder. My mom said goodbye to each of her family members. Named them by name and said something she rememebered about them and told them she wanted to see them again in heaven. When she finished with all her brothers and sisters, children, grandchildren and great grandchildren, she yawned. I'm tired she said. Where am I? Confused and tired she went to bed. She never again got out of bed. Durning the night she entered into a coma.

We made copied of the tape on CD's. At her funeral we passed out the CD's to all the family present. It was her final goodbye. A wonderful gift.

1 Votes

I am new to hospice, but saw this several times even in ICU patients. My own aunt who had an astrocytoma hadn't spoken a word in over 6 weeks. Just lay there sleeping, and when she did wake up, there was no acknowlegement that she recognized us, etc. Well, on Feb 12th my uncle was turning her and jokingly said, "I never thought I'd see you with a fat a##", she was always so tiny but had blown up from the Decadron. Well, she woke up, looked straight at him, laughed and actually talked coherently and sweetly with him for a few minutes before lapsing back into a coma. She died the next day. We always said it was her Valentine's gift to him, not dying on Valentines Day, but the bigger gift was that to this day he says..."she knew it was me taking care of her, not a stranger". This brings him great comfort and pride and was a wonderful final gift to him from her.

1 Votes
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