The Weiler Psi

Parapsychology Journalism: The People, The Theory, The Science, The Skeptics

Terminal Lucidity: A Review


Terminal Lucidity is the term used when dying people, who have previously been unresponsive or minimally responsive, suddenly gain clarity of mind for a few hours, often talking coherently with loved ones before passing away a short time later.  This has been known to occur even when the patient’s speech center has been destroyed and some have gained mobility where they previously had none.  It’s a remarkable, and very minimally studied area of medicine.  Anecdotes are plentiful though, as can be seen on this nurse’s forum.  (here.)

The reason that it hasn’t been studied much is that it doesn’t fit any current underlying theory of medicine, which is viewed in strictly materialistic fashion.  The most basic problem is that there is no biological need for people to suddenly regain lucidity within hours of dying.  Even if there is a material explanation for why this can take place, there is no reason why it should.  A biological system at the end of life is in decline and it doesn’t make sense for one part of that system to have a sudden positive change that creates lucidity, but then goes away a short time later.

Even more troublesome for a materialist explanation is that terminal lucidity only makes sense in the context of personal meaning.  The one thing that all cases of terminal lucidity have in common is that they are full of personal meaning.  The dying get closure with their relatives; they have one last moment to say their final goodbyes before they are gone.

So here we have a physical event whose only purpose is to have meaning.  Meaning however, is of the mind and a brain is completely physical.  This means that something, which cannot be the brain, is making a decision, (which requires a mind) to temporarily change a biological decline process (which we assume is strictly material)  in order to experience something meaningful. (which is a domain belonging exclusively to the mind.)  It’s impossible to get away from the conclusion that terminal lucidity is a situation where the mind, perhaps at a deep subconscious level, is in complete control of the body.  This flies in the face of materialist theories of biology.

There has been some research into terminal lucidity, mainly because understanding it might help people who are suffering from dementia for any number of reasons such as whether  we can trigger it before people are on the brink of death.  Mostly, though, people have just looked at case studies.  The most significant of these is Terminal lucidity: A review and a case collection  which I will be drawing upon for this article:

At present, we have identified 83 cases of terminal lucidity mentioned in the literature of the last 250 years and have collected comparable unpublished contemporary accounts. The published cases were reported by 55 different authors, mostly by professionals working in the medical setting. Of the cases that contained a description of the course of the illness, 22 patients were female and 32 were male. In addition to those particular case references and descriptions, we identified 18 general claims of physicians or caregivers who stated that they had witnessed terminal lucidity in mental disorders but gave no details of their observations.

They surveyed case reports from the 19th century, but these were problematic in that diagnoses were not advanced and included mental diseases such as “mania” and “melancholia.”  More importantly for a study of terminal lucidity is when a diagnosis is dementia, it’s important to know what kind of dementia.  And some of the diagnoses occurred outside of a medical setting, making them less than reliable.  Nevertheless, there were some interesting findings:

In a case published in 1822, a boy at the age of 6 had fallen on a nail that penetrated his forehead. He slowly developed increasing headaches and mental disturbances. At the age of 17, he was in constant pain, extremely melancholic, and starting to lose his memory. He fantasized, blinked continuously, and looked for hours at particular objects. When he additionally started to throw up frequently, he was admitted to a hospital. He was not able to sit or get out of bed. He remained in the hospital in this state for 18 days. On the morning of the 19th day, he suddenly left his bed and appeared very bright, claiming he was free of all pain and feelings of sickness. He intended to leave the hospital the next day. A quarter of an hour after the attending physician left him, he fell unconscious and died within a few minutes. The front part of his brain contained two pus-filled tissue bags the size of a hen’s egg (Pfeufer, 1822).

There have also been examinations of recent cases where the patient received excellent diagnostics prior to death, leaving little doubt that terminal lucidity is a very strange phenomena:

Haig (2007) reported the case of a young man dying of lung cancer that had spread to his brain. Toward the end of his life, a brain scan showed little brain tissue left, the metastasized tumors having not simply pushed aside normal brain tissue but actually destroyed and replaced it. In the days before his death, he lost all ability to speak or move. According to a nurse and his wife, however, an hour before he died, he woke up and said good-bye to his family, speaking with them for about five minutes before losing consciousness again and dying.

This review was also divided into different medical conditions, which demonstrated that terminal lucidity is not confined to particular health problems.  They found examples of terminal lucidity in stroke victims, (Noyes, 1952), (Osis, 1961; Osis and Haraldsson, 1977), (Daumer, 1865); they found it in Alzheimer’s patients,(Nahm and Greyson, 2009), (Brayne et al., 2008), (Osis, 1961), and in meningitis, (Osis and Haraldsson 1977).

There have also been cases of terminal lucidity in patients with severe mental disorders.  Schizophrenia, (Turetskaia and Romanenko, 1975), (Osis, 1961) and possible affective disorders, although these cases were from the 19th century. (Butzke, 1840), (Jacobi, 1837), (Bergmann, 1829),.  Although Terminal lucidity was well known in the 19th century among physicians, investigations into this phenomena virtually stopped in the 20th century, with the earliest study occurring in the 1970’s.  (Interestingly enough, this coincides with the rise and fall and rise of the popularity of parapsychology in general.  Popular support seems to be necessary for scientists to investigate unusual topics.)

The authors of this review produced conclusions which I have edited into highlights:  I can add nothing to this.

. . . Some of the cases presented, particularly those involving destruction of brain tissue caused by tumors, strokes, or Alzheimer’s disease, pose difficulties for currently prevailing explanatory models of brain physiology and mental functioning.

At present, we think that it is not possible to formulate definitive mechanisms for terminal lucidity. Indeed, terminal lucidity in differing mental disorders might result from different processes, depending on the etiology of the diseases. For example, cachexia in chronically ill patients might conceivably cause shrinking of brain tissue, relieving the pressure exerted by space-occupying intracra- nial lesions and permitting fleeting return of some brain function.

. . .We hope that drawing attention to this phenomenon may stimulate research into the psychopathology and neuropathology involved in near-death states. Studying terminal lucidity could help elucidate the factors governing the peculiar relationship between mind and brain, particularly as the brain deteriorates (Fenwick et al., 2010); and it could facilitate the development of new therapies.

. . .Research into terminal lucidity might lead to better understanding of the processes involved in memory and cognition. The unexpected return of mental faculties raises questions about cognitive processing at the end of life, especially in diseases that involve the degeneration of the brain regions usually responsible for complex cognition, and may suggest new neuroscientific models for memory and cognition in terminal illnesses. In addition, increased awareness of unusual end-of-life experiences on the part of physicians, caregivers, and bereaved family members could help them prepare for witnessing such phenomena, and thus better cope with them.

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13 comments on “Terminal Lucidity: A Review

  1. MindBody
    March 18, 2017

    I remember working in a nursing home once and I was doing a round. One old lady had been virtually aphasic (no speech) for a couple of years, but on this day she looked at me, gave a big smile, looked at the nurse, and exclaimed “You’ve brought me a man”- then went back to her quiet, non responsive self.
    Lapses in to alertness are reasonably common in Alzheimers (though still hard to explain in terms of traditional neurological views of how speech works. They are, however much more likely to involve reminescences or anxieties about the past than contact with the current moment.

    I suspect that the terminal lucidity phenomenon may well be related to the phenomenon where dying people know a close relative is coming, and hold on until the arrival of the loved one, when by all rights they should have passed away some time before.

  2. Tom Butler
    October 9, 2014

    Good subject Craig.

    A couple of references may be applicable. One is the shared death experience written about by Raymond Moody (http://sharedcrossing.com/shared-death-experience). This seems to suggest an increase in psi influence to the field associated with the preparation for transition as if the person transitioning begins to influence the field and witnesses experience it as a stronger influence than usual which might be more easily clairvoyantly sensed.

    The heightened sensitivity to psi events in people anticipating the excitement of a ghost hunt seems similar. It is likely a factor in group hallucinations, making me wonder how many of the terminal lucidity reports might be explained as a shared death experience.

    Another interesting reference point is that there are reports from near-death experiencers that the moment of death is not painful (http://www.deathwithoutfear.com/what-happens-at-death.htm). This is relevant because of the implications of a change in relationship between body consciousness and physical body.

    If you accept the avatar relationship between personality and body, part of that model is the idea that we share worldview and the process of perception. (First Sight Theory speaks to the perception part). We can know this because we have to deal with our body’s instincts every day, and much of our view of our world is colored by those instincts. As I see it, the body consciousness is dominant in this relationship.

    The body functions are likely maintained by the body image (Nature’s habits in Rupert Sheldrake’s view.) If that is true, then the relationship between the physical body and body consciousness would be independent from the entangled relationship between personality and the body. Personality seems to be “pinned” to the body, as if by contract, and shares the conscious self. But if the body consciousness vacates just prior to the moment of death to avoid pain, then perhaps the personality–who we really are–would be released to assume full control.

    This is all hypothetical and need more careful reasoning, but the point is that terminal lucidity has all of the earmarks of a change of relationship between entangled personality and a retreating body consciousness.

    • Tom Butler
      October 9, 2014

      I should add that the first listed author of that report, Michael Nahm, is the same one who co-reported with Stephan Braude on physical medium Kai Muegge. See: http://ethericstudies.org/essays/the-felix-study-personal-attack-under-cover-of-science/

      The extremely poor reporting by Nahm on his magical explanations for how the medium is a fraud discredits the Society for Scientific Exploration which published the report (Braude is chief editor = circular peer review)and forces one to question the validity of his other work. Certainly, if it was not for Bruce Greyson’s contribution, I would discount the article you used as tainted by an irrational reporter.

      • Mark
        October 9, 2014

        Now, this is very interesting. I listened to an interview with Dr. Braude where he said that he believes that the table levitation from Kai is real, but that Braude does not know if the ectoplasm is real. Dr. Braude also claimed that Braude believes that Kai has engaged in some fraud in the past, and that Kai might be both a fraud and a person with real paranormal abilities, like Eusapia Palladino. Braude also said that he wants a more strict set of protocols put on Kai before Braude will believe that the ectoplasm is real. If I remember properly, he said this on a show called Medium At Large on the All 1 Broadcast internet radio network. I think that Kai was also a guest on that same show at a later date. I have not, yet, listened to the Kai interview, but I think I’m going to have to make it a priority, after reading this. I might also have to listen, again, to the Braude interviews that I have already listened to on that network, as well, because I’m going on memory, here. I only listened to the Braude interviews on Medium At Large and A1B Spotlight.

        • Tom Butler
          October 9, 2014

          I hold an BSEE and not a doctorate in physiology like Braude, but I sat with Kai 7 times or so and had complete control of the room in 5 of those, including body (not cavity) search, sitter and room search (our room) and we used hands-on control of everyone including Kai. Phenomena was produced as advertised. (http://atransc.org/circle/felix_circle.htm)

          The problem I have is that Braude, and certainly biologist Nahm, does not show a very deep understanding of darkroom séance phenomena. They claim past fraud by Kai based on innuendo that apparently only exists as a cultural artifact. The medical doctor circle leader of the FEG, as well as Kai say there is no such evidence. Certainly there has been none in my 7 experiences.

          Meanwhile Kai bent over backwards to accommodate Braude’s research, which is something he is normally very against because, as anyone experienced with these phenomena should know, demonstration under close scrutiny impairs sitter/medium trust and production of phenomena. (http://archived.parapsych.org/papers/09.pdf) The sitters are part of the circuit and too much real-world input apparently enables the sitter’s worldview to take over, preventing much of the experience. (Yes, I know this sounds kind of suspicious, but you need to be there to understand.)

          My problem, and the only reason I feel justified in complaining, is that I asked Braude why his protocol didn’t cover his concerns. He just shrugged and said things come up. A scientist can only report on what is in the data. A scientist is ethically obliged to protect his or her test subject. Magical thinking about things outside of the protocol is not a scientific critique and reports of this nature in a peer-reviewed journal of which Braude is chief editor is conflict of interest.

          Everything that is wrong with mainstream science and mainstream skepticism when it come to things paranormal is showcased in the two reports and subsequent campaigning. It makes me feel like I am back on Wikipedia.

          • craigweiler
            October 9, 2014

            Thanks for sharing that. It’s interesting.

  3. Jami
    October 9, 2014

    I don’t have a personal contribution to this fascinating topic, but I really appreciate what I’ve learned just now, also in regards to Robert’s comment on yin/yang. I guess I would say that I am so curious where medical science will be once it fully acknowledges the spirit as something non material (at least in terms of our current, mainstream instruments of measurement). Thank you for touching upon this topic!

  4. zebzaman
    October 9, 2014

    Thank you, Robert, for your illuminating comment up here, and Craig, for the post in the first place. I have not observed this phenomenon myself, but have seen something else, related to this : two (or more) people I saw close to dying looked more beautiful … as in , the true self seemed to be shining through more clearly then before. It was almost by this sign I knew my mother was not going to be around much longer. It was like the world beyond had already touched her and taken all her worries away. Her death was still two month away at that time, but it was the last time I saw her, as sadly we lived half a world apart. Same with an uncle of mine dying of cancer, though he was ravaged from the disease, his face had taken on a bliss and beauty not there before. Maybe one has to be slightly psychic to see it. But even a young woman dying by sudden violence ( murder) I heard showed bliss as maybe never before just hours before her death and again in death on her face- as if touched much more strongly by what lay beyond then immediately ahead. A surviving witness told me about this. Well, it certainly seems there is an echo from the beyond.

  5. Robert
    October 8, 2014

    In Chinese medicine we called this condition “floating yang” or “false vitality”. It’s not possible to explain this in modern terms so I’ll have to use the ancient medical explanation. The body has yin and yang. The yin is the substance, the essence, the material, and the anchor. It holds the yang down and produces the yang. Yang is action, fire, vitality, and qi… it is the functional activities which support life and it also creates more yin.

    When a person has floating yang, all of their yin has been depleted, so the yang is no longer anchored and floats to the surface. It makes them seen vital because their cheeks get rosy, suddenly they have a big appetite again, they are talkative and feel good — and then within a day they are no longer alive. It’s like a candle burning all its wax and right towards the end the flame becomes huge before it finally extinguishes.

    Chinese medicine uses pulse diagnosis for everything. The pulse of a floating yang person person feels full and vital, but when you push deep it is non-existent. The pulse only exists on the superficial level, or the most outer. It’s why they look spirited, but really they aren’t.. When we feel this pulse, we inform the family that they should say their goodbyes. Death is usually within 12 hours or so.

    The floating yang is the final stage of the physical body’s life. Once the body dies, the yang detaches further and leaves the body, traveling to “tian” (heaven). The body is the final yin, or material substance, which anchors the spirit. Once it’s dead the final bit of yang moves on. This is the spiritual side of the ancient understanding.

    Each organ has its own spiritual nature. The lungs house the corporeal spirit, or the spirit of this ego. When a person dies their corporeal spirit dies with the body. The essence, or heart spirit, moves on to who knows where. The ethereal soul, housed by the liver, if it feels restless at death, can stay behind and become what people call “ghosts”. The ethereal soul is an incomplete version of the person. It has some emotional intent but it lacks the direction of the over-soul to really take further meaningful action.

    In a nutshell… the ancient understanding is that consciousness is separate from the body and remains more or less in tact after death. The lucid state or floating yang state is probably to give the person a chance to do their final spiritual rites to prepare them for the next emanation, whatever that may be. I don’t think the floating yang state is unique to humans, but we are the only ones really capable of using it for something meaningful.

    • donsalmon
      October 8, 2014

      Your statement, “it’s impossible to explain in modern medical terms” is excellent. I wish skeptics would stop saying, “there’s no such as alternative medicine. If it works, it’s “medicine.” Your post is a perfect example of how there are many “medicines” – allopathic is a particular way of thinking about (or not thinking about!) and exploring health and disease (mostly disease). Chinese, like Indian and other “complementary” (or real!?) medicines, are radically different ways of understanding the body and health – in particular, they’re non materialistic, possibly the most important aspect – or to put it another way, they are spiritually based. Whatever one might say about allopathic medicine, it is hardly spiritually based.

      Very nice letter, and nice explanation.

    • craigweiler
      October 8, 2014

      What a wonderful contribution! Thank you.

  6. donsalmon
    October 8, 2014

    Hi Craig: This is not only beautiful, but quite timely. My Dad just turned 96 last week, and my Mom is 93. They share a room in a retirement community in northwestern New Jersey. My mother has been pretty much out of it (Alzheimers) for the last 2 or 3 years. My father has started to get more and more confused over the past year, though he has his lucid moments.

    My mother has moments where she suddenly seems completely clear. Last time I visited, she asked me to play “Rhapsody in Blue” on the piano; something I used to play about 45 years ago. A few minutes later she couldn’t recall my name. (i course, couldn’t’ remember more than a few bars of the piece myself:>)

    Along with this idea of terminal lucidity, there’s also an interesting coming in and out of clarity that goes on, and a touching of deep inner realms. Last year, just prior to his 95th birthday, my father had this amazing dream (he often has dreams that he says seem “more real” than waking).

    A very non-religious man (a mechanical engineer most of his life), he dreamt that he was sitting in the front of a church, facing a congregation. There were long lines of people, coming up to him one by one, giving him gifts. He said he felt an ecstasy, a delight, he had never felt in his life.

    When Jan and I came up for his birthday, we bought a bunch of small gifts, and arranged a room so as to recreate the church scene. Somehow he remembered it, and perhaps this was a way of connecting his inner and outer worlds. He couldn’t remember the dream (or even the birthday party) when we mentioned to him by phone some months later, but I suspect somewhere in his inner consciousness a bridge may have formed.

    All kinds of rather amazing varieties of consciousness, outer, inner, subtle, not so subtle, much subtler – how much we will be discovering in the coming decades as your work and the work of others helps lift the ban on seeing this entire universe ablaze with the Fire of Spirit.

    • craigweiler
      October 8, 2014

      Thank you for sharing that Don. I found it very touching. I remember visiting my grandmother as she was comatose in a bed in a rest home and got the urge to rub her feet.

      She briefly came out of it and looked seriously annoyed at me for bringing her back. Then she quickly slipped back into her comatose state. She died about a couple of weeks later.

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