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The End Of Life Rally: Terminal Lucidity

(This article was first published on Debbie Moore-Black’s blog, Do Not Resuscitate, in 2022 and is used with permission. Debbie is an RN who has worked in the ICU for over 30 years. She created her blog to share nursing stories, offer ideas to improve care, discuss dilemmas facing patients and healthcare providers, provide a little humor, and offer opinions and insight on dying and dignity. Her stories are a composite of fiction and facts, based on the things she’s seen and experienced.)

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Granny Rachel, my husband’s mother, was an old country soul. She was a simple lady who loved the Lord.

She accepted me with open arms, when my own parents turned their backs on me. Granny Rachel made the best sweet tea, the best homemade vegetable soup with corn bread, and gave unconditional love to all.

She totaled two of her cars twice. Her son would check on her and found multiple candles lit in her house. She left the tub on until it overflowed with water.

Rachel could no longer be independent.

We relocated her to an assisted living center. An almost five-star-like hotel. Happy, friendly people, and Rachel found a new best friend, her roommate, Sally. They giggled and laughed together over silly things.

After two years at the assisted living center, at the age of 89, Rachel started to deteriorate. Her CHF, her COPD from years of working in a mill in the south where there was pollution and no filters, destroyed her lungs. Brown lung disease.

Granny Rachel was dying. She let out agonal breaths. At any time, we thought, this was it. It was the grande finale. My husband, our son, and myself gathered around her. We held her hand and waited for Granny Rachel to let out her last breath.

My son opened up the Bible as he read, “Though I walk through the valley of the shadow of death …” And then we heard a course whisper from Granny as she recited, “I will fear no evil, for thou art with me. Thy rod and thy staff, they comfort me.”

Beyond disbelief, some type of chills ran through our bodies. For one lucid minute, Granny Rachel was with us. She was here to let us know she was traveling through the tunnel to eternity.

My mother. Colon cancer with mets to her lungs and brain. We did vigils at her house. Us daughters. We took turns watching her and caring for her with the assistance of hospice. She would slip in and out of consciousness. The time had come. Her breathing had slowed down. And then she opened her eyes. She said to us, “I see angels. Beautiful angels,” just as clear as could be. And then she said, “Joe, there’s our baby Terrence.”  Joe was my dad. Terrence was the baby she lost at birth many, many years ago.

Sargent Sam (Sarge), a World War 2 veteran. A father of five and a wife of over 50 years.

When it’s time to transfer out of our ICU, like a promotion, that’s a good thing. But this was a transition to our comfort care suite.

Sarge did not want to be on a ventilator with his lung cancer. He knew it was time. He just wanted his family by his side. As the technicians wheeled Sarge on his stretcher out of the ICU, Sarge, who had an incredible sense of humor, shouted out to me, “I’m going to tell my wife you tried to flirt with me!!!” And with that, I blew him a kiss. Sadness filled my heart as I knew this was it. With his entire family by his side, Sarge died comfortably two days later.

How do we explain this end of life rally? Maybe we can’t. Maybe it’s their way of saying goodbye as they enter the heavens. They are on the brink of death and they wake up. Stable, lucid, they want to talk and eat and drink.

Rallying is a hallmark pre-death sign of improvement before death. This can last for a few moments or even days. They can sit up and talk. This rallying is also called Terminal Lucidity.

Try to cherish that last goodbye. That one last opportunity to connect with your loved one while still earthly creatures. They are saying their last goodbyes, with love in their hearts. With peace.

And they want you to know …

All is well.


Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.

Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.

Author Debbie Moore-Black

More posts by Debbie Moore-Black

Join the discussion 5 Comments

  • Gary Wedersphn says:

    An American Psychological Association journal study of “124 people with dementia who experienced terminal lucidity found that more than 80% exhibited a return of their responsive verbal ability, memory, and orientation. While over 90% of the participants experienced extreme cognitive impairment, around 80% had periods of lucidity involving clear verbal communication that appeared almost typical.”

  • Bill Simmons says:

    So nice. Thank you Debbie for making random stories we’ve all heard over the years into reality.

  • Ann Mandelstamm says:

    An absolutely beautiful gift to all of us. Thank you, Debbie, for this blog.

  • Diane Barry says:

    This is a beautiful, comforting and heartfelt read. We can only hope that when it’s our time, we can experience what these people did – knowing that we are crossing over and being at peace with it. Thank you so much for sharing.

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