Terminal lucidity: why do loved ones with dementia sometimes ‘come back’ before death?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Dementia is often described as “the long goodbye”. Although the person is still alive, dementia slowly and irreversibly chips away at their memories and the qualities that make someone “them”.
Dementia eventually takes away the person’s ability to communicate, eat and drink on their own, understand where they are, and recognise family members.
Since as early as the 19th century, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals.
It is estimated 43% of people who experience this brief lucidity die within 24 hours, and 84% within a week.
Why does this happen?
Terminal lucidity or paradoxical lucidity?
In 2009, researchers Michael Nahm and Bruce Greyson coined the term “terminal lucidity”, since these lucid episodes often occurred shortly before death.
But not all lucid episodes indicate death is imminent. One study found many people with advanced dementia will show brief glimmers of their old selves more than six months before death.
Lucidity has also been reported in other conditions that affect the brain or thinking skills, such as meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury.
Moments of lucidity that do not necessarily indicate death are sometimes called paradoxical lucidity. It is considered paradoxical as it defies the expected course of neurodegenerative diseases such as dementia.
But it’s important to note these episodes of lucidity are temporary and sadly do not represent a reversal of neurodegenerative disease.
Why does terminal lucidity happen?
Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that music can sometimes improve lucidity. But many episodes of lucidity do not have a distinct trigger.
A research team from New York University speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost.
Paradoxical and terminal lucidity are also very difficult to study. Not everyone with advanced dementia will experience episodes of lucidity before death. Lucid episodes are also unpredictable and typically occur without a particular trigger.
And as terminal lucidity can be a joyous time for those who witness the episode, it would be unethical for scientists to use that time to conduct their research. At the time of death, it’s also difficult for scientists to interview caregivers about any lucid moments that may have occurred.
Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife.
Why is it important to know about terminal lucidity?
People can have a variety of reactions to seeing terminal lucidity in a person with advanced dementia. While some will experience it as being peaceful and bittersweet, others may find it deeply confusing and upsetting. There may also be an urge to modify care plans and request lifesaving measures for the dying person.
Being aware of terminal lucidity can help loved ones understand it is part of the dying process, acknowledge the person with dementia will not recover, and allow them to make the most of the time they have with the lucid person.
For those who witness it, terminal lucidity can be a final, precious opportunity to reconnect with the person that existed before dementia took hold and the “long goodbye” began.
Yen Ying Lim, Associate Professor, Turner Institute for Brain and Mental Health, Monash University and Diny Thomson, PhD (Clinical Neuropsychology) Candidate and Provisional Psychologist, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Younger Next Year – by Chris Crowley & Dr. Henry Lodge
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Is it diet and exercise? Well, of course that’s a component. Specific kinds of exercise, too. But, as usual when we feature a book, there’s more:
In this case, strong throughout is the notion of life being a marathon not a sprint—and training for it accordingly.
Doing the things now that you’ll really wish you’d started doing sooner, and finding ways to build them into daily life.
Not just that, though! The authors take a holistic approach to life and health, and thus also cover work life, social life, and so forth. Now, you may be thinking “I’m already in the 80 and beyond category; I don’t work” and well, the authors advise that you do indeed work. You don’t have to revamp your career, but science strongly suggests that people who work longer, live longer.
Of course that doesn’t have to mean going full-throttle like a 20-year-old determined to make their mark on the world (you can if you want, though). It could be volunteering for a charity, or otherwise just finding a socially-engaging “work-like” activity that gives you purpose.
About the blend of motivational pep talk and science—this book is heavily weighted towards the former. It has, however, enough science to keep it on the right track throughout. Hence the two authors! Crowley for motivational pep, and Dr. Lodge for the science (with extra input from brain surgeon Dr. Hamilton, too).
Bottom line: if you want to feel the most prepared possible for the coming years and decades, this is a great book that covers a lot of bases.
Click here to check out “Younger Next Year” and get de-aging!
Share This Post
-
Men have a biological clock too. Here’s what’s more likely when dads are over 50
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We hear a lot about women’s biological clock and how age affects the chance of pregnancy.
New research shows men’s fertility is also affected by age. When dads are over 50, the risk of pregnancy complications increases.
Data from more than 46 million births in the United States between 2011 and 2022 compared fathers in their 30s with fathers in their 50s.
While taking into account the age of the mother and other factors known to affect pregnancy outcomes, the researchers found every ten-year increase in paternal age was linked to more complications.
The researchers found that compared to couples where the father was aged 30–39, for couples where the dad was in his 50s, there was a:
- 16% increased risk of preterm birth
- 14% increased risk of low birth weight
- 13% increase in gestational diabetes.
The older fathers were also twice as likely to have used assisted reproductive technology, including IVF, to conceive than their younger counterparts.
Steven van Loy/Unsplash Dads are getting older
In this US study, the mean age of all fathers increased from 30.8 years in 2011 to 32.1 years in 2022.
In that same period, the proportion of men aged 50 years or older fathering a child increased from 1.1% to 1.3%.
We don’t know the proportion of men over 50 years who father children in Australia, but data shows the average age of fathers has increased.
In 1975 the median age of Australian dads was 28.6 years. This jumped to 33.7 years in 2022.
How male age affects getting pregnant
As we know from media reports of celebrity dads, men produce sperm from puberty throughout life and can father children well into old age.
However, there is a noticeable decline in sperm quality from about age 40.
Female partners of older men take longer to achieve pregnancy than those with younger partners.
A study of the effect of male age on time to pregnancy showed women with male partners aged 45 or older were almost five times more likely to take more than a year to conceive compared to those with partners aged 25 or under. More than three quarters (76.8%) of men under the age of 25 years impregnated their female partners within six months, compared with just over half (52.9%) of men over the age of 45.
Pooled data from ten studies showed that partners of older men are also more likely to experience miscarriage. Compared to couples where the male was aged 25 to 29 years, paternal age over 45 years increased the risk of miscarriage by 43%.
Older men are more likely to need IVF
Outcomes of assisted reproductive technology, such as IVF, are also influenced by the age of the male partner.
A review of studies in couples using assisted reproductive technologies found paternal age under 40 years reduced the risk of miscarriage by about 25% compared to couples with men aged over 40.
Having a male under 40 years also almost doubled the chance of a live birth per treatment cycle. With a man over 40, 17.6% of treatment rounds resulted in a live birth, compared to 28.4% when the male was under 40.
How does male age affect the health outcomes of children?
As a result of age-related changes in sperm DNA, the children of older fathers have increased risk of a number of conditions. Autism, schizophrenia, bipolar disorders and leukaemia have been linked to the father’s advanced years.
A review of studies assessing the impact of advanced paternal age reported that children of older fathers have increased rates of psychiatric disease and behavioural impairments.
But while the increased risk of adverse health outcomes linked to older paternal age is real, the magnitude of the effect is modest. It’s important to remember that an increase in a very small risk is still a small risk and most children of older fathers are born healthy and develop well.
Improving your health can improve your fertility
In addition to the effects of older age, some chronic conditions that affect fertility and reproductive outcomes become more common as men get older. They include obesity and diabetes which affect sperm quality by lowering testosterone levels.
While we can’t change our age, some lifestyle factors that increase the risk of pregnancy complications and reduce fertility, can be tackled. They include:
- smoking
- recreational drug taking
- anabolic steroid use
- heavy alcohol consumption.
Get the facts about the male biological clock
Research shows men want children as much as women do. And most men want at least two children.
Yet most men lack knowledge about the limitations of female and male fertility and overestimate the chance of getting pregnant, with and without assisted reproductive technologies.
We need better public education, starting at school, to improve awareness of the impact of male and female age on reproductive outcomes and help people have healthy babies.
For men wanting to improve their chance of conceiving, the government-funded sites Healthy Male and Your Fertility are a good place to start. These offer evidence-based and accessible information about reproductive health, and tips to improve your reproductive health and give your children the best start in life.
Karin Hammarberg, Senior Research Fellow, Global and Women’s Health, School of Public Health & Preventive Medicine, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Share This Post
-
What does it mean to be transgender?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Transgender media coverage has surged in recent years for a wide range of reasons. While there are more transgender television characters than ever before, hundreds of bills are targeting transgender people’s access to medical care, sports teams, gender-specific public spaces, and other institutions.
Despite the increase in conversation about the transgender community, public confusion around transgender identity remains.
Read on to learn more about what it means to be transgender and understand challenges transgender people may face.
What does it mean to be transgender?
Transgender—or “trans”—is an umbrella term for people whose gender identity or gender expression does not conform to their sex assigned at birth. People can discover they are trans at any age.
Gender identity refers to a person’s inner sense of being a woman, a man, neither, both, or something else entirely. Trans people who don’t feel like women or men might describe themselves as nonbinary, agender, genderqueer, or two-spirit, among other terms.
Gender expression describes the way a person communicates their gender through their appearance—such as their clothing or hairstyle—and behavior.
A person whose gender expression doesn’t conform to the expectations of their assigned sex may not identify as trans. The only way to know for sure if someone is trans is if they tell you.
Cisgender—or “cis”—describes people whose gender identities match the sex they were assigned at birth.
How long have transgender people existed?
Being trans isn’t new. Although the word “transgender” only dates back to the 1960s, people whose identities defy traditional gender expectations have existed across cultures throughout recorded history.
How many people are transgender?
A 2022 Williams Institute study estimates that 1.6 million people over the age of 13 identify as transgender in the United States.
Is being transgender a mental health condition?
No. Conveying and communicating about your gender in a way that feels authentic to you is a normal and necessary part of self-expression.
Social and legal stigma, bullying, discrimination, harassment, negative media messages, and barriers to gender-affirming medical care can cause psychological distress for trans people. This is especially true for trans people of color, who face significantly higher rates of violence, poverty, housing instability, and incarceration—but trans identity itself is not a mental health condition.
What is gender dysphoria?
Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity, or their internal sense of gender. A 2021 study of trans adults pursuing gender-affirming medical care found that most participants started experiencing gender dysphoria by the time they were 7.
When trans people don’t receive the support they need to manage gender dysphoria, they may experience depression, anxiety, social isolation, suicidal ideation, substance use disorder, eating disorders, and self-injury.
How do trans people manage gender dysphoria?
Every trans person’s experience with gender dysphoria is unique. Some trans people may alleviate dysphoria by wearing gender-affirming clothing or by asking others to refer to them by a new name and use pronouns that accurately reflect their gender identity. The 2022 U.S. Trans Survey found that nearly all trans participants who lived as a different gender than the sex they were assigned at birth reported that they were more satisfied with their lives.
Some trans people may also manage dysphoria by pursuing medical transition, which may involve taking hormones and getting gender-affirming surgery.
Access to gender-affirming medical care has been shown to reduce the risk of depression and suicide among trans youth and adults.
To learn more about the trans community, visit resources from the National Center for Transgender Equality, the Trevor Project, PFLAG, and Planned Parenthood.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
Share This Post
-
The Vitamin Solution – by Dr. Romy Block & Dr. Arielle Levitan
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
A quick note: it would be remiss of us not to mention that the authors of this book are also the founders of a vitamin company, thus presenting a potential conflict of interest.
That said… In this reviewer’s opinion, the book does seem balanced and objective, regardless.
We talk a lot about supplements here at 10almonds, especially in our Monday Research Review editions. And yesterday, we featured a book by a doctor who hates supplements. Today, we feature a book by two doctors who have made them their business.
The authors cover all the most common vitamins and minerals popularly enjoyed as supplements, and examine:
- why people take them
- factors affecting whether they help
- problems that can arise
- complicating factors
The “complicating factors” include, for example, the way many vitamins and/or minerals interplay with each other, either by requiring the presence of another, or else competing for resources for absorption, or needing to be delicately balanced on pain of diverse woes.
This is the greatest value of the book, perhaps; it’s where most people go wrong with supplementation, if they go wrong.
While both authors are medical doctors, Dr. Romy Block is an endocrinologist specifically, and she clearly brought a lot of extra attention to relevant metabolic/thyroid issues, and how vitamins and minerals (such as thiamin and iron) can improve or sabotage such, depending on various factors that she explains. Informative, and so far as this reviewer could see, objective and well-balanced.
Bottom line: supplementation is a vast and complex topic, but this book does a fine job of demystifying and simplifying it in a clear and objective fashion, without resorting to either scaremongering or hype.
Click here to check out The Vitamin Solution, and upgrade your knowledge!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Great Sex Never Gets Old – by Kimberly Cunningham – by Kimberly Cunningham
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Here some readers may be thinking “after 40? But I am 70 already” or such, so be assured, there’s no upper limit on the applicability of this book’s writings. The number of 40 was chosen more as the start point of things, because it is an age after which the majority of hormonal declines happen (and with them, often, sex drive and/or physical ability). But, as she explains, this is by no means necessarily an end, and can instead be an exciting new beginning.
She kicks things off with a “wellness check”, before diving into the science of the menopause—and yes, the andropause too.
She doesn’t stop there though, and discusses other hormones besides the obvious ones, and other non-hormonal factors that can affect sex in what for most people is the later half of life.
Nurse Cunningham, much like most of modern science, is strongly pro-HRT, and/but doesn’t claim it to be a magic bullet (though honestly, it can feel like it is! But here we’re reviewing the book, not HRT, so let’s continue), or else this book could have been a leaflet. Instead, she talks about the side-effects to expect (mostly good or neutral, but still, things you don’t want to be taken by surprise by), and what things will just be “a little different” now if you’re running on exogenous bioidentical hormones rather than ones your own body made. A lot of this comes down to how and when one takes them, by the way, since this can be different to your body making its own natural peaks and troughs.
But it’s not all about hormones; there are also plenty of chapters on social and psychological issues, as well as medical issues other than hormones.
The style is very light and conversational, while also casually dropping about 30 pages of scientific references. Like many nurses, the author knows at least as much as doctors when it comes to her area of expertise, and it shows.
Bottom line: if your sex has ever hit a slump, and/or you simply recognize that it could, this book could make a very important difference.
Click here to check out Great Sex Never Gets Old, and enjoy the best of life in the bedroom too!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Chipotle Chili Wild Rice
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This is a very gut-healthy recipe that’s also tasty and filling, and packed with polyphenols too. What’s not to love?
You will need
- 1 cup cooked wild rice (we suggest cooking it with 1 tbsp chia seeds added)
- 7 oz cooked sweetcorn (can be from a tin or from frozen or cook it yourself)
- 4 oz charred jarred red peppers (these actually benefit from being from a jar—you can use fresh or frozen if necessary, but only jarred will give you the extra gut-healthy benefits from fermentation)
- 1 avocado, pitted, peeled, and cut into small chunks
- ½ red onion, thinly sliced
- 6–8 sun-dried tomatoes, chopped
- 2 tbsp extra virgin olive oil
- 2 tsp chipotle chili paste (adjust per your heat preferences)
- 1 tsp black pepper, coarse ground
- ½ tsp MSG or 1 tsp low-sodium salt
- Juice of 1 lime
Method
(we suggest you read everything at least once before doing anything)
1) Mix the cooked rice, red onion, sweetcorn, red peppers, avocado pieces, and sun-dried tomato, in a bowl. We recommend to do it gently, or you will end up with guacamole in there.
2) Mix the olive oil, lime juice, chipotle chili paste, black pepper, and MSG/salt, in another bowl. If perchance you have a conveniently small whisk, now is the time to use it. Failing that, a fork will suffice.
3) Add the contents of the second bowl to the first, tossing gently but thoroughly to combine well, and serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Brown Rice vs Wild Rice – Which is Healthier?
- Making Friends With Your Gut (You Can Thank Us Later)
- Capsaicin For Weight Loss And Against Inflammation
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
