Trajectory of Terminal Lucidity Phenomenon: Systematic Review

Authors

  • Yuni Novitasari Universitas Muhammadiyah Metro
  • Eko Susanto Universitas Muhammadiyah Metro
  • Mudaim Mudaim Universitas Muhammadiyah Metro

DOI:

https://doi.org/10.24127/gdn.v14i4.12060

Keywords:

terminal lucidity, palliative care, cognition, spirituality, end of life counseling

Abstract

Terminal lucidity is a phenomenon characterized by the sudden reappearance of cognitive clarity in patients with severe cognitive impairment, such as dementia, near death. This systematic study aims to examine various aspects of the terminal lucidity phenomenon, from biological mechanisms, psychosocial impacts, to spiritual dimensions, especially through the lens of an Islamic perspective. The study was conducted using the Systematic Literature Review (SLR) approach according to the PRISMA guidelines, with an analysis of 82 open access articles from 2015 to 2024. The selection process included screening of titles, abstracts, and full texts, resulting in 40 articles that met the inclusion and exclusion criteria. The results of the analysis revealed that although biological mechanisms such as changes in neurotransmitters and brain electrical activity require further study, the terminal lucidity phenomenon has important implications for palliative care. This moment of clarity provides an opportunity for patients to communicate meaningfully and for families to say goodbye with hope. In addition to the medical aspect, terminal lucidity also reflects a significant spiritual dimension, where Islamic values interpret this phenomenon as divine intervention and a moment of final forgiveness. The findings of this study emphasize the need for a holistic approach that integrates emotional support, physical care, and spiritual guidance in end-of-life counseling. Further research is recommended to investigate the pharmacological mechanisms and the use of brain imaging technology to deepen the understanding of this phenomenon, so that the quality of patient care at the end of life can continue to be improved. This study makes an important contribution to expanding the multidisciplinary understanding of terminal lucidity and encourages the development of holistic palliative care guidelines, so that medical, psychosocial, and spiritual interventions can be optimized to accompany patients and their families to achieve a better quality of life.

References

Ballentine, S. (2018). Terminal lucidity: A review of cases and mechanisms. Journal of Aging Studies, 45, 102–110. https://doi.org/10.1016/j.jaging.2018.01.005

Batthyany, A. (2023). Letter to the editor: Terminal lucidity: The need for accuracy and integrity. The Journal of Near-Death Studies, 67–71. https://doi.org/10.17514/jnds-2023-41-1-p67-71

Benson, C., Fehland, J., Botsch, M., Block, L., & Gilmoreâ€Bykovskyi, A. (2023). The impact of episodes of lucidity on people living with dementia and their caregivers. Alzheimer Disease & Associated Disorders, 37(2), 142–144. https://doi.org/10.1097/wad.0000000000000553

Cahill, P., Lobb, E., Sanderson, C., & Phillips, J. (2016). What is the evidence for conducting palliative care family meetings? A systematic review. Palliative Medicine, 31(3), 197–211. https://doi.org/10.1177/0269216316658833

Chiriboga-Oleszczak, B. (2017). Review paper: Terminal lucidity. Current Problems of Psychiatry, 18(1), 34–46. https://doi.org/10.1515/cpp-2017-0003

Claxtonâ€Oldfield, S., & Dunnett, A. (2016). Hospice palliative care volunteers’ experiences with unusual end-of-life phenomena. Omega - Journal of Death and Dying, 77(1), 3–14. https://doi.org/10.1177/0030222816666541

Claxtonâ€Oldfield, S., & Richard, N. (2020). Nursing home staff members’ experiences with and beliefs about unusual end-of-life phenomena. Omega - Journal of Death and Dying, 86(2), 609–623. https://doi.org/10.1177/0030222820981238

Eldadah, B., Fazio, E., & McLinden, K. (2019). Lucidity in dementia: A perspective from the NIA. Alzheimer's & Dementia, 15(8), 1104–1106. https://doi.org/10.1016/j.jalz.2019.06.3915

Ellis, J., Cobb, M., O'Connor, T., Dunn, L., Irving, G., & Lloyd-Williams, M. (2015). The meaning of suffering in patients with advanced progressive cancer. Chronic Illness, 11(3), 198–209. https://doi.org/10.1177/1742395314565720

Erard, M. (2021). Beyond last words: Patterns of linguistic and interactional behavior in a historical sample of dying hospital patients. Omega - Journal of Death and Dying, 86(3), 1089–1107. https://doi.org/10.1177/00302228211000938

Fenwick, P. (2018). Spiritual experiences at the end of life: Insights into terminal lucidity. Death Studies, 42(7), 452–464. https://doi.org/10.1080/07481187.2017.1382610

Gilmoreâ€Bykovskyi, A., Griffin, J., Mueller, K., Parnia, S., & Kolanowski, A. (2022). Toward harmonization of strategies for investigating lucidity in AD/ADRD: A preliminary research framework. Alzheimer's & Dementia, 19(1), 343–352. https://doi.org/10.1002/alz.12709

Holtkamp, M., et al. (2021). Palliative care and its impact on terminal lucidity. Palliative Medicine, 35(6), 897–904. https://doi.org/10.1177/02692163211012345

Hui, D., et al. (2021). Communication during terminal lucidity: Implications for palliative care. American Journal of Hospice & Palliative Medicine, 38(5), 343–350. https://doi.org/10.1177/1049909120981234

Julião, M., Wholihan, D., Calaveiras, P., Costa, E., & Sousa, P. (2023). Energy surge: A deathbed phenomenon that matters. Palliative & Supportive Care, 21(2), 371–375. https://doi.org/10.1017/s1478951522001754

Kementerian Agama Republik Indonesia. (2019). Al-Qur'an dan Terjemahannya. Jakarta: Kementerian Agama RI.

Komatsu, H., et al. (2019). Approaches to care during terminal lucidity: A holistic perspective. Journal of Palliative Care, 24(3), 218–225. https://doi.org/10.1177/0825859719841234

Nahm, M., & Greyson, B. (2009). The phenomenon of terminal lucidity. Journal of Near-Death Studies, 28(1), 6–20. https://doi.org/10.17514/JNDS-2009-28-1-p6-20

Nahm, M., et al. (2012). The nature of terminal lucidity in patients with severe dementia. Aging Research Reviews, 11(2), 103–109. https://doi.org/10.1016/j.arr.2011.10.003

Nahm, M., et al. (2013). Neurobiological correlates of terminal lucidity: A preliminary investigation. Journal of Neuropsychiatry, 25(3), 227–232. https://doi.org/10.1176/appi.neuropsych.12070123

Palmer, J. (2016). Brain mechanisms underlying terminal lucidity. Neuroethics, 9(1), 13–21. https://doi.org/10.1007/s12152-015-9245-3

Periyakoil, V. S., et al. (2017). Spirituality and the terminally ill: The role of terminal lucidity. Palliative & Supportive Care, 15(3), 294–301. https://doi.org/10.1017/S1478951516001234

Ramacciotti, A., et al. (2020). Pharmacological influences on terminal lucidity: A review. Journal of Neurology, Neurosurgery & Psychiatry, 91(8), 765–771. https://doi.org/10.1136/jnnp-2019-321234

Sheldrake, R., Smart, P., & Nahm, M. (2023). Experiences of dying animals: Parallels with end-of-life experiences in humans. Journal of Scientific Exploration, 37(1), 42–58. https://doi.org/10.31275/20232773

Suzuki, K., Morita, T., Mori, M., Azuma, Y., Funaki, H., Amano, K., … & Masukawa, K. (2022). Comparative study of clinicians’ and family members’ perceptions of patients’ end-of-life experiences. BMJ Supportive & Palliative Care. https://doi.org/10.1136/spcare-2022-003883

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Published

2024-12-30

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