Have your dying loved ones experienced “the surge?”

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Have your dying loved ones experienced “the surge?”

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My mom has been on hospice for five months with moderate vascular dementia. She recently moved to a new facility and had a terrible transition, lasting about six weeks. She had no recollection of the last six months or her last two care facilities, and demanded to be taken back to her home, which she sold months prior. Every time I talked to her she thought I was taking her home that day and then accused me of abandoning her when I explained she could not go back home. It was awful. Then one day her mood changed. We came to visit her and she happily spent the time with me and my brother without asking us to take her home. A week or two later, her mood improved even more. She expressed love and gratitude for her caregiver, told me that she was “exactly where she should be” and became extremely positive despite the fact that she felt much weaker than usual. Now, over the last few days, this positivity has turned into euphoria, even mania. She has hardly any dementia symptoms now, but at the same time acts like she is drugged - singing, laughing, talking nonstop (and often to herself) and wanting to speak about dying, past events, and asking us to pass along messages to old friends. Mind you, my mom has always been rather depressed and negative. This is not normal behavior. Her hospice nurse confirmed nothing had changed with her meds and is stumped by her behavior, especially since her vitals are okay.
I can’t help but believe this is what they call “the surge,” common to those who are dying. But I’m shocked her care team hasn’t mentioned it - especially the hospice nurse.
Has anyone else seen this level of giddiness/euphoria in their loved ones who were dying?

Behavior Change End of Life End of Life Signs

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My mother had vascular dementia and was under hospice care too. She was always a miserable, complaining, glass half empty type person. A few months before she passed, she started telling me she was living in a beautiful hotel (the memory care AL) and how her "girls" would take her out every evening to a delicious restaurant (she had always complained about the food in memory care) and to a lovely show! Then they'd drive her over to a new and fancy hotel to sleep for the night. She was thrilled, just confused how they were able to get all her things transferred to the new hotel so quickly, including the furniture. 😊

She was finally happy, this woman who had been unhappy her entire life. I didn't care why, I was just glad she was happy and had stopped complaining. Maybe God was giving her a glimpse of the afterlife, who knows?

We can't always make sense of what a mind addled with dementia is thinking. But we sure CAN appreciate seeing our mother's happy and feeling good for a change, huh? I choose to look at it as God giving them that glimpse of what life is going to look like for them very soon.

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Reply to lealonnie1

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Yes this does sound somewhat similar to my mom’s situation except she knows exactly where she is and is even aware that she’s acting strange. It’s the oddest thing. But yes, we are not too concerned as long as she’s happy!

(3)

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UPDATE: Thank you everyone for your responses. My mother passed away overnight in her sleep today. It appears that this was some sort of surge, after all. This is what I thought - her turnaround was so remarkable. She didn’t seem like she had been actively dying in the weeks prior, though she had gotten weaker. Anyhow, I hope this post will be helpful for anyone who experiences something similar, especially those whose loved ones are dying from COPD. I am so grateful that her last days were extremely peaceful, lucid, and without struggle. ❤️

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Reply to itsgoingtobeok

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Our condolences for certain. You gave a beautiful description of the surge as it can occur.
I wish you peace and I wish you relief in knowing that there are no further losses for this mom you gave such marvelous care to. That she is at peace and that you never need again to fear standing witness to her losses. My heart goes out to you.

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What we in nursing may have come closest to in terms of a surge is that many people who are ill almost to the stage of being comatose, may recover and converse gently with family, often more reasonably than in recent past years, and will say their "goodbyes" expressing that they have family member who have passed waiting for them. We often saw that.

I cannot say giddiness/euphoria to this extent you describe, so there may be some lack of oxygen to the brain that is acting somehow to cause something GOOD, but who knows.
I am afraid the line is long and the list lengthy of people who are trying to find any
"answers" about human behavior.

I did experience a whole ton of changes near end of life. Some were profound in that the persons separated (mentally) even from family which is very loving, really transitioned to another seemingly very peaceful place in which they may have been doing any number of things including life review, and memories seemed involved. I have seen people very relieved, very at peace with leaving, some looking forward to this great unknown they had imagined for a lifetime.

Whatever is happening, what a relief that it is for her so lovely.

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Reply to AlvaDeer

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Thank you for the reply!

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Mum didn't have a "surge" just before dying, but some months before.
She had been withdrawn for a few years and couldn't make decisions or express her thoughts, although she still showed signs of intelligence. Mum had vascular dementia following a cerebral haemorrhage, but was doing relatively well - until COVID and lockdown. Then, her cognitive awareness deteriorated rapidly.

However, during a hospital spell earlier this year, from which we didn't think she would recover, Mum suddenly became bright, lucid and just like her old self. She expressed care for me - it really choked me up - and she was interested in life again.
For a little while, I had my mum back, after having lost her some years before. I'm grateful for those precious moments, and they kept me going when she went downhill rapidly, a couple of months later.

Enjoy these moments of positivity and joy while you can. Store them up for a rainy day. You know the dark clouds are on the horizon, but hopefully they'll bring a rainbow, too.

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Reply to MiaMoor

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Yes. I am grateful. Thank you for sharing.

(1)

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Here is what the surge looked like for my dad. He’d spent weeks weakening, becoming jaundiced. Getting pain and a swollen abdomen. Was diagnosed with liver failure and cancer. We moved him to a small care home with hospice supervision. He spent several days sleeping most of the time with brief awake periods. Barely ate bites and drank a bit more than that. Hadn’t used his phone in days.
In the early morning the day before he died, he texted me, said he needed me. I rushed to his bedside. He couldn’t talk very well, but emphatically wanted food and drink. I could not understand what he wanted . He said it was “white”. He drank half a vanilla Boost but that wasn’t it. He finally got out that he wanted a Sprite. So we got that. He spent several hours much more awake. He waggled his eyebrows in a joking way when the hospice nurse complimented his full head of silver hair.
And about mid day he was back to mostly sleeping. He then passed at 3 am.

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Reply to Oedgar23

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What a beautiful story. I’m glad he didn’t suffer and kept his charm to the end.

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My father was 90 in January 2021 when COVID really started to spread. He had bad COPD and, as safe as we tried to be, he contracted it. I think he got it at the hospital when he was there for an unrelated issue. Several days after coming home, he, along with my brother and sister-in-law who lived with him to care for him all became sick with COVID. Dad ended up going to the hospital (different hospital). He did not want to go on a ventilator. I think he just wanted to go be with my mother who died several years prior.
So, when it was clear that he would not survive, we brought hospice in. I was the only one able to go daily to see him because everything was locked down and my bro and his wife were sick. The hospital was very gracious about making an exception for me to go in and sit with him (I had to be in head to toe PPE. I was the one who had to call his sister and my step-brother so he could talk to them before he was unable to. I also set up a call from the pastor of their church who talked to Dad and said the Lord's Prayer with him.
Dad was very sick. He would sometimes go days without calling or texting (even though I went in daily). One day, he was sending texts and saying he felt much better and the doctors said he was doing better. That was the "rally"...aka, the surge. Shortly after that, he went downhill and become unresponsive. He died a day or two later. The rally/surge is a very real thing.

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Reply to dmg1969

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I have not experienced this myself, but have heard of it happening.

When they talk about the surge, I think they mean when a person is actively in the dieing process. This doesn't quite sound that way , but whatever it is, you are very lucky to have it.

Stay strong, and take care of yourself, through out this very hard trying time.

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Reply to Anxietynacy

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Thanks for the reply. We definitely are grateful to have a happy version of our mom right now. If she does pass soon, at least we will have this memory of her.

(3)

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Everyone's death is their own. My mom did not experience any such changes before she died. She was always a very positive, loving person even in her dementia. She had been growing weaker for her final six months and had a fall and lost the ability to stand by herself about a month before her passing. She rapidly grew weaker in the time that followed, and on her last day she could no longer speak.

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Reply to TopsailJanet

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It’s always helpful to hear what others have experienced. Thank you.

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My mom also has vascular dementia. She has been on hospice 7 mo after a stroke and improved markedly. Was discharged from hospice. Then she had another event about 5 months later, back on hospice, swallowing issues, increased confusion and in a fog. She was ambulatory, so I would take her out of memory care. Took her to a nature reserve and it was like she was 30 yrs ago!! Very lucid, interacting with other visitors, looking at and reading about plants and now she is being discharged from hospice. Now with all the talk of your doing so good, she is talking about going home and driving. The improvement for her happened 2 weeks before her husbands 1 yr anniversary of his passing, so everyone was concerned she would take a downward turn; so far, so good but she cannot live by herself nor drive due to her confusion and inability to make appropriate decisions to remain safe. But, yes, I have witnessed people perk up and “look great”, only to die in a couple days or as my mother in law convinced us to go eat, arrested and died when we werent there…she did not want her son to be there and told him to leave several times.

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Reply to Sadiemydog

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As others have posted, the end of life can have a surge or rally. My brother, who hadn't been able to walk for 5 months, got up one day during physical therapy and walked across his nursing home room, back to his bed, and around the room, and called to tell me he was finally well. I asked the therapist if he was indeed well and she said no, to expect him to return to his inability to walk and hallucinations at some point. The very next day that's exactly what happened and he died a few days later, screaming for our mom. It was awful. But this that your mom is doing sounds very different. Perhaps she is just really happy about the ways she is being cared for and it took her a long time to adjust. I hope it continues for her, but if it is only a surge, how wonderful that she's going out happy.

Have your dying loved ones experienced “the surge?”

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