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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?

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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itsgoingtobeok Nov 9, 2024
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!
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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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itsgoingtobeok Nov 9, 2024
Thank you for the reply!
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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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itsgoingtobeok Nov 9, 2024
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.
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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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itsgoingtobeok Nov 9, 2024
It’s always helpful to hear what others have experienced. Thank you.
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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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A death "rally" usually occurs after it seems imminent that one is dying and then suddenly they seem to come back to life for a short period of time, before slipping back into their dying process.
What you are describing doesn't sound like a rally at all, but instead that your mom is experiencing moments of clarity in her dementia, which isn't that unusual especially with vascular dementia, as in vascular dementia, the mind is actually the last thing to go unlike the other dementias.
With vascular dementia a person typically will start with an unsteady gait, incontinence, agitation or behavioral symptoms, issues with problem solving and a slower speed in their thinking before their memory will go, so I will just say to enjoy these moments of clarity with your mom and know that just because your mom is under hospice care doesn't mean that she will be dying anytime soon.
My late husband who had vascular dementia, was under hospice care for the last 22 months of his life.
And even though vascular dementia is the most aggressive of all the dementias with a life expectancy of just 5 years, only the Good Lord knows the day and time that He will call your mom Home.
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Reply to funkygrandma59
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itsgoingtobeok Nov 9, 2024
Thanks much.
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My MIL who died of vascular dementia had a "surge" of life about two weeks before she died. She had been failing quite hard physically and had been unable to do anything for a couple of months. Suddenly she was wide awake and wanted to make phone calls to all of her friends and family. They were all crying during the phone calls which puzzled her. The next day when I arrived to bring the stuff she had asked me to bring her during the surge, she was back in the unable to respond state.
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Reply to OncehatedDIL
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itsgoingtobeok Nov 9, 2024
Thank you.
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A day after my dad went into hospice, he was well enough to be wheeled out to mom. He then declined, passing 10 days later.
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