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?
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.
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.
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.
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.
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.