Towards the end of life, a nurse has shared insights on a common phenomenon that frequently occurs with patients nearing their final moments.
While the exact time of death remains unknown to us, individuals in palliative care, those battling terminal illnesses, or those of advanced age often have a more defined timeframe.
Ruby Gramlow, a registered nurse in the United States, has observed signs that indicate the approach of death through her role as a hospice and palliative care nurse at Hospice of the Red River Valley (HRRV), a nonprofit hospice with facilities in over 50 counties across North Dakota and Minnesota.
In a blog entry for the hospice, Ruby expressed that navigating the transitions at the end of life is “one of the most challenging journeys we will all face some day.”
Over her career in palliative care, Ruby has noted certain indicators that life is drawing to a close, particularly a phenomenon she describes as an “unpredictable, mysterious flash of life and vitality.”
Termed as a “surge of life,” Ruby observed that some might witness this phenomenon while attending to a loved one in their dying moments.
This energy burst is “usually short,” Ruby clarified, though it can range from “a few minutes to several hours” and may occur one to two days before passing.
During this time, family members or medical personnel might see the patient displaying an increased appetite, improved “wakefulness” or communication, and heightened energy, which could manifest as restlessness or anxiety.
Ruby pointed out that “not everyone will experience such a noticeable burst of energy,” as it is “unique to each person.”
While this sudden improvement might suggest recovery, Ruby emphasized that healthcare professionals understand the reality.
She explained: “It can be difficult for families and caregivers to acknowledge and understand these sudden changes as anything but signs of recovery. No one wants to lose someone they love. But it’s important the family understands what the patient is experiencing, so they can prepare themselves and the patient for what is to come.”
Ruby advised against assuming recovery, but mentioned that “special memories” can be formed during this period of renewed vitality. She encourages taking pleasure in the time when their loved one is more alert.
“Reminisce, visit, listen to music,” she suggested. “Use this time to express your feelings and say goodbye. Most importantly, being present with your loved one—even if you don’t know what to say or if you aren’t sharing the same experience—can be meaningful and create a sense of comfort, calm for the person.”