Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-28T06:47:21.340Z Has data issue: false hasContentIssue false
  • English
  • Français

Lightening up before death

Published online by Cambridge University Press:  26 November 2009

A.D. (Sandy) Macleod
A.D. (Sandy) Macleod*
Affiliation:
Nurse Maude Hospice, Christchurch, New Zealand
*
Address correspondence and reprint requests to: A.D. (Sandy) Macleod, Nurse Maude Hospice, 15 Mansfield Avenue, Christchurch, New Zealand. E-mail: ad.macleod@cdhb.govt.nz
Get access Rights & Permissions [Opens in a new window]

Abstract

A lightening, or clearing, of the mental state in the hours or days before death, particularly in those delirious, is occasionally noted by those caring for the dying. Similar phenomena have been described in the natural world and in classical literature. This brief period of lucidity is generally followed by a rapid terminal decline. The author reports on his experience with six cases illustrating this phenomenon. The increasing use of palliative sedation may diminish the possibility of lightening up before death occurring. The theoretical concepts of Hughlings Jackson may provide an explanation for this phenomenon.

Keywords

LighteningDeathDeliriumLucidityHughlings Jackson
Type
Case Report
Information
Palliative & Supportive Care , Volume 7 , Issue 4 , December 2009 , pp. 513 - 516
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Boswell, J. (1986). Life of Samuel Johnson. Harmondsworth: Penguin Books (originally published in 1791).Google Scholar
Cervantes. (1952). Don Quixote. Cohen, J.M., trans. Harmondsworth: Penguin Books (originally pubished in 1615).Google Scholar
Halford, H. (1833). Essays and Orations Read and Delivered at the Royal College of Physicians (2rd ed.). London: John Murray.Google Scholar
Junger, E. (1996). The Storm of Steel: From the Diary of a German Storm-Troop Officer on the Western Front. London: Chatto and Windus (originally published in 1926).Google Scholar
Lawler, P.G., Gagnon, B., Manchini, I.L., et al. (2000). Occurrence, causes, and outcome in patients with advanced cancer. Archives of Internal Medicine, 160, 786–794.CrossRefGoogle Scholar
Levin, M. (1965). Our debt to Hughlings Jackson. JAMA, 191, 991–996.CrossRefGoogle ScholarPubMed
Macleod, A.D. (2006). Delirium: The clinical concept. Palliative and Supportive Care, 4, 305–312.CrossRefGoogle ScholarPubMed
Melville, H. (1972). Moby-Dick: or, The Whale. Harmondsworth: Penguin Books. (originally published in 1851).Google Scholar
Munk, W. (1887). Euthanasia: Or Medical Treatment in Aid of an Easy Death. London: Longmans, Green and Co.Google Scholar
Noyes, R. (1972). The experience of dying. Psychiatry, 35, 174–184.CrossRefGoogle ScholarPubMed
Oakley, S. (1972). The Story of Denmark. London: Faber and Faber.Google Scholar
Owens, J.E., Cook, E.W., & Stevenson, I. (1990). Features of “near death experience” in relation to whether or not patients were near death. The Lancet, 336, 1175–1177.CrossRefGoogle ScholarPubMed
Porta Salas, J. (2001). Sedation in terminal care. European Journal of Palliative Care, 8, 97–100.Google Scholar
Power, T.D. (1965). Some aspects of brain-mind relationship. British Journal of Psychiatry, 111, 1215–1223.CrossRefGoogle ScholarPubMed
Simmons, E.J. (1937). Pushkin. London: Oxford University Press.CrossRefGoogle Scholar
Stengel, E. (1963). Hughlings Jackson's influence in psychiatry. British Journal of Psychiatry, 109, 348–355.CrossRefGoogle ScholarPubMed
Weir, R.F. (ed.). (1980). Death in Literature. New York: Columbia University Press.Google Scholar
Witzel, L. (1975). Behaviour of the dying patient. British Medical Journal, 2, 81–82.CrossRefGoogle ScholarPubMed
York, G.K. & Steinberg, D.A. (2002). The philosophy of Hughlings Jackson. Journal of the Royal Society of Medicine, 95, 314–318.CrossRefGoogle ScholarPubMed