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Some research published in medical journals suggests changes in brain activity, or even brain size, shortly before death may prompt terminal lucidity. But the bottom line is that scientists

don’t fully understand what causes it, Jackson says. “I’m very humble that I don’t know what psychospiritual things happen for patients in that very last phase of their life,” she says. HOW

SHOULD CAREGIVERS NAVIGATE END-OF-LIFE RALLIES? Hard as it is, it’s important for caregivers to accept that their loved one probably is not getting better, no matter how much they seem to

bounce back, Newport says. Periods of lucidity rarely necessitate changes to someone’s treatment plan — although, Karlawish says, they can reinvigorate caregivers. “Embrace [a rally as] a

gift, for however long it is,” Jackson recommends. “This might be just a few hours or days, still in a downward trajectory.”  During a rally, a caregiver’s most important job is spending

quality time with their loved one. Resist the urge to run and grab others, she says, since episodes of lucidity can be over within minutes. “Just be present; take advantage of the

opportunity,” Newport says. If the episode goes on for a while, let the rallying person set the tone. If they’re not up for a deep or complex conversation, don’t force one. In some cases,

though, people “come to” with a specific agenda of things they want to do or say, Newport says. If your person is up to it, you can use a rally to sort out emotional or logistical issues, or

to ask how they would like their care to progress.  Bear in mind, though, that even someone who appears lucid may not be fully processing the moment. People sometimes say ambiguous things

during lucid episodes, which can be confusing for caregivers, Chin says. “Do what you think your loved one would have wanted,” she says. “There’s no right or wrong answer.” If nothing else,

Jackson says, a rally is a wonderful moment to affirm how much you care for your person. “You can’t really go wrong with ‘I love you,’” she says.