Terminal Lucidity as a Health Promotion Challenge in End-of-Life Care

Abstract

This study examines terminal lucidity (TL) as a health promotion challenge in end-of-life care. It explores TL as a phenomenon, debates its classification as a natural or pathological occurrence, and investigates its emotional and social impacts on healthcare professionals, caregivers, and family members. A mixed-methods systematic review of 21 studies—spanning qualitative, quantitative, and mixed-method designs—was conducted using 10 academic databases. Studies were assessed for quality using the CASP, JBI checklist, and mixed-methods appraisal tools. The findings were narratively synthesized to examine TL's nature, classification, and significance. TL was characterized as a sudden return of cognitive clarity near death, with conflicting perspectives on its classification. While some viewed it as a natural part of the dying process, others argued for further research into its neurological basis. Across all studies, TL was associated with significant emotional effects, including joy, grief, and confusion, underscoring its impact on stakeholders in end-of-life care. TL poses a substantial challenge in end-of-life care, requiring enhanced understanding and preparedness. Educational programs for caregivers and healthcare professionals are essential to address the phenomenon's complexities. Future research should focus on its neurobiological mechanisms, cultural implications, and role in care decision-making to improve end-of-life care practices.