Is Terminal Lucidity a Window Into the Soul?

Patients with dementia sometimes
“come back” briefly into lucid conversation.
How is that possible?

Science cannot study everything. “Terminal lucidity” is an observed phenomenon among elderly dementia patients, wherein the patient appears to emerge from mental fog and talk like their old self for a brief period before relapsing, but this is very difficult for science to study, and may be unethical to research. The phenomenon is a challenge for materialists to explain.

Terminal lucidity: why do loved ones with dementia sometimes ‘come back’ before death? (The Conversation, 6 May 2024). Two writers from Monash University, Yen Ying Lim (a brain health specialist) and Diny Thomson (a psychology PhD candidate) say that the phenomenon is not a recent discovery.

Since as early as the 19th century, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals.

Lim and Thomson say that lucidity also occurs with some others who are not near death with dementia, such as those with “meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury.” Such cases are called “paradoxical lucidity” because they do not indicate death might be imminent. The lucidity contradicts the expected course of the disease. With elderly dementia patients, the ‘come back’ moments precede death within a week in most cases, they say, although how they know this was not documented; certainly there are exceptions.

Why Can’t Science Study Terminal Lucidity?

The authors ask why this occurs, but admit that science is limited in what it can learn about it. In moments of brief, joyous communication between loved ones, it would be unethical to have a scientist intervening to take notes or run tests. Such moments are no time to put the patient into an MRI or CT machine to study brain tissues or blood flows. Consequently, scientists can usually only speculate from anecdotal reports.

Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that music can sometimes improve lucidity. But many episodes of lucidity do not have a distinct trigger.

A research team from New York University speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost.

Science cannot study such things that appear deeply personal, and would not want to interfere with a loved one’s “final, precious opportunity to reconnect with the person that existed before dementia took hold and the ‘long goodbye’ began.”

Attempted Explanations Fall Short

Credit: Illustra Media, “Image of God” film

For evolutionary materialists, the mind is the brain, and mental activity is a consequence of blood flow, neural signals and other material stuff. Yet terminal lucidity is not reproducible or accessible to the scientific method. Knowing that scientists cannot pontificate about something so unexpected yet widely experienced as this, all Lim and Thomson can do is list some possible ways to account for it.

Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife.

Nothing in their short list comports with materialism. How could a dying person “say final goodbyes” or “gain closure” or “reconnect” through a brain that is not working right, where memories have been destroyed? In a politically correct way, Lim and Thomson mention a generic concept of an “afterlife” as a belief of “some” people. For this rare occasion, it was noteworthy that The Conversation did not censor two individuals who kept open the possibility of theological explanations.

I know terminal lucidity by experience. When my mother was in her last year of terminal dementia, there were brief moments of clarity. I remember one time especially when she looked at me with a smile, and spoke in clear words to the effect of “Thank you for all you are doing for me.” It was brief, but seemed distinct from the usual confused responses our family normally saw, different even from the expected sensations of comfort when being fed something she enjoyed. It was like a heart-to-heart, soul-to-soul communication. For that brief moment, I saw her old self again. I treasure that memory.

Being a substance dualist (someone who believes the mind and body are separate), I see soul-based explanations for terminal lucidity. I’ve considered the analogy of the mind operating the brain, like a user operating a computer. The user is distinct from the computer, but must use the computer (the brain and body) to get work done in the physical realm. The brain and body are tools for doing what the soul is trying to accomplish. Have you ever found yourself talking to yourself mentally? “Get up, you lazy fool… time to get to work!” Who are the parties involved? Is your soul trying to force your physical parts to obey? When you are thinking about something, you are using words, but who is speaking to whom?

This would imply that the soul can be healthy and fine but struggling to communicate through a broken machine. Degenerating neurons, tau protein tangles and other physical maladies like brain injuries can prevent the body from obeying the soul. Think of a frustrated computer user trying to type a message “I love you” but the computer mangles it into nonsense. No amount of shouting at the screen or pounding the keyboard helps. There’s nothing the user can do about it.

But now consider that a loving God sometimes mercifully permits the message to get through. The Bible tells us that God answers prayer and shows mercy to all the inhabitants of earth, not only those who follow him (see Psalms 66 and 67). Doesn’t the Creator of our bodies, brains and souls know how to operate them? Because death is ordained for all (Hebrews 9:27-28, Romans 5), God allows nature to take its course, but he can and does intervene according to his will for certain purposes or in answer to prayer. In this view, the Lord Jesus, whom my mother had loved and served all her life, operated her eyes, mouth and face to communicate to me what her soul was struggling to say.

I’m speculating here on things not possible to demonstrate scientifically, but the ideas comport with the Bible’s description of our Creator and the way he works with people. Christ followers have great and precious promises (II Peter 2:4) of eternal life, sealed and confirmed by Jesus’ death and resurrection. Consequently I have confident assurance that I will again see my father, mother and faithful relatives in a great reunion with new incorruptible bodies with the Lord Jesus Christ in heaven (I Peter 1:20-25).

What is the alternative? Death is the end of a meaningless existence that appeared by accident and has no purpose? Is the body nothing more than meat waiting to become manure? Why, then, even care about “science” or anything? Why do you use words? Words refer to thoughts and concepts, which are immaterial. This demonstrates that everyone already believes in the supernatural. Why not in a Creator God who designed us and filled the earth, in spite of its rebellion, with goodness and mercy.

We each have all the evidence we need that God’s promises are trustworthy. The Savior is waiting.