Show Notes
After years of dementia, many people have reduced their communication to minimal levels. Sometimes, they don’t say anything at all, and family members may be tempted to assume that memories have disappeared along with cognitive function. Occasionally, such a person will become surprisingly coherent and able to discuss aspects of their lives for a few minutes or even hours. Because they often die within days of such an episode, researchers have termed the phenomenon “terminal lucidity.” Our guest, Dr. Marjorie Woollacott, suggests that the more inclusive term “paradoxical lucidity” might be more appropriate. What do these unexpected events have in common with near-death experiences? Can they teach us about consciousness?
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What Is Terminal Lucidity?
An article by Billy Brennan in the New York Times Magazine (July 15, 2026) was titled, “Why Do Some Dementia Patients ‘Return’ Just Before They Die?” The subtitle explained, “As they near death, some dementia patients recover mental faculties assumed to be long lost. Researchers want to know why.” Coincidentally, the Washington Post also ran a story recently on terminal lucidity: “Some dementia patients grow lucid near the end. Scientists hope it’s a clue.”
We were fascinated by the story Mr. Brennan shares about a conversation with a grandmother a few days before her death. It reminded us of an experience a friend of ours had shared about his own mother. She had dementia and had not communicated much with anyone for a long time. When the nursing home called him and told him she had broken her hip, he expected she would be even more incoherent because of the opioids she would be administered for the pain. So when he arrived at the hospital to find her oriented to time and place and aware of the situation, he was astonished. In this instance, her unexplained clarity continued for a few weeks. We can’t call it “terminal” lucidity, though, as she survived several more years.
Such tales suggest that even a disordered brain is not completely lacking in consciousness. But what do we mean by consciousness?
A Stroke of Insight to Teach Us About Consciousness
Neuroscientists usually assume that the brain creates consciousness, although they haven’t explained exactly how it does so. Some philosophers postulate that consciousness is a fundamental property of the universe. In this view, our brains act as filters so that we don’t become entirely overwhelmed and unable to function. Many years ago, we interviewed Dr. Jill Bolte Taylor, a neuroanatomist, about her brilliant book, My Stroke of Insight. In it, she recounts her own experience and perceptions as she suffered a massive hemorrhagic stroke that affected the left side of her brain. She observed as her brain circuits went offline, one by one. In particular, she was struck by a sense of joy and unity with the entire universe. Our guest for this episode, Dr. Marjorie Woollacott, suggests that during this time, Dr. Bolte Taylor’s stroke removed the usual filters that our brain puts on our consciousness.
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