A hospice nurse has disclosed that approximately one-third of patients experience a ‘rally’ during their final moments. Known as ‘Hospice Nurse Julie’ on YouTube and TikTok, she uses her social media accounts to discuss hospice care, death, and dying. Her goal is to educate, help people prepare, and reduce the fear of death.
In a TikTok video earlier this year, Julie described the ‘rally’ stage, a phenomenon that occurs for many at the end of life. Julie noted that not many are aware of this stage, so she provided an explanation in the video. She began by mentioning that medical professionals, including herself, cannot fully explain the ‘rally stage’.
Julie described the ‘rally’ as a phase where someone who appears very ill and close to dying suddenly shows improvement. She explained this improvement can take various forms and shared some examples. Julie stated: “Patients might wake up fully conscious, have energy, and their personality may return, allowing them to joke.”
She also noted that patients often regain their appetite and may even get out of bed and move around as if they have recovered. However, this improvement is misleading. Julie added: “The heartbreaking part is they usually pass away within a few days of this energy burst, sometimes even the same night.” For healthcare providers, this phenomenon is challenging due to the lack of concrete evidence supporting the ‘rally’.
Additionally, they often need to explain to families, who might believe their loved one is improving, that this surge of energy is not a sign of recovery. According to AMN Healthcare, nurse Lina Velikova said: “End-of-life ‘rallies’ can be very distressing and confusing for the loved ones of the patient. It contradicts what we typically understand about life and death. Medical staff should prepare friends and family for these instances.”
Fellow nurse James Cobb emphasised the importance of being factual when communicating with a patient’s loved ones. “In these situations, I stick to the facts,” Cobb said. “It’s not fair to eliminate hope, but it’s also necessary to inform the patient’s friends and family that this surge or terminal lucidity doesn’t indicate a cure.” Recently, Julie also discussed the ‘messy’ aspect that often occurs when someone takes their final breath.
She explained how a person’s body ‘relaxes’ upon death, which can lead to ‘messy’ events. This can result in urination, bowel movements, and sometimes fluid discharge from the nose, eyes, or ears in the moments following death. For those who have experienced a bereavement and wish to talk in confidence, contact The Compassionate Friends on (877) 969-0010.
Frequently Asked Questions
Here are some common questions asked about this news
What is the ‘rally’ stage in hospice care?
The ‘rally’ stage is when a dying patient temporarily shows unexpected improvement.
How common is the ‘rally’ stage among hospice patients?
‘Hospice Nurse Julie’ states that about one-in-three patients experience the ‘rally’ stage.
How do patients behave during the ‘rally’ stage?
Patients may become fully conscious, regain energy, and even joke or get out of bed.
Does the ‘rally’ stage mean the patient is getting better?
No, patients usually die within a few days or even the same night after the ‘rally’ stage.
How should families be prepared for the ‘rally’ stage?
Medical staff should inform families that the ‘rally’ doesn’t indicate recovery and prepare them for the patient’s imminent death.