"It's important the family understands what the patient is experiencing."
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Doctors and end-of-life nurses have noticed a common phenomenon that often happens to patients one or two days before they pass away.
US nurse Ruby Gramlow, who has cared for many people in their final days, is determined to raise awareness about what happens during the last stage of life.
Her goal is to provide support not only for her patients but also for their families as they go through this challenging time.
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Gramlow works for the nonprofit hospice organization Hospice of the Red River Valley (HRRV), which serves more than 50 counties across North Dakota and Minnesota.
In a blog post for HRRV, she offered guidance on how family members and friends can be there for their loved ones right before they pass away.
She also shared a particular event that often happens shortly before death.
End-of-life nurse says people should listen to special songs with their loved ones before they pass.
Cavan Images/Raffi Maghdessian/Getty Images
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One of the most important pieces of advice she gave is to simply "be present" with your loved one in those final moments.
"Most importantly, being present with your loved one—even if you don’t know what to say or if you aren’t sharing the same experience—can be meaningful and create a sense of comfort and calm for the person," Gramlow wrote.
She suggested encouraging your loved one to listen to special songs, talk about old memories, or have conversations to say anything that’s on your mind while you still can.
Through her experience with many end-of-life patients, Gramlow has noticed that some people experience a sudden burst of energy shortly before they pass.
She cautioned that this shouldn’t be mistaken as a sign of recovery.
"You might have witnessed this surge of life yourself while attending to a loved one," she explained.
"This surge of energy is usually short, lasting anywhere from a few minutes to several hours, and may occur one to two days prior to death," she added.
"This is unique to each person, and not everyone will experience such a noticeable burst of energy.
"This energy spike may involve surge in their appetite, wakefulness, [and] communication that can last from a few minutes to several hours, and may occur one to two days prior to death."
Not everyone experiences the energy surge before death.
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In patients with Alzheimer's or other forms of dementia, this is known as terminal lucidity.
It's a brief period where patients suddenly regain their memories and personality just before they pass away.
Gramlow recognized that it’s natural for family members to interpret this energy as a positive sign, but she urged them to be prepared for what is coming next.
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"This time can often be misinterpreted by loved ones as a recovery and that the patient is getting better," she explained.
"It can be difficult for families and caregivers to acknowledge and understand these sudden changes as anything but signs of recovery.
"No one wants to lose someone they love," she continued.
"But it's important the family understands what the patient is experiencing so they can prepare themselves and the patient for what is to come."