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Gilmore-Bykovskyi A, Dillon K, Coulson A, Fehland J, Benson C, Sanson-Miles L, Mueller K. An observational study protocol to capture, validate and characterise lucid episodes in people living with advanced dementia receiving hospice care. BMJ Open 2024; 14:e085897. [PMID: 38760031 PMCID: PMC11103230 DOI: 10.1136/bmjopen-2024-085897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/25/2024] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION Lucid episodes (LEs) in advanced neurodegenerative disease, characterised by a transient recovery of abilities, have been reported across neurological conditions, including Alzheimer's disease and related dementias. Evidence on LEs in dementia is extremely limited and draws predominantly from retrospective case reports. Lucidity in dementia has received growing attention given the clinical, caregiving and potential epidemiological implications of even a temporary return of abilities in advanced disease. Following a funding initiative by the National Institute on Aging, several new investigations are focused on establishing foundational evidence on lucidity in dementia. The objectives of this study are to capture, characterise and validate potential LEs via audiovisual observation, computational linguistic and timed-event coding of audiovisual data, and informant case review for face validation of LEs. METHODS AND ANALYSIS This prospective multifaceted observational study will investigate LEs in advanced dementia through longitudinal audiovisual observation within an inpatient hospice unit. Audiovisual data will be coded to generate variables of participant verbal output, verbal expressions, non-verbal communicative actions and functional behaviours to enable measurement of features that can be used to characterise LEs. Multiple methods will be used to identify potential LEs including field interviews with caregivers/clinicians who witness significant events during data collection, reports from research staff who witness significant events during data collection and detection by researchers during video data processing procedures. Potential LEs will undergo a structured case review with informants familiar with the participant to facilitate validation and enable triangulation across measures generated through coding. ETHICS AND DISSEMINATION This study will be conducted in accordance with all Federal Policies for the Protection of Human Subjects and the protocol (ID 2021-1243) has been approved by the University of Wisconsin-Madison Institutional Review Board. Findings will be disseminated via scientific conferences, journal publications and newsletters shared with participants and through dementia-focused and caregiver-focused networks.
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Affiliation(s)
- Andrea Gilmore-Bykovskyi
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kayla Dillon
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Alison Coulson
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jess Fehland
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Clark Benson
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Leah Sanson-Miles
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kimberly Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Álvarez-Fernández B, Marín-Carmona JM. [Paradoxical lucidity and personal identity in patients with advanced dementia: change of paradigm?]. Rev Esp Geriatr Gerontol 2024; 59:101493. [PMID: 38691896 DOI: 10.1016/j.regg.2024.101493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/01/2024] [Accepted: 03/13/2024] [Indexed: 05/03/2024]
Abstract
In this article we approach the concept of paradoxical lucidity (LP) (an unexpected, spontaneous, significant and relevant episode of communication or connection) in persons with advanced dementia. The existence of LP could change the paradigm of dementia as a degenerative, chronic, progressive and irreversible disease (where neuronal death plays the leading role), towards a model where functional deficits of neuronal networks acquire importance, which raises new potentially reversible therapeutic and rehabilitative possibilities. We analyze the ethical consequences that these episodes may have with respect to the implicated persons (patients, caregivers and professionals in charge of their care) and try to answer the following question: Do persons with advanced dementia continue to maintain their personal identity despite suffering cognitive impairment so severe?. The LP indicates that this is possible. In this work we make a transversal outline of the different concepts and theories of personal identity in these patients, from different areas of knowledge (philosophy, psychology, neuroscience).
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Affiliation(s)
| | - José Manuel Marín-Carmona
- Especialista en Geriatría. Programa de Memoria, Centro de Envejecimiento Saludable, Ayto, Málaga, España.
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Coulson A, Benson C, Fehland J, Dillon K, Mueller K, Gilmore-Bykovskyi A. Feasibility and Acceptability of a Multifaceted Observational Protocol to Investigate Lucidity in Advanced Dementia. Alzheimer Dis Assoc Disord 2024; 38:140-146. [PMID: 38587070 PMCID: PMC11141205 DOI: 10.1097/wad.0000000000000615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/01/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE Episodes of lucidity (ELs), characterized by spontaneous, transient recovery of abilities, are reported across neurological conditions, including advanced dementia. Despite the significance of these events, existing research is limited to retrospective reports. Approaches to prospectively capturing and characterizing ELs in dementia are lacking. METHODS This pilot study determined the feasibility and acceptability of a multifaceted observational protocol to capture, characterize, and validate ELs in individuals with advanced dementia in hospice. Feasibility was measured through enrollment/retention rates, workload/usability assessment of video observation, and data processing procedures to facilitate the measurement of verbal and nonverbal features for EL characterization. The acceptability of observation and informant validation procedures was qualitatively examined with clinician and family caregiver participants. RESULTS Study procedures were endorsed as highly acceptable among clinician (N = 49) and caregiver (N = 16) participants, demonstrating higher than anticipated thresholds for observation duration. Enrollment and retention rates for patient participants (N = 6) were 100% and 84%, respectively. Workload and usability measures demonstrated low disruptiveness and high ease of use after training. DISCUSSION Longitudinal video observation among individuals with advanced dementia in hospice care for the detection of lucidity was feasible and highly acceptable. Multidimensional, temporal coding of features of ELs is feasible but time-intensive.
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Affiliation(s)
- Alison Coulson
- University of Wisconsin-Madison School of Medicine and Public Health BerbeeWalsh Department of Emergency Medicine
| | - Clark Benson
- University of Wisconsin-Madison School of Medicine and Public Health BerbeeWalsh Department of Emergency Medicine
| | - Jess Fehland
- University of Wisconsin-Madison School of Medicine and Public Health BerbeeWalsh Department of Emergency Medicine
| | - Kayla Dillon
- University of Wisconsin-Madison School of Medicine and Public Health BerbeeWalsh Department of Emergency Medicine
| | - Kimberly Mueller
- University of Wisconsin-Madison Department of Communication Sciences and Disorders
| | - Andrea Gilmore-Bykovskyi
- University of Wisconsin-Madison School of Medicine and Public Health BerbeeWalsh Department of Emergency Medicine
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Bangerter LR, Griffin JM, Kim K, Finnie DM, Lapid MI, Gaugler JE, Biggar VS, Frangiosa T. A Delphi Approach to Define Lucid Episodes in People Living With Dementia. Alzheimer Dis Assoc Disord 2024; 38:147-151. [PMID: 38757575 DOI: 10.1097/wad.0000000000000621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/07/2024] [Indexed: 05/18/2024]
Abstract
PURPOSE Lucid episodes (LEs: unexpected episodes of spontaneous, meaningful, and relevant communication or behavior) in Alzheimer disease and related dementias are a new area of scientific inquiry that lacks clinical consensus and require more conceptual attention. METHODS We aimed to measure consensus from an expert group on: (1) potential medical or clinical explanations for LEs; (2) necessary medical and clinical context to LEs; and (3) interpretation of LEs. PATIENTS We convened 13 experts from different disciplines (neurology, psychiatry, psychology, pharmacy, palliative care, hospice, nursing, social work, primary care, geriatrics, and professional home caregivers) to identify elements of LEs. RESULTS Experts provided a range of opinions on medical and clinical explanations and questions to understand LEs. Consensus on LEs when presented with clinical vignettes was not reached. Panelists highlighted key medical and contextual factors needed to make a definitive judgement about LEs. CONCLUSION There is variability in how LEs are interpreted by clinical experts, which complicates the identification of LEs in Alzheimer disease and related dementias.
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Affiliation(s)
- Lauren R Bangerter
- Health Economics and Aging Research Institute, MedStar Health Research Institute, Hyattsville, MD
| | - Joan M Griffin
- Division of Health Care Delivery Research and Kern Center for the Science of Healthcare Delivery
| | - Kyungmin Kim
- Kern Center for the Science of Healthcare Delivery
| | - Dawn M Finnie
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester
| | - Maria I Lapid
- School of Public Health, University of Minnesota, Minneapolis, MN
| | - Joseph E Gaugler
- Department of Child Development and Family Studies, Research Institute of Human Ecology, Seoul National University, Seoul, Korea
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Griffin JM, Kim K, Finnie DM, Lapid MI, Gaugler JE, Batthyány A, Bangerter LR, Biggar VS, Frangiosa T. Developing and describing a typology of lucid episodes among people with Alzheimer's disease and related dementias. Alzheimers Dement 2024; 20:2434-2443. [PMID: 38305566 PMCID: PMC11032560 DOI: 10.1002/alz.13667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION This study examined lucid episodes among people living with late-stage Alzheimer's disease and related dementias (PLWD) and then developed a typology of these episodes to help characterize them. METHODS Family caregivers of PLWD provided information about witnessed episodes, including proximity to death, cognitive status, duration, communication quality, and circumstances prior to lucid episodes on up to two episodes (caregiver N = 151; episode N = 279). Latent class analysis was used to classify and characterize empirically distinct clusters of lucid episodes. RESULTS Four lucid episode types were identified. The most common type occurred during visits with family and among PLWD who lived > 6 months after the episode. The least common type coincided with family visits and occurred within 7 days of the PLWD's death. DISCUSSION Findings suggest that multiple types of lucid episodes exist; not all signal impending death; and some, but not all, are precipitated by external stimuli.
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Affiliation(s)
- Joan M. Griffin
- Division of Health Care Delivery Research and Kern Center for the Science of Healthcare DeliveryMayo ClinicRochesterMinnesotaUSA
- Kern Center for the Science of Healthcare DeliveryMayo ClinicRochesterMinnesotaUSA
| | - Kyungmin Kim
- Department of Child Development and Family StudiesResearch Institute of Human EcologySeoul National UniversitySeoulRepublic of Korea
| | - Dawn M. Finnie
- Kern Center for the Science of Healthcare DeliveryMayo ClinicRochesterMinnesotaUSA
| | - Maria I. Lapid
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Joseph E. Gaugler
- School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Alexander Batthyány
- Viktor Frankl Research Institute for Theoretical Psychology and Personalist StudiesPázmány Péter Catholic UniversityBudapestHungary
| | - Lauren R. Bangerter
- Health Economics and Aging Research InstituteMedStar Health Research InstituteHyattsvilleMarylandUSA
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Ross JP, Post SG, Scheinfeld L. Lucidity in the Deeply Forgetful: A Scoping Review. J Alzheimers Dis 2024; 98:3-11. [PMID: 38339937 DOI: 10.3233/jad-231396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Background Even in severe states of Alzheimer's disease and related dementias (ADRD), accounts of an unexpected or paradoxical return of awareness and lucidity have been reported in some patients, documented formally, and studied. Objective A scoping review was undertaken to survey the literature on the topic. Methods Five databases were searched using pertinent search terms. Results were deduplicated and subsequently screened by title and abstract for relevance. Remaining reports were read and included or excluded using specific inclusion criteria. 30 results consisted of a mix of perspective papers, case reports, qualitative surveys of caregivers, law journal comments, and mechanistic speculation. Results An equal mix of primary and secondary research was identified. Conclusions The papers collected in this review provide a valuable methodological outline for researching the topic of lucid episodes in ADRD. The verified legitimacy and simultaneous inexplicability of these events promote philosophical discussion, mechanistic investigations, and sorely needed research in the field of ADRD.
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Affiliation(s)
- John Paul Ross
- Department of Family, Population and Preventive Medicine, Center for Medical Humanities, Compassionate Care and Bioethics, Renaissance School of Medicine at SUNY Stony Brook, Stony Brook, NY, USA
| | - Stephen G Post
- Department of Family, Population and Preventive Medicine, Center for Medical Humanities, Compassionate Care and Bioethics, Renaissance School of Medicine at SUNY Stony Brook, Stony Brook, NY, USA
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Benson C, Fehland J, Botsch M, Block L, Gilmore-Bykovskyi A. The Impact of Episodes of Lucidity on People Living With Dementia and Their Caregivers: A Case Report. Alzheimer Dis Assoc Disord 2023; 37:142-144. [PMID: 36988619 PMCID: PMC10238644 DOI: 10.1097/wad.0000000000000553] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/30/2023] [Indexed: 03/30/2023]
Abstract
People living with dementia (PLWD) may experience the episodes of lucidity (ELs), defined as a sudden return of abilities presumed to have been lost and presenting as meaningful communication and connection. Early research on ELs in advanced disease stages suggests these are predominantly positive events. This case report draws from 1 outlier case from a descriptive qualitative study on caregivers of PLWDs' experiences with ELs. The caregiver-reported events perceived as an EL being accompanied with unexpected self-awareness, leading to a negative emotional reaction and feelings of loss. This case report contributes insights to the current understandings of ELs as exclusively relevant in advanced stages of dementia, as similar events may present in earlier disease stages, and may be associated with the negative emotional experiences among PLWD. Future research is needed to consider the ethical implications surrounding ELs and to support the caregivers in anticipating and responding to ELs.
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Affiliation(s)
| | | | | | - Laura Block
- BerbeeWalsh Department of Emergency Medicine
| | - Andrea Gilmore-Bykovskyi
- BerbeeWalsh Department of Emergency Medicine
- Center for Health Disparities Research, University of Wisconsin-Madison School of Medicine & Public Health, Madison, WI
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Gilmore-Bykovskyi A, Block L, Benson C, Fehland J, Botsch M, Mueller KD, Werner N, Shah MJ. "It's You": Caregiver and Clinician Perspectives on Lucidity in People Living With Dementia. THE GERONTOLOGIST 2023; 63:13-27. [PMID: 35797987 PMCID: PMC10091484 DOI: 10.1093/geront/gnac095] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Episodes of lucidity (ELs), or a transient return of abilities believed to be lost in people living with dementia, are a growing area of interest. These events hold important implications for care, caregiving, and our understanding of underlying etiologies. Research on ELs is largely limited to retrospective reports. The perspectives of professional and family caregivers on ELs and research approaches can inform efforts to define and study lucidity. The present study examined family caregiver and hospice clinician experiences with and perspectives on ELs in people living with dementia and observational approaches to studying these events. RESEARCH DESIGN AND METHODS This exploratory, descriptive qualitative study employed semistructured interviews (N = 20 caregivers, N = 6 clinicians). Data were analyzed using Rapid Identification of Themes and subsequent duplicate review of interview data to enhance trustworthiness. RESULTS Most participants readily recalled events they perceived as ELs, describing a transient return of abilities they felt was significant and/or meaningful. Defining features, interpretations, and the perceived impact of ELs varied, although ELs were commonly conceptualized as a manifestation of self. Caregivers described extensive efforts to detect patterns and supportive social conditions for ELs. Participants supported use of audiovisual observation to study ELs and provided recommendations for privacy, workflow, and caregiver engagement. DISCUSSION AND IMPLICATIONS Interpretations of ELs are heterogeneous, and recognition of these events may necessitate close familiarity with the person living with dementia. Participants endorse observational approaches and integration of caregivers in this research.
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Affiliation(s)
- Andrea Gilmore-Bykovskyi
- BerbeeWalsh, Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin, USA.,Center for Health Disparities Research, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Laura Block
- BerbeeWalsh, Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Clark Benson
- BerbeeWalsh, Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Jess Fehland
- BerbeeWalsh, Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Meghan Botsch
- BerbeeWalsh, Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Kimberly D Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nicole Werner
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Mindy J Shah
- Department of Medicine Division of Geriatrics, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin, USA
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Gilmore‐Bykovskyi A, Griffin JM, Mueller KD, Parnia S, Kolanowski A. Toward harmonization of strategies for investigating lucidity in AD/ADRD: A preliminary research framework. Alzheimers Dement 2023; 19:343-352. [PMID: 35757902 PMCID: PMC9792622 DOI: 10.1002/alz.12709] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Abstract
Episodes of lucidity (ELs) in Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD), have garnered increasing attention as an important area of research. Efforts to study lucidity suffer from a lack of clear definitional criteria, inconsistent conceptualization, and diverse approaches to operationalizing features of these events. To advance systematic investigation of ELs in AD/ADRD, there is a need for clarity and precision in labeling event attributes, markers, and specific measurement strategies that enable operational harmonization across distinct approaches to investigating the relatively broad and nascent phenomenon. To that end, we propose a preliminary research framework to guide harmonization of approaches to investigating ELs in AD/ADRD. Our goal is to provide an initial schematic that encourages uniform labeling of operational decisions about ELs.
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Affiliation(s)
- Andrea Gilmore‐Bykovskyi
- Department of Emergency Medicine, University of Wisconsin‐Madison School of Medicine & Public HealthMadisonWisconsinUSA
- UW Center for Health Disparities ResearchMadisonWisconsinUSA
| | - Joan M. Griffin
- Division of Health Care Delivery ResearchMayo ClinicRochesterMinnesotaUSA
- Kern Center for the Science of Health Care DeliveryMayo ClinicRochesterMinnesotaUSA
| | - Kimberly D. Mueller
- University of Wisconsin‐Madison Department of Communication Sciences and DisordersMadisonWisconsinUSA
- Division of GeriatricsDepartment of MedicineUniversity of Wisconsin‐Madison School of Medicine & Public HealthMadisonWisconsinUSA
| | - Sam Parnia
- NYU Langone Medical CenterNew York CityNew YorkUSA
| | - Ann Kolanowski
- Penn State Ross and Carol Nese College of NursingState CollegePennsylvaniaUSA
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Teresi JA, Ramirez M, Ellis J, Tan A, Capezuti E, Silver S, Boratgis G, Eimicke JP, Gonzalez-Lopez P, Devanand DP, Luchsinger JA. Reports About Paradoxical Lucidity from Health Care Professionals: A Pilot Study. J Gerontol Nurs 2023; 49:18-26. [PMID: 36594915 PMCID: PMC11100277 DOI: 10.3928/00989134-20221206-03] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Although clinicians caring for persons at the end of life recognize the phenomenon of paradoxical/terminal lucidity, systematic evidence is scant. The current pilot study aimed to develop a structured interview instrument for health care professionals to report lucidity. A questionnaire measuring lucidity length, degree, content, coinciding circumstances, and time from episode to death was expanded to include time of day, expressive and receptive communication, and speech during the month prior to and during the event. Thirty-three interviews were conducted; 73% of participants reported ever witnessing paradoxical lucidity. Among 29 events reported, 31% lasted several days, 20.7% lasted 1 day, and 24.1% lasted <1 day. In 78.6% of events, the person engaged in unexpected activity; 22.2% died within 3 days, and 14.8% died within 3 months of the event. The phenomenological complexity of lucidity presents challenges to eliciting reports in a systematic fashion; however, staff respondents were able to report lucidity events and detailed descriptions of person-specific characteristics. [Journal of Gerontological Nursing, 49(1), 18-26.].
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Affiliation(s)
- Jeanne A. Teresi
- Research Division, Hebrew Home at Riverdale by RiverSpring Living, Riverdale, New York, USA
- Columbia University Stroud Center at New York State Psychiatric Institute
| | - Mildred Ramirez
- Research Division, Hebrew Home at Riverdale by RiverSpring Living, Riverdale, New York, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College
| | - Julie Ellis
- Nursing and Midwifery Department, La Trobe University
| | - Amil Tan
- Graduate Center, City University of New York
- School of Nursing, Hunter College
| | | | - Stephanie Silver
- Research Division, Hebrew Home at Riverdale by RiverSpring Living, Riverdale, New York, USA
| | - Gabriel Boratgis
- Research Division, Hebrew Home at Riverdale by RiverSpring Living, Riverdale, New York, USA
| | - Joseph P. Eimicke
- Research Division, Hebrew Home at Riverdale by RiverSpring Living, Riverdale, New York, USA
| | - Paloma Gonzalez-Lopez
- Research Division, Hebrew Home at Riverdale by RiverSpring Living, Riverdale, New York, USA
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Griffin JM, Kim K, Gaugler JE, Biggar VS, Frangiosa T, Bangerter LR, Batthyany A, Finnie DM, Lapid MI. Caregiver appraisals of lucid episodes in people with late-stage Alzheimer's disease or related dementias. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12313. [PMID: 35775022 PMCID: PMC9219100 DOI: 10.1002/dad2.12313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Little is known about how family caregivers who witness unexpected and spontaneous communication among people in late stages of Alzheimer's disease and related dementias (ADRD) appraise these episodes of lucidity (EL). METHODS In an electronic, cross-sectional survey for former and current caregivers who participate in UsAgainstAlzheimer's A-LIST®, participants who reported witnessing an EL were asked how positive and stressful ELs were, if they made or changed decisions based on an EL, and what resources they sought out to explain ELs. RESULTS Caregivers reported 72% of ELs to be quite a bit or very positive, 17% to be stressful, and 10% to be both stressful and positive. Twelve percent of caregivers changed care plans because of ELs and 13% sought out information about ELs. DISCUSSION These exploratory data suggest caregiver reactions to EL vary. Caregivers may change or postpone care decisions due to EL, and few resources exist to address caregiver queries about EL.
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Affiliation(s)
- Joan M. Griffin
- Division of Health Care Delivery Research and Kern Center for the Science of Healthcare Delivery, Mayo ClinicRochesterMinnesotaUSA
| | - Kyungmin Kim
- Department of Child Development and Family StudiesResearch Institute of Human EcologySeoul National UniversitySeoulKorea
| | - Joseph E. Gaugler
- School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | | | | | | | - Dawn M. Finnie
- Kern Center for the Science of Healthcare Delivery, Mayo ClinicRochesterMinnesotaUSA
| | - Maria I. Lapid
- Department of Psychology and Psychiatry, Mayo ClinicRochesterMinnesotaUSA
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Peterson A, Clapp J, Harkins K, Kleid M, Largent EA, Stites SD, Karlawish J. Is there a difference between terminal lucidity and paradoxical lucidity? Alzheimers Dement 2022; 18:540-541. [PMID: 35102707 PMCID: PMC10911068 DOI: 10.1002/alz.12579] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Andrew Peterson
- Institute for Philosophy and Public Policy, George Mason University, Fairfax, Virginia, USA
| | - Justin Clapp
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kristin Harkins
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Melanie Kleid
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Emily A Largent
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Shana D Stites
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jason Karlawish
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Nahm M. Terminal lucidity versus paradoxical lucidity: A terminological clarification. Alzheimers Dement 2022; 18:538-539. [PMID: 35102690 DOI: 10.1002/alz.12574] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Michael Nahm
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
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