Is it a rally, or are they getting better?

How can I tell the difference?

A rally often looks like this:

• It comes suddenly, after days of sleeping, confusion, or not eating
• It is usually brief
• Other signs of the final days are still there, such as breathing changes or cool, blotchy hands and feet
• The decline usually returns soon after

Real improvement usually looks different:

• It builds slowly over days or weeks
• Your person keeps eating, staying awake, and doing more
• It lasts

The National Institute on Aging says sudden clear moments near death are likely temporary and not necessarily a sign of getting better. For more on what a rally looks like, read what the rally before death is.

Is it foolish to hope?

No. When someone you love suddenly smiles, talks, or asks for food, hope is a natural response. It is part of loving them.

You can hold hope and still use the time well. Say what you want to say. Call the people who would want to know.

What should I ask the nurse?

• "What do you see when you look at them today?"
• "Do the other signs suggest the end is still near?"
• "Should I call family now?"
• "Is it safe for them to eat or drink what they're asking for?"

Your nurse can tell you what they are noticing. If your person does keep getting stronger over time, your hospice team will talk with you about what that means for their care.