People with severe dementia exhibit episodes of lucidity. A population-based study

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Aims and objectivesTo describe frequency and characteristics of people with severe dementia who according to care providers, exhibit ELs in a population of those with dementia in institutional care.BackgroundThere are reports in the literature concerning episodes when the resident unexpectedly says or acts in a way that surprises the care provider because the resident seems to be much more aware of her/his situation than usual. This is labelled ‘episodes of lucidity’ (ELs).DesignThe study is based on data from a point prevalence study from institutions for the older people in northern Sweden in May 2000.MethodsOut of 3804 residents, assessed by key care providers, by means of the Multi-Dimensional Dementia Assessment Scale (MDDAS) with questions about ELs added, 92 residents were found to have severe dementia and difficulties with verbal communication. The key care providers' competence in assessing severe dementia was not evaluated. An ethics committee approved the study.ResultsFifty-two residents (57%) were assessed as exhibiting ELs. Residents who showed ELs had higher orientation scores and expressed more emotions than residents who did not show ELs. More residents who exhibited ELs took outdoor walks with their care providers exhibited ELs than those who did not (P = 0·001).ConclusionsEvery second resident with severe dementia and difficulties with verbal communication showed ELs.Relevance for clinical practiceThe fact that every second resident with severe dementia and difficulties with verbal communication showed ELs and that this was noticed especially when care providers took outdoor walks with the residents imply that closer contact between care providers and residents with severe dementia could change the care providers' expectations and enhance communication between the parties.

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