The surge before death, also known as terminal agitation, is a common phenomenon that can occur in the final stages of life. It is characterized by a sudden increase in restlessness, confusion, or agitation and can be distressing for the patient and their loved ones.

The exact causes of terminal agitation are not fully understood, but it is thought to be related to changes in the brain and nervous system as the body shuts down. It may also be related to changes in electrolyte balance or other metabolic factors.

Terminal agitation can be challenging to manage, as the patient may be unresponsive to usual methods of calming or sedating. Treatment may involve a combination of medications to manage symptoms, such as pain, anxiety, or delirium, and environmental modifications to create a calm and supportive environment. The hospice team will work closely with the patient and their family to develop a care plan that addresses their symptoms and provides comfort and support during their final life stages.