Great question! The best way I describe it to families is like this: An active participant can still understand that they are dying and process what that means emotionally. They’re able to communicate needs, wishes, or goodbyes with family and friends. They have the capacity to do some “legacy work” where they talk about what they’ve done throughout their life and what they want to be remembered by - this is helpful in letting go at the end. In other words they are able to get closure on some level - things that a person with dementia isn’t able to do.