End of life nurse explains why you don't need to fear signs that somebody is about to die

A hospice nurse who wants to ‘normalise death and dying’ has explained why you don't need to fear the signs that somebody is about to pass away.

Dealing with the death of someone close to you is a difficult time, especially if you find yourself caring for them in their final days.

Julie McFadden - who goes by @hospicenursejulie on TikTok - is based in Los Angeles and has spent years working in palliative care.

She's put her expertise into a book - called Nothing to Fear: Demystifying Death to Live More Fully - to 'alleviate the fear and stigma' around dying.

Julie regularly takes to social media to share her advice on how best to approach tricky conversations as well as 'comforting' facts about death and what the final stages of life can look like.

And while not every patient will experience every stage, there's a good chance that you will recognise at least a couple - with Julie emphasising it's nothing to be afraid of.

Terminal lucidity

Julie claimed this is seen in one third of all patients and refers to when 'someone is looking very close to death' but then suddenly, their condition improves.

Signs of this include a renewed appetite and energy, with the hospice nurse saying some patients even get up and out of bed.

But Julie explained that sadly this doesn't usually last, and the patient will often pass away hours, or up to a couple of days later.

It can be a saddening part of the process for family, and give them a false sense that their loved one is going to recover.

Visioning

Visioning is when the patient begins to see relatives or friends who have previously passed away.

"I have a patient who is seeing dead relatives, they are seeing their dead wife and dead friends," said Julie.

"The family was concerned because they think he is hallucinating, maybe so, but he was very comforted by the images."

Choosing a time

Julie explained that she has seen cases where patients 'choose' when the time is right.

This could be because they are waiting to see somebody, or because they are waiting for family to leave before they let go.

"Some people will wait until after a milestone like a birthday or after a wedding… they stay alive because they want to get to that date and then their body will finally let go," she said.

Julie noted it can also depend on the patient's personality, adding: "Someone who is very private and independent will wait until everyone leaves."

The death reach

Julie explained that a 'death reach' refers to a gesture in which the person reaches out into the air, seemingly trying to grab something that isn't there.

"This is when a person is lying in bed and they reach up in the air, almost like they’re seeing someone or reaching for someone to hug them or to shake their hand," she said.

The hospice nurse revealed that the patient often talks or says a name at this point, too.

The death stare

Julie said that the 'death stare' and the 'death reach' can often happen at a similar time.

"What that usually looks like is someone staring off into the corner or side of the room, for sure looking at something intently," she continued.

"If you’re snapping your finger in front of their face or trying to say their name to snap them out of it, they won’t, until they’re ready."

The shared death experience

Perhaps one of the most daunting prospects is what Julie calls the 'shared death experience' which is when a loved one 'feels' what is happening to the patient themselves.

"People tell me it was giving them feelings of freedom and joy and telling them they were okay and they couldn’t believe how amazing it was," she said.

If you have experienced a bereavement and would like to speak with someone in confidence, contact Cruse Bereavement Care via their national helpline on 0808 808 1677.