A HOSPICE nurse has revealed six “unimaginable phenomena”
The thought of dying can be scary and often something we’re hesitant to confront.
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But knowing what might happen to you or loved one in their final days could give you an idea of when they might die and help you fully enjoy your last moments together, Julie McFadden, 41, shared.
The Los Angeles-based registered nurse specialises in end of life care and shares insights from her work with the aim of alleviating “the fear and stigma around death and dying”, according to her website.
Shedding light on the parts of life that many of us are too scared to confront has garnered Julie – known as Hospice Nurse Julie on social media – millions of followers on TikTok and other platforms.
“Death and dying doesn’t have to be scary, it can also be fascinating,” she explained in a recent video posted to her YouTube channel.
“There are many deathbed phenomena and I’ve seen them all. Let’s break them down,” she began her video by stating.
The former ICU nurse shared that she didn’t start notice these deathbed quirks until she started working in hospice.
She noted that not everyone will experience these exact phenomena.
“But it does happen enough that I like to educate about them,” Julie said.
According to the end of life expert, people often do or experience six things in the days or weeks before they pass, which she dubbed the “end of life phenomena”.
1. Terminal lucidity
The first common deathbed occurrence Julie touched upon was what she called “terminal lucidity”, but what you might know as “the rally or the surge”.
“This happens when someone who looks very ill will suddenly get a burst of energy and look like they’re getting ‘better’,” the hospice nurse explained.
Some think a burst of cortisol or other hormones might make people “perk up” in their final days, but Julie said we don’t really know why this happens.
“It happens very often – about one in three of all of our patients will have terminal lucidity,” Julie went on.
Sometimes you clock that someone is experience this surge of lucidity until afterwards.
“That’s why I think it’s really important to educate about it now,” Julie said, so people “know to enjoy” these moments and expect that their loved one will “die soon after”.
Someone experiencing terminal lucidity might suddenly become more alert and “have a really great day, they’re suddenly hungry, they’re suddenly able to walk”, the hospice nurse explained.
“And then shortly after, usually a day or two, they will die,” she said.
“If you don’t know it’s coming, you can think they’re getting better and then they die, which can be very devastating.”
2. Visioning
According to Julie, the “most talked about” end of life phenomenon is something called “visioning”, where people see loved ones who have already passed.
“It usually happens a few weeks before death, so it’s not always right before they die” Julie said.
These end of life visions are different to hallucinations caused by psychosis or delirium, as it’s “always comforting and the person is usually alert and oriented”, she explained.
A person can be “up and having a normal conversation […] and saying they’re seeing their dead father standing in the corner who is smiling and telling him that he’s coming to get him soon”, she added.
I have seen some extreme cases of this, people just saying, “Tonight’s when I’m going to die I know it, I can feel it,” and they do
Julie McFadden
Julie advised that you “just go with it” if your loved one does this, especially if their vision is comforting.
Feel free to ask them questions about what they saw and “just know that it’s normal”.
“This does kind of give you a timeline of when they will die,” the nurse noted.
“Usually when someone is visioning they are about a month away from death.”
3. Choosing a time of death
In some cases, people will choose when they are going to die, Julie said.
“I have seen some extreme cases of this, people just saying, “Tonight’s when I’m going to die I know it, I can feel it,” and they do.
“There’s also a time when people will wait for everybody to get into town or get into the room, arrive at the house and then they will die.”
More private people might wait to be left alone until they pass away, and others might hold on until they’ve surpassed a big milestone, like a birthday or wedding.
“They are almost kept alive by wanting to get to that date and they body will finally let go,” Julie said.
4. The death reach
Julie explained that many phenomena will come hand in hand with others, one of these being the “death reach”, which often accompanies visioning.
“It’s when the person is lying in bed and they reach up into the air, almost like they’re seeing someone or they’re reaching for someone, either to hug them or to shake their hand.
“A lot of times they’ll hold their hands up for a long time.
“Nothing to do about it, especially if they look comfortable, just let their body do its thing and know it’s normal.”
5. The death stare
Fifth on Julie’s list was “death stare”, which she said often happens with the reach too.
“What that usually looks like is someone staring off into the corner of the room or the side of the room, basically looking at something intently but 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 hospice nurse said.
Sometimes they’ll come out of their reverie suddenly and might even tell you what they were fixated on.
“I just had man the other day say ‘Jesus’,” Julie recalled.
She advised you once again “go with it”.
6. The shared death experience
The last phenomenon of Julie’s list – “the most impactful thing that has ever happened to me” – was the “shared death experience”.
The hospice nurse said: “A shared death experience is when someone who is not dying feels or sees or understands what’s happening to the person who is dying.
“It’s kind of like the dying person gives you the sensation of what they’re going through.
“There may have been some times where that’s not a good thing, but from my experience and all the stories I’ve heard it’s usually a good feeling.
“From what I experienced, it was a very good feeling. It was like the person was giving me these feelings of freedom and joy and kind of telling me that they were okay and basically they couldn’t believe how amazing it was again.
“At the time, I was shocked, I didn’t know what was happening, but I’ve come to find out that that’s called a shared death experience.”
Julie also gave the example of suddenly knowing that someone in your life has passed away before it’s been confirmed to you.
It comes after palliative care physician Dr Christopher Kerr revealed what people see in the days before they die and why it’s nothing to be scared of.
What is end-of-life care?
END-of-life care is support for people who are in the last months or years of their life.
It should help you live your last days as well as possible and help you die with dignity, according to the NHS.
Depending on your needs, different health and social care professionals may be involved in your end-of-life care. They can include hospital doctors and nurses, your GP, hospice or social care staff, chaplains, and physiotherapists.
End-of-life care can last a few days or months, or sometimes more than a year.
Though it isn’t always possible to predict, people are considered to be approaching the end of life when they are likely to die within the next 12 months.
This includes people who might die imminently, as well as people who:
- Have an advanced incurable illness, such as cancer, dementia or motor neurone disease
- They are generally frail and have co-existing conditions that mean they are expected to die within 12 months
- Have existing conditions if they are at risk of dying from a sudden crisis in their condition
- Have a life-threatening acute condition caused by a sudden catastrophic event, such as an accident or stroke
If you are approaching the end of life or caring for someone who is and want to find out about the care and support available, your first step is to speak to your GP or call the number your healthcare professionals have given you.
They can help you understand the services available to you locally.