A hospice nurse has lifted the lid on the signs she sees most often in the final 24 hours of a patient\u2019s life, and says they\u2019re not as terrifying as people might think.<\/p>\n
Julie McFadden, a California-based palliative care nurse known online as Nurse Julie, has worked in end-of-life care for 16 years. She\u2019s gained 1.7 million TikTok followers by sharing her experiences and helping to break the stigma and fear around death.<\/p>\n
Julie has even written a book, Nothing to Fear: Demystifying Death to Live More Fully, explaining what really happens in our last moments.<\/p>\n
Speaking on the Dr Karan Explores podcast, she said some people appear to have a surprising level of control over when they pass. \u201cThey basically will say, \u2018I\u2019m going to die after this date\u2019 or \u2018I\u2019ll wait for my daughter\u2019s wedding,\u2019\u201d she said.<\/p>\n
\u201cI\u2019ve literally had a patient say, \u2018I\u2019m dying tonight\u2019 and then die, even though they weren\u2019t actively dying at the time.\u201d<\/p>\n
Now, Julie has shared the three most common signs she\u2019s seen when death is just a day away.<\/p>\n
1. The \u2018death rattle\u2019
\nThe first \u2014 and often most unsettling for families \u2014 is a sound called the \u201cdeath rattle.\u201d This happens when the patient can no longer swallow or cough, allowing saliva and mucus to collect in the throat and airways.<\/p>\n
As air moves through the fluid, it creates a rattling or gurgling noise. According to Julie, this almost always happens within 24 hours of death but despite how it sounds, it\u2019s not painful. \u201cIt\u2019s just part of the body shutting down,\u201d she explains.<\/p>\n
2. Changes in breathing
\nThe second sign is a change in breathing patterns. Breaths may become slower, more irregular, or spaced far apart. Some patients take long pauses between breaths, making it look like they\u2019ve stopped breathing entirely.<\/p>\n
In the final hours, many people also display \u201cagonal breathing\u201d; short, gasping breaths that can appear alarming. Julie reassures families that this is a natural reflex when the brain isn\u2019t getting enough oxygen, and it\u2019s not causing the patient distress.<\/p>\n
3. The \u2018death stare\u2019
\nFinally, Julie describes what she calls the \u201cdeath stare.\u201d The patient may have their eyes and mouth open but be completely unresponsive. Their gaze is fixed and unfocused, as if \u201cno one\u2019s really home.\u201d<\/p>\n
While it can be confronting, Julie says it\u2019s often a peaceful moment, and that hearing is usually the last sense to go, meaning loved ones\u2019 voices can still be comforting.<\/p>\n
She stresses these signs are common, but not universal. \u201cSome people die suddenly, some take longer,\u201d she says. \u201cBut knowing what to expect can make it less scary for everyone.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
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