The topic of death and dying can be scary, but one hospice nurse has been educating people on TikTok about the signs that happen before someone dies in the hopes of preparing us for when the worst happens.
Many of us don't like to dwell too much on what happens when we die, or the thought of watching somebody we love pass away.
Hospice nurse, Julie McFadden - who goes by @hospicenursejulie on TikTok - is based in Los Angeles, and has spent years working in palliative care.
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She regularly shares content to educate people on end of life and has recently shared some of the most common behaviour she notices with patients.
While, of course, not everyone will experience every single one of these things, there's a good chance you'll see at least a few.
Terminal lucidity
Julie explained 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.
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Signs of this include a renewed appetite and energy, with Julie 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.
Julie says she always tries to educate families and patients so they know what to expect if this happens.
Visioning
Visioning is when the patient begins to see relatives or friends who have previously passed away.
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"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."
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Choosing a time
Julie explained that she has seen cases where patients 'choose' when the time is right.
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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 explained it can also depend on the patient's personality, adding: "Someone who is very private and independent will wait until everyone leaves, or if they’re very protective, they’ll die when 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.
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"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 explains.
The hospice nurse revealed that the patient often talks or says a name at this point, too.
Julie explained it doesn't always happen but she likes to educate families so they're not concerned if their relative exhibits this.
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The death stare
Julie explained 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," says Julie.
"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.
"Maybe if you’ve been in your room and all of a sudden you knew that your grandma had died, and you call your mum who says 'yeah she just died', that could be a shared death experience – you somehow just know what’s happening."
Julie said she has actually experienced this herself, explaining it changed her perspective on life and death forever.
"I had no idea what was going on," she said, explaining it happened with a female patient she had become close to.
"I could suddenly hear her voice in my head, 'oh my gosh Julie', I could feel what she was feeling... excitement, exuberance... 'if I only would have known'.
"The feeling was, 'if I only would have known how good this was going to be I wouldn't have been afraid'. That's the feeling she gave me."
Lucy Devine