Although death happens to us all, many of us are unaware of how it happens – something hospice nurse Julie McFadden hopes to change.
The 41-year-old, based in LA, believes ‘education decreases fear,’ and wants to share what she’s learned throughout her career in palliative care in an effort to demystify the topic of death.
In a TikTok video, Julie answered a question she regularly hears in her work: what does the dying process actually look like?
While this all depends on how you pass away and what from, if it’s a case of ‘natural progression’ rather than a sudden incident, there are a few things that happen to the body as the end draws near.
First stage
Slowing down
In the early stages of dying, around six months before you pass, the symptoms you experience are more ‘generalised’.
Julie says: ‘For instance, you’re just going to be generally tired, generally lethargic, not eating and drinking as much, probably being less social.’
Second stage
Sharp decline in strength
‘The closer you get to death – let’s say three months out – you’re going to be more debilitated,’ explains Julie.
‘It’s going to be difficult for you to leave the house, you probably are eating and drinking very little throughout the day, and you’re sleeping more than you’re awake.’
Third stage
Transitioning
Before the last stage of life, Julie describes a period of ‘transitioning’ which happens around a month before death and can include a phenomenon known as ‘visioning’.
The nurse says: ‘This is when people will start seeing dead relatives, dead loved ones, dead pets, things like that.’
Julie previously explained this has happened to a number of her patients, is ‘always comforting’, and always when they’re ‘alert and oriented.’
She says that typically, someone ‘can be up and having a normal conversation with their family’, all the while ‘saying they’re seeing their dead father in the corner who is smiling and telling them he’s coming to get them soon and not to worry.’
Fourth stage
Actively dying
According to Julie, this final period is considered the most ‘distinct time in the dying process’ – when the body starts to fully shut down.
‘The actively dying phase is what scares people, because they’re not used to seeing it and they don’t know what the heck’s going on,’ she says.
At this point, Julie explains that a person is likely fully unconscious, with no food or water potentially for days at a time. They may appear unresponsive, but their bodily functions will still be taking place, making them fully dependent on carers to change and bathe them.
Additionally, ‘they will have changes in breathing, so their breathing is going to look different,’ says Julie.
‘Metabolic changes’ such as a difference in skin colour, high and low temperature,or the ‘death rattle’ – a gurgling noise (also known as terminal secretions) caused by a buildup of fluids in the throat and upper airways – follow before they later pass on.
However, while it’s natural to find these things upsetting, Julie assures people this stage is a ‘normal part of death and dying’, and ‘it’s not hurting your loved one.’
‘It’s important to be educated about what death actually looks like,’ she adds. ‘Movies and television don’t do it justice, then people see it in real life when it’s their loved ones and they freak out.’
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