Death is an inevitable part of life, yet it remains a subject many find difficult to discuss, often shrouded in fear and uncertainty. Julie McFadden, a seasoned hospice nurse from Los Angeles, has dedicated over 15 years to end-of-life care, aiming to demystify the dying process and provide comfort to both patients and their families. Through her extensive experience in intensive care units (ICU) and hospice settings, McFadden has observed common occurrences in the final stages of life that, while natural, can be unsettling to those unfamiliar with them.
One of the most notable phenomena McFadden discusses is the change in breathing patterns as individuals approach death. This alteration, known as Cheyne-Stokes respiration, is characterized by cycles of rapid breathing followed by periods of apnea, or pauses in breathing. These cycles can last anywhere from 30 seconds to two minutes and are a result of the body’s metabolic changes as it begins to shut down. To those witnessing it, this breathing pattern can appear distressing; however, McFadden reassures that it does not indicate suffering. She emphasizes that the person is typically unconscious during this phase and does not experience a sensation of suffocation. The body’s relaxed state during these breathing patterns suggests an absence of discomfort.
Another common occurrence is the “death rattle,” a term used to describe a distinct gurgling sound emanating from the throat of a dying person. This sound results from the accumulation of saliva and secretions in the throat, as the body’s reflexes, including the ability to swallow, diminish. While the noise can be alarming to loved ones, McFadden clarifies that it is a normal part of the dying process and does not cause pain or distress to the individual. The sound is merely a byproduct of air passing through the pooled secretions in the airway.
McFadden also sheds light on the early signs that may indicate a person is entering the final months of life. Approximately six months prior to death, individuals often exhibit generalized symptoms such as increased introspection, reduced social interaction, heightened fatigue, and decreased intake of food and water. As the process advances to about three months before death, there is typically a noticeable decline in physical abilities, with individuals spending more time confined to their homes, experiencing difficulty performing basic tasks, and continuing to eat and drink less. These signs are part of the body’s natural preparation for the end of life
In the weeks leading up to death, McFadden notes that individuals may experience “end-of-life visioning,” where they report seeing or conversing with deceased loved ones or spiritual beings. This phenomenon is common and often brings comfort to the dying person, indicating that the mind is processing and preparing for the transition. Additionally, physical signs such as changes in skin color, cooler extremities, and glassy or teary eyes may become evident as the body’s systems gradually slow down.
Understanding these signs can alleviate the fear and uncertainty surrounding death. McFadden emphasizes that the body possesses an inherent knowledge of how to die, and many of these symptoms are indicative of the body’s natural process. By recognizing and understanding these signs, families and caregivers can better prepare for the impending loss, ensuring that their loved ones experience a peaceful and dignified death.
Through her educational efforts, McFadden aims to foster open conversations about death and dying, encouraging individuals to confront their fears and gain a clearer understanding of what to expect in the final stages of life. Her insights serve as a valuable resource for those seeking comfort and knowledge during one of life’s most challenging times.
