Hospice nurse shares three things you see in the last 24 hours before someone dies

A hospice nurse has revealed the things you tend to see in patients in the last 24 hours before their last breath.

What happens when we come to the end of our life has been a frightening topic of interest that has transcended the ages, though palliative nurses have been trying to ease the anxieties surrounding death by revealing it's not so scary as we might think.

To this end, Julie McFadden, a California-based hospice nurse who goes by Nurse Julie to her 1.7 million followers on TikTok, even wrote a book called Nothing to Fear: Demystifying Death to Live More Fully based on her 16 years of experience in the field.

Recently, Julie revealed the common phrases people tend to say before they pass away, usually along the lines of 'I love you' to their loved ones, 'Thank You' and 'I forgive you' - and even said it's not uncommon for her patients to 'choose' when they say goodbye.

"They basically will say, 'I'm going to die after this date' or 'I’ll wait for my daughter's wedding'. I've literally had a patient say; 'I'm dying tonight' and then die even though they weren't actively dying," she said on the Dr Karan Explores podcast.

Now, she's lifted the lid on the three things you might expect to 'see' in a patient in the 24 hours before passing on.

She says passing away is a process (Getty Images)

The death rattle

Terrifying as it might sound, patients nearing the end of life often make gurgling noises that has been dubbed a 'death rattle', but science suggests it's just a part of the dying process.

According to Very Well Health, the sound comes from a dying person as they can no longer independently swallow or cough, resulting in phlegm and saliva building up in the back of the throat and airways.

The unusual noise patients make is the sound of the fluid build-up as air passes through it.

"You will most likely hear this in the last 24 hours before they die," Julie says.

The death rattle can be uncomfortable to hear, but it's totally normal (Getty Images)

Changes to breathing

Another prevailing sign that death is imminent is changes in breathing, notably breaths becoming slower or more spread out.

It can look like the patient is taking a long pause before catching their next breath, or, as Julie notes, 'you might think that they are dead'.

Then comes 'agonal breathing', which can look like desperate gasps for air.

Although it can be disconcerting for families and loved ones to witness this, the nurse reassures us that it's all apart of the scientific process and the patient is not suffering any pain.

WebMD adds it's not 'true breathing' but simply a 'natural reflex that happens when your brain is not getting the oxygen it needs to survive.'

Although the brain is alive, agonal breathing shows the patient is rapidly approaching death - and Julie says it's a key indicator that death will occur in the next 24 hours.

Julie says patients can have a 'death stare' if their eyes are open when they become unconscious (Getty Images)

The death stare

Finally, and perhaps the most comforting stage to witness, is the unconscious stage.

Although the patient is 'alive', and might have their eyes and mouth open, Julie said: "They will not be waking up, no matter what you do."

She said it's not unusual for their eyes to be glazed over and not really looking at anything in particular since they're not fully present, though they can still hear and possibly feel your presence.

Julie dubs this the 'death stare,' stating it's like 'no one's really home.'

The nurse stressed though these three stages are common in patients who die within a period of 24 hours, it's not always the case as some might die suddenly, quicker or take longer.