A hospice nurse has revealed the two most ‘disturbing’ changes that happen to a dying patient which families say they wished they’d known beforehand.
Julie McFadden, from Los Angeles in California, said two sudden changes to the breathing of dying patients often catch their loved ones off guard.
The 41-year-old has worked in intensive care and hospices for over 15 years, caring for terminally-ill patients in the months leading up to their death.
Now, she shares videos on social media on what she says she has learnt about death and dying, in the hopes of destigmatizing it.
In one, seen 75,000 times, she revealed one of the ‘most disturbing’ things families ‘wish they would have known about’ is called Cheyne–Stokes respiration.
Sharing a clip of a female patient undergoing this process Ms McFadden explained it was series of abnormal rapid breaths followed by a long pause.
Experts believe this occurs because of a delay in a dying patient brain’s ability to detect levels of carbon dioxide in the blood throwing off the normal healthy pace of breathing.
While this can make it look like a patient is in distress Ms McFadden said it doesn’t cause a patient to suffer.
People in their final moments often experience two sudden changes to that catch their loved ones off guard, according to Julie McFadden. Stock image
‘This person, as you can see, is fully unconscious. This is not causing them suffering, this is not making them feel like they are suffocating,’ she added.
‘We know this because the body is showing that it is relaxed. It is not acting like it can’t breath.
‘They are not thrashing around, moaning, acting scared. The body is built to know how to die and has built in mechanisms to help it do that.
‘By the time there are these changes in breathing, they are fully unconscious.’
For patients who may look uncomfortable, however, she added there are steps health professionals can take to make them more settled.
‘If the person is looking like they’re breathing too hard or too laboured or too fast or they look uncomfortable on their face or they are restless during this time, we definitely can medicate and we do,’ Ms McFadden said.
‘But it’s important to remember that those things aren’t necessarily needed because this is expected.’
The second most disturbing breathing problem she highlighted is called the death rattle.
Now, Ms McFadden shares videos on Instagram on what she says she has learnt about death and dying, in the hopes of destigmatizing it
She described this as ‘that gurgle-y wet breath that you hear your loved one doing when they’re dying’.
Despite the traumatising nature of the noise, Ms McFadden insisted it was normal part of the dying process.
It doesn’t cause patients, who are normally unconscious, any pain being triggered by air passing through fluid building up in the mouth as someone breathes.
In a separate video Ms McFadden added: ‘The death rattle, it is the most normal thing and to be expected at the end of life.
‘However, if you’re not used to hearing it, it can feel like the scariest thing you’ve ever heard.’
Normally, the body is constantly producing mucus in the mouth which is cleared by the brain subconsciously sending signals to the throat to swallow.
But in those reaching the ends of their lives, this system breaks down — with saliva no longer being swallowed leading to a build-up in the mouth.
This then starts to ‘rattle’ as air moves in and out while someone takes their final breaths.
Social media users praised Ms McFadden for raising awareness about what happens as people die.
One wrote: ‘I’ve sat beside this in real life and I wish I’d seen your videos then.
‘Thank you for demystifying death, it makes grief harder than it needs to be not knowing these things.’
Another commented: ‘I just went through this with my husband. Wish I had been educated before hand.’
And a third added: ‘I witnessed everything you said with my sibling recently.
‘Watching this video now takes me back to that moment when he passed away in front of me. Thank you for sharing this information.’
A hospice is specialised service that cares for patients whose illness has been diagnosed as terminal.
Some hospice services are run in specialist facilities while others care for patients in their own home through regular visits, depending on a patient’s needs and wishes.
Patients may enter hospice care upon their diagnosis or may go in and out of it at different times over the course of their terminal illness depending on the exact nature of their condition.
In the UK such services are free, funded by the NHS or charities, however there have been repeated warnings the sector is facing funding problems.
Last year, hospice representative group Hospice UK warned the sector faced a £60million deficit.
