We all face the same fate — death. Yet, it remains one of our greatest fears, shrouded in mystery and uncertainty.

Now, a hospice nurse has taken to social media to shed light on some of the most unsettling things people do before they pass away — helping families understand the dying process and easing the fear surrounding it.

Has seen a lot of death

Julie McFadden, a nurse specializing in end-of-life care, has made it her mission to educate people on what to expect when a loved one is nearing death.

The Los Angeles native has spent over 15 years working in intensive care and hospice and through her online videos and her book, she shares firsthand insights into the final moments of life. Her aim is to remove the stigma around death and help people feel more prepared.

”I was an ICU nurse for about 8 years and saw a lot of death. As healthcare workers, we would talk amongst ourselves about the likelihood of our patients dying, but we wouldn’t be talking with the patients or families.  This lead me to want to speak up and advocate for my patients and their families and start having family meetings,” she says.

In one of her most talked-about posts, McFadden highlights the two most common yet ”disturbing” things that happen as someone nears the end: changes in breathing and the infamous ”death rattle.”

1. Changes in Breathing

One of the most shocking things families experience at a loved one’s bedside is a sudden shift in breathing patterns. McFadden explains that this can be alarming, especially when people are unaware it’s a natural part of the process.

”You’ll notice rapid breathing, followed by long pauses, and then rapid breathing again,” she says.

This phenomenon is known as Cheyne-Stokes breathing, and it happens due to metabolic changes in the body as it shuts down. The pattern repeats itself, with each cycle typically lasting between 30 seconds and 2 minutes.

While it may look distressing, McFadden reassures families that it does not mean their loved one is suffering.

Ms. McFadden shared a video of a female patient experiencing the process, describing it as a sequence of quick, irregular breaths followed by a prolonged pause. Experts suggest that this occurs when the brain of a dying patient struggles to properly detect carbon dioxide levels in the blood, disrupting the usual rhythm of breathing.

”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. We know this because the body is showing that it is relaxed. It is not acting like it can’t breath”,
Julie said.

2. The ”Death Rattle”

Another common but unsettling symptom is what’s known as the death rattle — a gurgling noise that can sound alarming to those unfamiliar with it.

McFadden explains that as the body nears the end of life, the brain stops sending signals to swallow saliva, leading to a buildup in the mouth. This creates a rattling sound as air moves through the throat.

”People often think it’s coming from their lungs, but it’s really just saliva collecting in the mouth,” she says.

Though the sound can be unsettling, McFadden emphasizes that it’s completely normal and not painful or distressing for the dying person.

The body knows how to die

Despite how unnerving these signs may seem, McFadden reassures families that the body has a natural process for dying.

“The body is built to know how to die,” she explains, adding that if there is any sign of discomfort, medications can help keep the patient at peace.

Her message is clear: death is not something to fear. By understanding the process, families can be better prepared and more at ease when saying their final goodbyes.

Research shows that immediately after death, the body begins to break down. Changes in the metabolism of a dying person can result in a distinctive odor in their breath, skin, and bodily fluids, often resembling the smell of nail polish remover.

During this process, putrescine — a toxic compound with a pungent odor — is released into the air. At a subconscious level, humans can detect this foul scent, which is associated with decomposition. When the brain recognizes this smell, it triggers an instinctive response linked to the recognition of death.