**Nurse Reveals Hidden Symptom Frequently Seen Days Before Death**
A senior hospice nurse has brought to light an often misunderstood and emotionally charged phenomenon seen in many patients nearing their final days. Julie McFadden, a palliative care specialist with extensive experience in end-of-life nursing, has spoken candidly about a puzzling symptom that commonly appears just before death — surprising both families and caregivers alike.
This particular symptom, known as ‘terminal lucidity’, is characterised by a sudden and unexpected improvement in a patient’s mental clarity, energy, or physical abilities after a long period of decline. For many loved ones, these brief moments of apparent recovery generate false hope, leading to a complicated mixture of relief, confusion, and ultimately, grief when death soon follows.
McFadden, whose insights have reached a substantial online audience via her YouTube channel, describes terminal lucidity as one of the most psychologically taxing aspects of her profession. “It is something that can genuinely throw families,” she explains, noting that such episodes often occur in roughly one in three patients she has supported during her career.
Medical professionals themselves remain baffled by the mechanisms behind terminal lucidity. Some suggest it is related to a sudden surge of hormones like cortisol, while others believe additional unexplored factors could be at play. Despite the lack of a definitive scientific explanation, the consistency of its occurrence means hospice staff are now more proactive in preparing families for what they may witness.
According to McFadden, terminal lucidity often manifests as a “rally” or “surge”, during which a terminally ill individual may become alert, engage in normal conversation, eat enthusiastically, or even regain mobility. “It’s vital that families cherish these moments,” she advises, “but also understand that this burst of vitality is usually short-lived — typically lasting just a day or two before death.”
In her video, the nurse goes on to explain that not every uptick in wellbeing qualifies as terminal lucidity. If a patient enjoys sustained improvement over several weeks, she cautions, it is unlikely to be associated with imminent death. Clarity on this distinction can help families separate genuine recoveries from these final, poignant rallies.
McFadden also explored a wider range of end-of-life phenomena that often defy explanation but are frequently reported in palliative care settings. Among these is ‘visioning’, where dying patients report seeing deceased loved ones or friendly figures — experiences that are typically described as comforting rather than frightening. “Families are often told by patients that they see a parent or friend waiting for them,” McFadden said. “It’s a recurring and soothing experience that I wouldn’t have believed myself if I hadn’t seen it so many times.”
Another behaviour involves a patient’s awareness of their impending death. Some individuals seem to intuitively sense their final hours, choosing to pass either surrounded by family, or waiting for a moment of solitude to let go. Remarkably, some even manage to hold on until after major events, such as a family wedding or a birthday.
Additional deathbed signs identified by McFadden include the ‘death reach’, when patients stretch their arms upward as if greeting someone unseen, and the ‘death stare’, an intense focus on a blank space in the room. These are often observed together and can be disconcerting for relatives.
Perhaps most profoundly, McFadden describes the “shared death experience”, in which the living feel they briefly share the dying person’s journey — often reporting sensations of peace or joy. She suggests that while rare, this phenomenon offers comfort and reassurance to those left behind.
Conversations around dying and death remain sensitive and, in many communities, taboo. However, with practitioners like McFadden opening up about these lesser-known aspects of the dying process, there is new hope that families and patients can be better prepared for the realities of life’s final chapter — and perhaps find meaning and comfort amid the sorrow.