Hospice nurse explains 'active dying' and the signs someone is going through it

Warning: This article contains content which some readers may find distressing

Losing a loved one is never a nice experience, it can be incredibly tough.

So to offer a little support to those preparing for the death of someone close, palliative care nurse Julie McFadden has explained what ‘active dying’ is.

The 41-year-old took to TikTok to explain the signs someone is going through this stage of death which can be the scariest part.

The hospice nurse, who also has a book, often shares videos to help ‘normalise death and dying’ in a hope to ‘alleviate the fear and stigma’.

After earlier stages including ‘slowing down’, a ‘decline in strength’ and the ‘transitioning phase’, McFadden explained how the process of active dying is the final stage before a person passes away.

“The actively dying phase is what scares people, because they're not used to seeing it and they don't know what the heck's going on,” she said.

The nurse explained that as this point, your loved one will ‘likely be fully unconscious’ with ‘no food or water’ as it may go on ‘for days’.

She added that during this time they will also be incontinent and if you’re looking after them, you’ll need to change them.

Perhaps one of the most unnerving parts of this stage is the change in breathing which McFadden described as the rather macabre ‘death rattle’.

She explained: “It's literally just a bit of saliva collecting at the back of their throat because their mouth is open, their breathing is going over their saliva and causing a gurgle."

As well as this rather haunting sound, there can also be ‘metabolic changes’ including a difference in skin colour as well as high and low temperature.

Of course, this can be pretty upsetting to see but the hospice nurse assured it’s all ‘a normal part of death and dying’ and said it’s ‘not hurting your loved one’.

"It's important to be educated about what death actually looks like," McFadden added. "Movies and television don't do it justice, then people see it in real life when it’s their loved ones and they freak out."

A doctor also previously shared how a study on hospice patients experiencing ‘active dying’ found that most unresponsive patients still had a response to being played different sounds, with some people still being able to hear things right up until their final moments.

If you have experienced a bereavement and would like to speak with someone in confidence, contact Cruse Bereavement Care via their national helpline on 0808 808 1677.