Speaker 1: Now here's a highlight. From Coast to Coast AM on iHeartRadio,
Speaker 1: we are back.
Speaker 2: With Julie McFadden, the author of Nothing to Fear, Demystifying Death,
Speaker 2: Demystifying Death, to Live more Fully. You can follow her
Speaker 2: on social media at Hospice Nurse Julie. I want to
Speaker 2: get back to some of the more of the biological
Speaker 2: details of dying before we get into the otherworldly deathbed phenomena.
Speaker 2: The death rattle. We hear that often when the breathing changes,
Speaker 2: and it's described as a death rattle. What is that
Speaker 2: death rattle?
Speaker 3: Yes, the real name for that, the medical term would
Speaker 3: be terminal secretions. But that sound that people hear, it
Speaker 3: sounds like a rattle or a gurgle, and people really
Speaker 3: hate it, and I get it, but the I think
Speaker 3: it helps to educate about what it actually is. So
Speaker 3: a lot of people think it's their loved one quote
Speaker 3: unquote drowning, or its fluid coming from their lungs, but
Speaker 3: it's not. It's so we create saliva in our mouths
Speaker 3: twenty four to seven naturally, and then our body, without
Speaker 3: us knowing, automatically will swallow it. Just like right now,
Speaker 3: I just did it. And that all happens automatically. Towards
Speaker 3: the end of life. Your body is still creating that
Speaker 3: saliva to keep your mouth noise, but your brain is
Speaker 3: not always telling you to swallow it, or the muscles
Speaker 3: to swallow are really relaxed, so they're not swallowing. So
Speaker 3: that little bit of saliva builds up in the person's
Speaker 3: mouth and then their mouth breathing. Usually so because their
Speaker 3: mouth breathing, that breath will go over the secretions and
Speaker 3: cause a gurgle noise, and even a little bit of
Speaker 3: secretions can make a really big noise. So I think
Speaker 3: it's important to let people know what it truly is
Speaker 3: so they don't have to be so afraid because it's
Speaker 3: generally not disturbing the person who is dying, but the
Speaker 3: sound is disturbing the people hearing it.
Speaker 2: Does it Is it advisable to swab the inside of
Speaker 2: the mouth or not?
Speaker 3: Yeah, So there's certain things we could do, and if
Speaker 3: we do do this, it's usually for the family, not
Speaker 3: the patient, just because people don't like it so much.
Speaker 3: So you can reposition the person. So I usually lift
Speaker 3: the head of bed up a little bit, maybe to
Speaker 3: thirty sixty degrees, just shifting your loved one can help.
Speaker 3: Even turning them to the side so the secretions come
Speaker 3: out can help. There's medications we give to dry up
Speaker 3: the secretions. That's usually the first thing we try to do.
Speaker 3: I don't think it's totally necessary because sometimes one it
Speaker 3: doesn't work, and two then the person has a drying out,
Speaker 3: But that's definitely something we still can do now in
Speaker 3: the hospital and at home. Sometimes they'll get you a
Speaker 3: suction machine, kind of like at the dentist where you
Speaker 3: can kind of like suction things out of the knock.
Speaker 3: That can be done, and they do it a lot
Speaker 3: in the hospital just because we're taught to, but generally speaking,
Speaker 3: we don't on hospice because doing that will actually create
Speaker 3: more saliva, so it'll actually make it get worse. So
Speaker 3: we don't always do that, but it's an option if
Speaker 3: we have to.
Speaker 2: What is the way, okay, what is the silence scream
Speaker 2: in a dying patient?
Speaker 3: The silent scream? So to be honest, I actually don't
Speaker 3: see this very much, but many of my followers would
Speaker 3: write into me and say, I loved one and I
Speaker 3: have seen it a few times, but it's not I
Speaker 3: haven't seen it very frequently, but my followers would say,
Speaker 3: you know, right before my loved one died and looked
Speaker 3: like they let out, like their face went into like
Speaker 3: a look like a scream, but nothing came out, but
Speaker 3: they that was kind of like their last thing that
Speaker 3: looked like they happen. That happened. And how I describe that,
Speaker 3: of course we don't truly know, But how I describe
Speaker 3: any kind of weird quote unquote weird thing you might see,
Speaker 3: like a silent scream or sometimes people can even like
Speaker 3: growl and stuff. At the end of life is the
Speaker 3: person you know, the essence of that person is kind
Speaker 3: of not there anymore. This is if you can truly
Speaker 3: just look at it as like a biology standpoint, This
Speaker 3: is a body and a wonderful hostess nurse who's like
Speaker 3: the og of teaching hospice and death and dying. Her
Speaker 3: name is Barbara Karnes. She likens death and the dying
Speaker 3: body to like for as like a laboring process. I
Speaker 3: love that analogy, but I also don't The only thing
Speaker 3: I don't like about it is that you associate labor
Speaker 3: with pain, and I don't think it's a painful process.
Speaker 3: But it's kind of like the body just doing things
Speaker 3: that it has to do to shut down, and it's
Speaker 3: going to do weird things sometimes like make a face
Speaker 3: before before the person dies or even while they're dying,
Speaker 3: but doesn't necessarily mean anything, but because it's your loved one,
Speaker 3: not to try to sense of every little thing that happens,
Speaker 3: because it's your loved one and it's not something you
Speaker 3: see every day, so it's hard to understand. So the
Speaker 3: silent scream is something that you might see and we
Speaker 3: don't really know what's going on, I mean likely. I
Speaker 3: think it's because our muscles all relax and fully let
Speaker 3: go at the end of life. So at the very
Speaker 3: very end, if it's like right at the end, everything
Speaker 3: will relax, including those mouth muscles. For the mouths going
Speaker 3: to suddenly hanging open, the eyes could pop open. Every
Speaker 3: muscle can kind of release us. Why people have like
Speaker 3: defecation and urination sometimes at death because the sphincter is
Speaker 3: relax That's why you can see fluid sometimes at the
Speaker 3: end of life. So all of these things are happening
Speaker 3: because it's like a full let go wow. But it
Speaker 3: can look scary at times at times if you don't
Speaker 3: know what's going on.
Speaker 2: When I was a kid, I used to love making
Speaker 2: faces in front of a mirror. So when I go,
Speaker 2: I'm going to make a face guaranteed, that's right.
Speaker 3: Yeah, yeah, yeah, Bryan.
Speaker 2: Ryot The I remember seeing my my uncle in the
Speaker 2: last days of his life and he was unconscious, but
Speaker 2: his arms and his legs were moving. He was on
Speaker 2: his side and they were just kind of moving and twitching.
Speaker 2: And is that what is referred to as is called
Speaker 2: terminal restlessness.
Speaker 3: Yeah, so terminal restlessness, terminal agitation. It can vary as
Speaker 3: far as like how bad it is, right, So if
Speaker 3: someone's just kind of people can kind of fidget, they'll
Speaker 3: fidget with the blanket, or they'll fidget with things as well.
Speaker 3: They don't seem super disturbed by it. I usually kind
Speaker 3: of let it go. But if they seem really restless
Speaker 3: or kicking, sometimes it'll be like a constant trying to
Speaker 3: get up out of bed even though they can't. And
Speaker 3: there's usually no talking any sense into them, so you
Speaker 3: can't be like no, no, no, sit down, like they don't.
Speaker 3: There's no like talking to them because they're not fully
Speaker 3: with it, if that makes sense. And again for terminal
Speaker 3: agitation or terminal restlessness. This is one of to me,
Speaker 3: one of the hardest parts that can happen at the
Speaker 3: end of life, and it doesn't happen to everyone, but
Speaker 3: it can happen. And we usually try to look to
Speaker 3: see if there's a reason why, Right, are they retaining
Speaker 3: urine and they feel like they have to pee that
Speaker 3: they can't. Are they impacted? Do they have to have
Speaker 3: a bale of it but they're impacted? Are they in pain?
Speaker 2: Right?
Speaker 3: So we kind of looked into assess the sea, is
Speaker 3: there's something going on here that's making them agitated. Once
Speaker 3: we can find that there isn't anything, then we would
Speaker 3: label it as terminal agitation. And really the only thing
Speaker 3: you can do for that is to kind of decrease stimuli, right,
Speaker 3: so you can turn on the lights, try to make
Speaker 3: it a little softer, nicer in there, and usually medication
Speaker 3: and sometimes a lot of it depending on how bad
Speaker 3: someone's agitated. And there's certain diseases and certain personalities that
Speaker 3: I see terminal agitation a little more so sometimes, And
Speaker 3: that's just really hard because basically it's like you have
Speaker 3: to medicate until they're comfortable, and sometimes that means they're
Speaker 3: either awake and agitated or asleep and comfortable. And that's
Speaker 3: hard for families to.
Speaker 2: Take.
Speaker 3: You know, they want their loves to be awake, but
Speaker 3: also when they're awake, they're not comfortable, so when we
Speaker 3: have to keep them not awake.
Speaker 2: About maybe a week before my mother went into hospital.
Speaker 2: She was in bed and sleeping a lot by this
Speaker 2: point and practically stopped taking water. So and the five
Speaker 2: children we would take turns, you know, coming home and
Speaker 2: staying with her and so forth. We wanted to keep
Speaker 2: her home as long and as long as possible. Ideally
Speaker 2: we were hoping to do it to the end, but
Speaker 2: we couldn't. But about a week before she went into hospice,
Speaker 2: and she was in hospice, I think three weeks. So
Speaker 2: she's in bed, sleeping most of the time, stopped taking
Speaker 2: water and food. My brother and I came home to
Speaker 2: spend the weekend with her. She got out of her bed,
Speaker 2: she came to the table. My brother cooked steak and
Speaker 2: she didn't need a big piece, but she sat at
Speaker 2: the table. This the last time we sat with her,
Speaker 2: had a meal with her, and she ate a steak. Now,
Speaker 2: apparently there is something called the rally. I don't know
Speaker 2: if that's if this counts as the rally. But talk
Speaker 2: to me more about the rally.
Speaker 3: Oh, I think that some counselos the rally. Yeah yeah,
Speaker 3: yeah yeah. So the rally, the real name is called
Speaker 3: terminal lucidity and are the medical terms. And it happens
Speaker 3: a lot, and it happens in one third of all of
Speaker 3: our patients, that's one in three. But many people miss it.
Speaker 3: People don't realize this is the rally. That's why I
Speaker 3: like to educate about it. And the rally is kind
Speaker 3: of just what you talked about. You know, you saw
Speaker 3: your mother sleeping most of the time, not really eating
Speaker 3: and drinking, kind of looking like and now I'm putting
Speaker 3: words in your mouth. But generally speaking, the person will
Speaker 3: seem like they're getting close, you know, the family that
Speaker 3: start talking about let her get people here, I think
Speaker 3: she's going to go soon, things like that, And then
Speaker 3: suddenly they do something like that, wake up, and not
Speaker 3: only wake up, they get out of bed. Now that
Speaker 3: all of a sudden they're eating steak, even if it's
Speaker 3: just a little bit, maybe talking a little more, getting
Speaker 3: their old spunk back a little bit. And then and
Speaker 3: then the trick is they're not like that for a
Speaker 3: long time, so it's usually twelve hours to maybe forty eight,
Speaker 3: and then they die suddenly afterwards, or at least go
Speaker 3: back into like a you know, being unconscious something like that,
Speaker 3: and die soon after. If someone continued to do so
Speaker 3: well for weeks as not the rally, the rally is down, down, down,
Speaker 3: spike and death. And we don't know why it happens.
Speaker 3: We don't know why it happens. They're theories, but we
Speaker 3: don't know for sure.
Speaker 2: So we've got about three minutes here before the top
Speaker 2: of the hour. I want to start talking about a
Speaker 2: section in the book called the other worldly Beauty of
Speaker 2: deathbed phenomena, and I want to share another one with you.
Speaker 2: My mother in law past here at the house where
Speaker 2: I'm speaking from in October of last year, and I mean,
Speaker 2: she was in failing health, but when the end came,
Speaker 2: it came very quickly. But she was sitting in front
Speaker 2: of the TV, eating would take her supper, in front
Speaker 2: of the television, watching Young and the Restless or something,
Speaker 2: and she suddenly called out to my wife, her daughter,
Speaker 2: and she said, did you see that? Did you see that?
Speaker 2: And my wife said, see what, mom? And she said
Speaker 2: a fairy just flew. The TV is on a big
Speaker 2: unit wall unit. A fairy flew from over there and
Speaker 2: it just landed on my plate. And she was looking
Speaker 2: down at her plate watching this fairy. And then she said, oh,
Speaker 2: she just passed away the fairy, meaning the fairy just died.
Speaker 2: And maybe two weeks later, my mother in law was gone.
Speaker 2: When people start to see things, and part of me
Speaker 2: believe she actually saw a fairy from my mother, she
Speaker 2: saw my late aunt outside the living room window a
Speaker 2: couple of weeks before she passed.
Speaker 3: My aunt through it.
Speaker 2: Yeah, isn't it? I mean, can you time sort of?
Speaker 2: Is there kind of a chronology when you start to
Speaker 2: see things like that, it's only a matter of time
Speaker 2: before they go.
Speaker 3: Yes, I mean this is also something that was so
Speaker 3: fascinating to me. So this is the second most scene death.
Speaker 3: The phenomena. It's called visioning. So people start seeing the unseen. Now,
Speaker 3: it's usually dead, like you said, like dead relatives, people
Speaker 3: who they liked. So not everyone likes their dead relatives,
Speaker 3: so it's usually a dead relative they liked or loved,
Speaker 3: dead relatives, dead pets, dead friends, children, sometimes deities, so
Speaker 3: a god, angels, fairy, sometimes things like that like something
Speaker 3: kind of mystical. And the crazy part to me that
Speaker 3: I think is so crazy is that as a healthcare professional,
Speaker 3: when someone starts telling me that they're seeing these things,
Speaker 3: or their families reporting to me, hey, my dad just
Speaker 3: saw his parents last night, right that to me, the
Speaker 3: hospice nurse tells me this person will likely die like
Speaker 3: two to four weeks from now, Like they it's a timeline.
Speaker 3: It's it's part of a part of the timeline where
Speaker 3: people and it happens so much that we had to
Speaker 3: tell people about it so they know.
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