Talking About Our Death Can Benefit Our Life

Julie McFadden is a woman on a fairly morbid mission: She wants all of us to start talking about death.

In her recently-released book "Nothing to Fear: Demystifying Death to Live More Fully," the hospice nurse and TikTok phenom states starkly, "It doesn't matter if you have thirty days left to live or thirty years. We're all dying. Some people have more information about when that's going to happen, but it's going to happen to all of us eventually."

Unfortunately, most of us actively avoid conversations about death. But by normalizing discussions about dying, McFadden says we can sever its psychological grip. "When we break the taboos around facing and discussing death, we also break the power of fear around it," she says.

McFadden has, in essence, a formula: Acceptance of our mortality and learning about the dying process can lead to a "peaceful death" — and to actually living better. That formula applies to everyone, she says. "Being able to look at and speak about death has demonstrable benefits, not just for our dying but also for our living," notes McFadden.

Next Avenue talked with McFadden about her book, which is a great first step toward getting more comfortable with this mostly taboo topic. The interview has been edited for length and clarity

Next Avenue: During your nursing career you made the switch from the ICU (Intensive Care Unit) to hospice care. Why did you make that change?

Julie McFadden: Even though we were saving lives in the ICU, the more I was there, the more I thought 'we are really missing the mark on death and dying' — we don't bring it up or we wait until someone is being kept alive on machines before we start having this conversation that we should have been having three months before that.

I knew people were dying differently on hospice — in their homes, choosing to go on the service —and I thought 'I'm willing to try that.'

Many people would conclude that hospice work must be thoroughly depressing. But you say in the book that '[i]n a way, it's actually a sacred gift to me.' Can you elaborate on that?

Mostly, I think hospice [care] is misunderstood. Many people think 'oh my gosh, I could never do that.' And that might be true. It's not for everyone.

But what I have grown to understand and accept is that we are all going to die. I think many people say they understand that, but they don't, really. So if that's the case, how would I want myself and my family members to die? How can we make our deaths as peaceful as possible? And as curated to our own liking as possible? That's what hospice helps us do.

So it's not depressing to me.

You say 'My goal is to promote peaceful death.' Can you briefly describe what a peaceful death would look like?

A peaceful death would look like symptoms being managed and that the person dying understands that they can allow their body to be their guide. And families understanding what is happening to their loved one, because a lot of times chaos can be created because families don't understand —when in reality what they're seeing is normal.

By peaceful I don't necessarily mean that everyone is quiet and there's a harp playing. Everyone's idea of what is peaceful is different — the environment they want, the people, even the music. (In her book, McFadden offers her own "end of life" plan. It includes "Have "The Office" playing at all times.")

One of your objectives in writing this book is to break the taboos that surround having conversations about death, and even about using the words 'death' and 'dying.' You call them 'the d-words.' Why should we talk about death, and use those d-words?

In the past, over a hundred years ago, the patient died at home, the family cleaned the body, the family had the wake and viewing in the home so it was just way more in our face.

There are now generations of people who are not used to seeing death or talking about it and I think it's grown into a bigger thing than it needs to be.

We're going to have to just get used to talking about death again. And language is important! We need to stop using the euphemisms, to be able to say 'They died, they're dead.' It is going to be uncomfortable but just because it's uncomfortable doesn't mean it isn't worth doing.

You also say, 'It's always time to talk about death.' How might readers get started on these death discussions?

If you really want to be intentional about it, you could have a family meeting where you would say what you need and want because you're the older one, you're aging. There are different organizations that can guide you, like Death Over Dinner.

That sounds like a murder mystery!

Yeah, it does! It doesn't have to be this awful scary thing. It can connect people and be a beautiful thing.

In the book I give step-by-step instructions on what you need to talk about. I think the biggest thing is 'if I become incapacitated, this is what I'd want my end to look like.' Even if it's the only time your family hears that, that takes some burden off them if that happens.

You devote a chapter to 'What The Dying Process Looks Like.' It's tough stuff — things like terminal secretions, incontinence and the 'death rattle.' Is this detailed information important for folks to hear?

I think it's the most important thing people need to hear.

We do a great job of shielding people from what death looks like and because of that people don't understand. They think it's going to be this lovely dialogue of saying 'I love yous' and then the person closes their eyes and they die.

That's just not how it goes down. When I first started out in hospice, the main message I would get was 'my dad's death was horrific, this and that happened, it was awful.' And a lot of things they were talking about were very normal. No one had explained why this was happening.

Is this education essential to arriving at the 'nothing to fear' point?

Yes, it is. And let me be clear: While I believe there's nothing to fear when it comes to the end of life, I also believe that it's normal to fear it and we can decrease that fear through education.

I never really set out to help folks with death anxiety but I have heard from many, many people saying that my videos have helped them with that. (McFadden has over 3 million followers across several social media platforms and 1.5 million on TikTok alone.)

You use the phrase 'clean, safe and comfortable' a lot throughout the book. Is this kind of a hospice mantra?

I would say so. I don't know when I started saying that, but it did become my mantra.

I do a lot of on-call work and I'd get to the dying person's home and they would be fine, but the caregiver isn't. They're wondering 'they haven't eaten anything today, they're sleeping a lot — is that normal? Am I just supposed to let them lay there like this?' And the answer is yes.

Ask yourself, so you can at least calm your mind: Are they clean? Are they safe? Are they comfortable? If the answers are yes, then take a breath and just be with your loved one. 

In your chapter on 'Deathbed Phenomena' — which describes things like the Death Rally and 'Reports from the Other Side'— you point out that visioning (when a dying person sees people or things that aren't physically present in the room) 'happens so often that our agency addresses it in the educational package we give to the families.' Is learning about deathbed phenomena part of  the knowing-more-fearing-less formula?

Yes, to me it is.

When I first saw these packets we're handing out to families that said, 'around 2 to 3 weeks before death, the patient may start seeing the unseen,' I was, like, 'are you kidding me? What do you mean 'seeing the unseen?'

But then you see it for yourself. My first year in hospice, I kept thinking, 'what the heck is going on here? Why is this happening so often?' And visioning was just so different. Most people were totally alert and oriented.

It's so important to educate people and tell them, 'This [information] is coming from a person who was skeptical at first, who is not trying to push their beliefs on you. It's just a matter of fact.' For some reason, at the end of life — specifically when you're dying naturally, allowing the natural processes to happen — these phenomena happen. And it happens so often, it can't go unacknowledged.

You say that you believe, due to your hospice experiences, 'that a better world awaits us' — that there is, indeed, an afterlife. Can you tell us more about what settled that Big Question for you?

I'd like to preface this with: this is a belief. I never want to be the person who says 'I'm sure of this.' Having said that, my hospice job has certainly led me to think there is something better after we die.

I've always kinda felt that there is something more. I've always felt that I've missed this place that I think we go to when we die. I feel almost a longing for it.

Being a hospice nurse and being in the room when so many people have taken their last breaths, I don't know how to explain it but it feels like this person is going home, that this person is going to that place that I've been longing for. Every time it feels that way.

What do you want readers to take away from your book?

I think one thing I want people to get from this book is this: We plan for everything in life. We plan for weddings, for births, for vacations, for new jobs and buying a house, so many things. But for some reason, we don't plan for dying and that's the one thing that we're all going to do. And it would relieve so much stress from our lives and our loved ones' lives if we just plan for it and talk about it.

And the book is basically instructions on how to do that.

And the other thing is that I believe that education decreases fear and most people have a fear of death or at least a limited knowledge of death and because of that they make up all of these assumptions about  it, and that makes it worse.

Despite the topic, reading this book is not going to make you feel worse. It's going to, hopefully, make you feel better and more equipped to help yourself and your loved ones during trying times.

Marie Sherlock practiced law for a decade before turning to writing and editing in her 30s — and never looked back. She's worked as the editor of several publications and is the author of a parenting book (Living Simply with Children; Three Rivers Press). She spends her empty-nest days writing about travel trends and destinations, simplicity, spirituality and social justice issues. Read More