Hospice nurses document a pattern in final weeks before death

Julie McFadden has sat with more than a hundred people as they died. As a hospice nurse with over half a million YouTube subscribers, she's noticed something that happens so consistently she now includes it in the educational packets families receive when their loved one enters hospice care: in the weeks before death, patients often begin seeing people who've already died.

They call it "visioning." McFadden reports it happens in more than half her cases — patients describe visits from deceased relatives, spouses, or pets. "Usually a few weeks to a month before someone dies, if they're on hospice, they will start seeing dead loved ones," she explains. The patients aren't confused or hallucinating in the medical sense. They're typically alert, oriented, and still have weeks of life ahead.

What makes this observation valuable isn't the mystery of it — the cause remains unknown — but the consistency. Christopher Kerr, CEO of Hospice & Palliative Care in Buffalo, New York, has studied this phenomenon extensively. He's noticed the visitors tend to be people who once provided comfort and protection to the dying person. A daughter might see her mother. A man might encounter his brother. The experience is almost always described as reassuring, even joyful. Patients report being encouraged to "let go," or they notice sensory details — the smell of a deceased relative's perfume, the presence of a familiar voice.

Kerr has spent years trying to understand the mechanism. "I have witnessed cases where what I was seeing was so profound, and the meaning for the patient was so clear and precise, that I almost felt like an intruder," he told BBC Brazil. "Trying to decipher the etiology seemed futile. I concluded that it was simply important to have reverence."

This matters because families often arrive at hospice frightened, unsure what to expect in the final weeks. When a patient suddenly describes seeing their dead mother standing at the foot of the bed, panic can follow. But hospice professionals have learned to frame this differently: not as a symptom to manage or a sign of decline, but as part of how the dying process unfolds. A sign, perhaps, that the transition is beginning.

The mechanism remains a question mark. But the pattern is clear enough that it's now part of standard hospice education — preparing families for something that, while unexplained, appears to bring comfort rather than distress.