A hospice nurse has sparked debate by sharing a contentious end-of-life symptom, drawing “heat” from both the public and fellow healthcare professionals. Julie, a hospice nurse with a strong TikTok presence, engages her 1.6 million followers in frank conversations about death.
As a best-selling author focused on palliative care, she dedicates herself to supporting her patients and ensuring that their families are well-informed. In a recent video, Julie disclosed to her vast audience a sign indicating that death is near, a claim that has stoked controversy even among medical staff.
She explains: “I get the most heat for saying this one thing, including from other health care workers, and that’s when I say people who are dying should be dehydrated. I know that can sound so jarring so let me explain to you why.”
She further elaborates on the body’s natural dying process: “When a person is dying from something, not from being dehydrated but they’re dying from something else and we know they’re dying from something else, your body will eventually start preparing itself to die. The body knows how to die, it has built-in mechanisms to help it do that.”
Julie adds: “And one of things it will do is start making the person not really hungry and not really thirsty. So the person will already not be wanting to eat and drink, usually. Of course, the family starts freaking out, they’re not eating, they’re not drinking, what are we going to do?”
Julie clarified that while families are understandably distressed when a loved one stops eating or drinking, fearing it will lead to death, the reality is somewhat different. She said: “What you have to remember is people dying are not dying because they’re not eating and drinking. They’re not eating and drinking because they’re dying and our body knows this.”
She detailed how the human body is intelligent enough to know that being drier with less food and drink intake makes the dying process less painful.
Julie elaborated: “The body will actually go into ketosis where it releases endorphins that make that person feel good and feel better.”
Julie also explained that dehydration in a dying person doesn’t cause the same thirst a healthy individual experiences in demanding situations like hiking or being in a desert. She continued: “It doesn’t feel like that where you have a headache and other things. It doesn’t feel like that. The body actually prepares itself to be dehydrated.”
She admitted that despite her explanation, people often insist on IV fluids for their dying relatives, not understanding that this could actually worsen matters.
Julie added: “If a healthy body got IV fluid the healthy body would feel better, they’d get hydrated and instantly start feeling better but when a dying body gets hydration, it doesn’t do what it’s supposed to do.”
Julie shared that excess fluid typically causes swelling in the lower extremities before affecting the heart. “The heart will say it can’t keep pumping this fluid around the body, it’s too much. It will then back up into the lungs and cause respiratory distress,” she added.
She explained that over-hydrating a dying patient can result in a less peaceful death due to respiratory distress, concluding: “Moral of the story. Dehydration at the end of life does not cause suffering and can in fact cause a more peaceful death.”
Viewers appreciated Julie’s straightforwardness, with one commenting, “Hydration would be prolonging death not prolonging life.”
Another professional agreed, saying, “GP here. This is the best explanation I have heard for this mechanism. Your patients and their families are lucky to have you.”