Working in end-of-life care can bring about moments of deep sorrow, but it also offers instances of quiet awe. One hospice nurse has recounted an experience she frequently observes in her work with those who are dying: a simple yet enigmatic gesture that many patients exhibit just before they pass away.
Katie Duncan, a nurse practitioner and ‘death care coach’ from Maryland, has dedicated years to assisting individuals in finding peace and dignity as they approach the end of their lives. With her background spanning intensive care units, home hospices, and long-term care facilities, she has noticed a pattern that she finds both puzzling and profoundly touching.
In a recent TikTok video, Katie shared what she refers to as one of the ‘mystical’ aspects of the dying process: numerous patients start reaching upwards, as if attempting to grasp something invisible above them.
‘In my experience, it’s very common,’ she mentioned in the video. ‘You’ll literally see someone reach up, as if they’re trying to hold someone’s hand or touch something in the air.’
At times, this gesture is paired with what are known as end-of-life visions. ‘People often report seeing someone—a loved one, a pet, or even an angel or a bright light,’ Katie elaborated. ‘Other times, they remain silent but still reach up, as if they are sensing a presence.’
Although there is no scientific explanation for this occurrence, many professionals in palliative care view it as a serene aspect of the transition. Importantly, Katie pointed out that patients usually do not seem to be in distress during these moments. ‘If anything, they appear comforted,’ she remarked. ‘These visions, regardless of their source, often provide individuals with a profound sense of tranquility.’
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She remarked: “It’s one of the more enigmatic elements of death that we, as caregivers, are fortunate enough to observe. It’s a humbling experience.”
Katie’s video resonated with many online, prompting numerous commenters to share their own impactful memories.
“My dad lifted both arms,” one individual shared. “Prior to that, he hadn’t been able to raise them at all.”
Another person noted: “It’s the in-between. What a privilege it is to witness.”
Others reflected this feeling: “They’re reaching for heaven,” one wrote. “I didn’t want to interrupt him; it felt sacred,” another expressed.
For countless families and caregivers, these gestures provide a quiet comfort, assuring them that their loved one is at peace, gently guided by something, or someone, just beyond their view.
