May 27, 2025 • 53 mins
How Understanding Death Can Help You Live More Fully — with Hospice Nurse Julie
This episode of Asking for a Friend is sponsored by Better Help. https://betterhelp.com/askingforafriend
What if facing the realities of death could actually help you live with more intention, gratitude, and peace—right now?
In this powerful episode of Asking for a Friend, I sit down with Julie McFadden, better known as Hospice Nurse Julie, a former ICU nurse turned nationally recognized hospice educator with over 15 years of experience and millions of followers online. Julie’s mission? To normalize conversations around death and provide comfort, clarity, and dignity at the end of life.
We explore:
- The most common experiences people have at the end of life—many of which are rarely talked about
- How Julie transitioned from ICU to hospice, and what she learned about life in the process
- Practical advice for midlife women navigating aging parents and caregiving responsibilities
- How to prepare emotionally and logistically for end-of-life situations—with grace and self-compassion
- Why contemplating our mortality might be the greatest gift for living more meaningfully
Julie’s new Nothing to Fear Journal offers a compassionate guide for reflection, planning, and healing—and this episode delivers the heart and honesty that midlife listeners crave.
✨ If you’re supporting aging parents, feeling overwhelmed, or simply curious about what a peaceful end-of-life journey can look like—this episode is a must-listen.
📘 Find Julie at https://www.hospicenursejulie.com/ and grab the Nothing to Fear Journal, available mid-June.
This episode of Asking for a Friend is sponsored by Better Help. Get 10% off your first month of therapy. https://betterhelp.com/askingforafriend
_________________________________________
Are you ready to reclaim your midlife body and health? I went through my own personal journey through menopause, the struggle with midsection weight gain, and feeling run-down. Faster Way, a transformative six-week group program, set me on the path to sustainable change.
https://www.fasterwaycoach.com/?aid=MicheleFolan
Have questions about Faster Way? Please email me at:
mfolanfasterway@gmail.com
Sign up for Michele's weekly newsletter for more health and fitness tips and insights. https://michelefolanfasterway.myflodesk.com/i6i44jw4fq
RIMAN skincare finally gave me real, visible results—restoring my glow, firmness, and confidence in my skin at 61. RIMAN Korea's #1 Skincare Line - https://michelefolan.riman.com
*Transcripts are done with AI and may not be perfectly accurate.
**This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their healthcare professionals for any such conditions.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Michele Folan (00:00):
Let's be honest, midlife can feel like a lot
shifting roles, changing bodies,aging parents and sometimes you
just need a safe space to talkit all through.
That's where therapy comes in.
It's not a sign of weakness,it's an investment in your
well-being and with BetterHelp,getting started is easier than
(00:21):
ever.
Betterhelp is entirely online,so it works with your schedule.
You fill out a briefquestionnaire and get matched
with a licensed therapist in aslittle as 48 hours and if it's
not the right fit, you canswitch.
No awkward breakup required.
Give yourself permission tofeel better.
Visit BetterHelpcom forwardslash.
(00:43):
Asking for a friend to get 10%off your first month of therapy.
That's BetterHelpcom forwardslash asking for a friend.
Health, wellness, fitness andeverything in between.
We're removing the taboo fromwhat really matters in midlife.
(01:05):
I'm your host, Michele Folan,and this is Asking for a Friend.
For many of us in midlife, thereality of aging parents,
shifting roles and our ownmortality starts to feel very
real.
Yet it's still one of the mostavoided conversations, whether
(01:26):
you're supporting aging familymembers, facing big questions
about your own future or simplycurious how to talk about death
without dread.
This episode is honest,empowering and full of heart.
Welcome to the show everyone.
On this week's episode ofAsking for a Friend, I'm joined
by the incredible Julie McFadden, a hospice and palliative care
(01:48):
nurse with over 15 years ofexperience, known to millions
online as Hospice Nurse, Julie.
Julie's mission is clear toreplace fear with understanding,
denial with peace and silencewith meaningful dialogue.
She's the New York Timesbestselling author of Nothing to
Fear and her newest project,the Nothing to Fear Journal,
(02:11):
offers a deeply personal,compassionate guide for
exploring what really matters atthe end of life and how we can
prepare, emotionally andpractically, starting now.
Julie McFadden, welcome toAsking for a Friend.
Julie McFadden (02:25):
Thank you so much for having me.
Michele Folan (02:34):
I'm excited to be here.
So, okay, first of all, beforeI roll into this conversation
because this conversation isvery meaty please share some
personal details about you, likewhere you're from, and anything
you want to share about yourfamily, like where you're from
and anything you want to shareabout your family.
Julie McFadden (02:50):
Okay, so yeah, my name is Julie.
I live in Los Angeles.
Now I've been here for about 13years, but I grew up in
Pennsylvania.
I'm 42.
My sister is also in Californiawith me, so her and I both live
in Los Angeles together.
The rest of my family's back inErie, Pennsylvania.
I'm a nurse.
I've been a nurse for 15, Ithink 16 years now and I'm also
a content creator.
Like you said, I go by HospiceNurse Julie online and an author
(03:13):
.
Now I mean, wow, all thesethings have kind of unfolded in
the past few years and it's beenreally exciting and kind of
mind-blowing that people want tolearn about death and dying and
hospice and palliative care,what that means, so it's been
really cool.
Michele Folan (03:29):
Well, so first of all, congratulations.
You know New York Timesbestseller and with the
popularity that you've gained onsocial media.
So kudos for all of that, thankyou.
That's fantastic.
Julie McFadden (03:44):
Thank you.
Michele Folan (03:55):
But you know, you're in a career that, first
of all, anyone like myself whohas known someone that has gone
through the hospice process, youall are angels, incredible,
incredible people.
So again, just a little pat onthe back there for you, for what
you're doing, and and and notjust for the patients but for
the families, because there'sthat interconnectedness there
(04:15):
that you have with them as well.
Yeah, yeah.
So take us back to thebeginning.
I'm I would love to know whatled you to becoming a nurse and
then, specifically, hospice andpalliative care.
Julie McFadden (04:28):
Yeah, I mean the journey to becoming a nurse to
me is like kind of immature, ifI'm honest.
In my early 20s I was a littlelost.
I had a degree in psychology.
I was working in a hospital assomething called a behavioral
tech, so I was working in like amental health floor where
(04:49):
people were going to get helpbecause of whatever mental
health issues were going onright and I was like running
groups and talking to peopleindividually and just doing
different things that someonewith a undergrad in psychology
would do right.
And one day a woman had aseizure right in front of me and
(05:12):
she fell and cracked her headopen and there was like blood
everywhere and really like itwas so shocking to my system in
the moment when it happened andI ran away, I yelled and I ran
opposite of this.
Michele Folan (05:29):
I didn't help this woman.
Julie McFadden (05:30):
I ran and I went to get the nurses.
So I did get help for her but Idid not help her.
And I remember being so shookup and having this image of all
these nurses running down thehallway to this woman and I
remember thinking it was like inslow motion.
I remember thinking like I wantto be like that, like how come
they can do that?
How did they?
Michele Folan (05:50):
do that, running to danger instead of running
away from it.
Julie McFadden (05:55):
They had to sit me down, other people had to sit
me down in a chair because Iwas about ready to be the second
patient, because I was so shookup by what I saw.
But that made me be like I wantto be that.
I want to know up by what I saw.
But that made me be like I wantto be that, I want to know how
to do those things.
And the woman ended up beingfine.
I saw her the next day.
I went to go visit her the nextday.
She ended up being fine, sothat all was great.
That kind of made me thinkwould I want to be a nurse, like
(06:17):
?
Instead of thinking like, oh, Icould never be a nurse, I
thought I want to learn how tolike run towards that when that
happens.
And then my friend was in anursing program.
So the school we went to had anaccelerated nursing program
where you could get yourbachelor's degree in three
months.
So it was this really intenseaccelerated program and at the
(06:39):
time, because I had already gonethrough school, like four years
of school, I was like I couldnot do another four.
I could not do another fouryears.
No, but this three semesterthing where you bust your butt
for three semesters.
I could maybe do so through abunch of.
It took a really long time andit was actually really hard to
get into the program, but Ieventually did.
And then I got my bachelor'sdegree in nursing and that
(07:01):
started my career out.
Michele Folan (07:03):
But your background in psychology I can
see being super helpful, thoughTotally, in what you're doing
now.
So, even though your careerpath wasn't linear, necessarily,
there was a purpose in all ofthis that you're now discovering
.
Julie McFadden (07:22):
Yes, of course I can look back on my life now
and be like, wow, look how itdoes all seem to flow.
It's like when you're in it itdoesn't feel like that, but
looking back it's easy to seelike, wow, I met this person and
this happened and because ofthat I did this and it feels
really cool.
Michele Folan (07:38):
Yeah, yeah.
And then when did youtransition into hospice?
Julie McFadden (07:42):
I think it took me about eight years of being a
ICU nurse, which do not do that,folks.
It was probably after two yearsof being an ICU nurse, I was
like I hate this.
I hate this.
I hate nursing.
I made the wrong choice.
This is not for me.
I can't do this anymore.
So it was probably like fouryears just strictly in the ICU
(08:05):
and then maybe another fouryears like being a travel ICU
nurse, then being an agencynurse and just trying to like
find my way in nursing, becauseit was like I worked so hard to
get this degree and here I amlike really not enjoying it.
And then finally, through myexperience of being an ICU nurse
, I finally was like you knowwhat?
(08:26):
The thing that's lacking hereis this idea of not discussing
that people will have an end oflife.
And I saw we did many wonderfulthings to keep people alive and
they did survive in the ICU,but there were many patients
where we took way too long tosay something to the family
about.
You know, this is probably theend.
(08:46):
This is, they are not going toget better.
And I just saw that.
You know, it took a while, but Ifinally saw that I could be an
advocate for people like thatand even though the advocacy was
them eventually dying, it feltbetter than trying to keep them
alive, like that, felt like wewere causing more pain and
suffering than anything.
(09:07):
So I thought I remember havingthis thought, like if people are
going to die, we all areeventually from one thing or
another.
You know there has to be abetter way to do this, and
that's what got me thinkingabout hospice, and it basically
just took me a million years totake the plunge and change and
change.
So don't do that If you have itin your heart already.
(09:29):
I probably had it in my heartlike three or four years into my
ICU setting, but then I tookanother four to actually take
the plunge.
Michele Folan (09:38):
Yeah, but some of that is that we just lack some
of that confidence to say, okay,because you're learning, you're
learning something new again,right, and you feel like you're
starting over in a sense.
So, yeah, and then so you dohospice, and then you decide to
take your message online.
(10:00):
Did you ever expect to become,I mean, really a social media
sensation?
I mean, I'm going to call youwhat you are with over.
Julie McFadden (10:11):
I honestly can't even.
It's so hard for me to takethat serious.
But thank you, I'm definitelyjust a normal.
I'm a normal girl over here.
I don't know what I'm doing.
That's the truth, but thank youyes go ahead.
Michele Folan (10:29):
Yeah, but you know many of my listeners
they're 50 plus.
They are navigating agingparents and caregiving.
What advice would you give themas they step into that role?
Julie McFadden (10:46):
Oh my gosh, there's so many avenues to take
there.
There's so many avenues, so one.
I think it's really importantto just talk about how hard it
is, because I think about it aslike new parents, right, when
new parents have babies andthey're like whoa, why didn't
someone tell us like this issuper hard?
Why do I feel like I'mconstantly failing?
Why does it feel like there'snothing out here to help support
(11:08):
me?
How is anyone doing this?
I'm not a parent, but all of myfriends are parents and they all
tell me this.
They all say we have a dualincome, we plan for children, we
did all the things and it stillseems so hard.
Right, how is everyone doingthis?
And I equate that to takingcare of aging loved ones or
(11:33):
someone who's terminally ill orhas a life-limiting disease.
It feels like that becausethat's what I hear from my
families on hospice andpalliative care.
Like no one told me I was goingto be in charge of everything.
No one told me I was going tohave to act like a nurse,
somewhat right, like no one toldme this.
This is so hard.
How does anyone do this?
And, honestly, I don't fullyhave answers to make it less
(11:57):
hard.
I have some tips and tricks,but also, like I like to just
normalize that you're not losingyour mind here.
It's actually that hard andthere are missing links in our
healthcare system and this isone of them.
So I like to just bring a voiceto that so people know that
they're not alone.
Everyone's thinking this You'redoing the best you can, and
(12:18):
that's the thing I want to drivehome is like whatever you're
doing, you're doing the best youcan.
And if you need more help, bethe squeaky wheel right, be the
advocate to the doctors you'reworking with, to the nurses
you're working with, to be likelisten, I need help, I need help
.
What else is there for me andmy loved one or my loved one
(12:39):
needs help.
And the last thing I'll say isto try your best to prepare as
much as you can, which it'sreally hard to prepare.
If you don't know what toprepare for, you're like but how
, what, what do I need toprepare?
I think that's where my videoscome in, my book comes in, the
journal comes in.
I hate to sound salesy, right,it's not about that.
(13:00):
It's about you do need someoneelse who knows how to do it, to
guide you through it.
Hence how the social mediathing developed.
I realized there isn't much outthere to support people.
So, yeah, you got to plan andyou got to know what to plan.
It'll help you.
Michele Folan (13:17):
Hey, Julie, we're going to take a quick break and
when we come back I'm going totalk a little bit about the
sandwich generation and some ofthat preparing that we need to
do.
You listen to the podcast.
You might even see my reels onInstagram.
Perhaps you've even clicked alink or two, but you still
haven't made a move.
You're still waiting for theright time to start.
(13:40):
But here's the truth.
There's no perfect time, butthere is today, and if you're
feeling stuck, low on energy andlike your body isn't responding
the way it used to, you are notalone.
That's why I coach womenthrough Faster Way.
We start with the basicsfueling your body with real food
, building strength and finallylearning how to support your
(14:02):
metabolism instead of fightingit.
No extremes, no restriction,just a support your metabolism
instead of fighting it.
No extremes, no restriction,just a smarter, proven approach
for women over 50.
If you're even a little curious,click the link in the show
notes or shoot me an email.
I'm happy to chat with nopressure, but maybe it's time to
stop watching and start doing.
(14:23):
Let's do this together.
Okay, we are back Before wewent on break.
I wanted to bring this up aboutthe sandwich generation because
so many women my age are takingcare of their aging parents and
(14:45):
they may even still have kidsat home.
And you know we talk aboutbeing prepared and it's like I
don't think anyone ever preparesyou for what this hospice
journey can be like, because itcan last a very, very long time,
(15:05):
right.
Julie McFadden (15:07):
Right, they can be on hospice.
I mean, depending on thedisease, right?
A lot of aging people are onhospice for dementia or
Alzheimer's or Parkinson'sdisease or congestive heart
failure, which is a long-lasting, life-limiting disease, so you
can kind of be on hospice, beoff hospice.
There's definitely a period oftime and this is the hardest
(15:30):
time, I think when you don'treally qualify for hospice but
you need help and there's noteasy answers for that.
This is what I mean by missinglinks in our healthcare system.
This, okay, this Aging peoplewho need extra help they don't
quite qualify for hospice.
Even if they did, hospice doesprovide things, but they still
(15:52):
don't really provide thecustodial care, which is like
the day-to-day care of someone,just to be there, to kind of
like watch them, make surethey're safe, make sure they're
getting the food they need,right?
That's not provided by hospice.
So it's the families that haveto step up, and most people
don't know that and most peoplearen't prepared for that.
Michele Folan (16:12):
Yeah, because it's maybe not a nursing home
type of situation, right?
So a friend of mine has abrother who has had some serious
health issues and he is inhospice now.
He's in his late 50s, I think,but he's in hospice now because
(16:33):
his weight got down to a certainplace where they just made him
eligible for hospice.
Is that state?
Julie McFadden (16:42):
by state.
No, all hospices in the USshould be acting under the same
guidelines because Medicare isthe one that funds hospice.
So, depending on what diseaseyou have, what disease you're
coming onto hospice with, thereare certain criteria for
specific diseases.
Now, every once in a whilethere's like strange outliers.
(17:03):
I'm not sure what disease hehas, but there's like I say
strange because it's like thereare little outliers of well,
they have this specific diseasethat's not technically terminal,
but they might be becausethey're so malnutritioned.
We basically have to prove toMedicare that they will likely
(17:23):
die in six months.
That's the main thing thehospice has to prove to Medicare
to make someone eligible.
So sometimes we'll look atfactors like malnutrition.
We'll look at their albuminlevel.
If it's below a certain numbermalnutrition We'll look at their
albumin level.
If it's below a certain number,that tells Medicare that this
person will likely die withinsix months.
Now will they?
(17:44):
That's who knows right andmaybe they'll be able to stay on
hospice for a year or two yearsif we can continue to tell
Medicare.
Hey look, they are stillshowing signs that this might
happen and some hospices arebetter at following guidelines
than others.
So there are some more lenienthospices that will take people
(18:05):
on, even though they may nottechnically meet criteria.
So it just depends.
Michele Folan (18:08):
Okay, so we're looking at organ function
basically, so like kidney, liver, that kind of thing, then in
determining how much longersomebody may live.
Julie McFadden (18:22):
No.
So the way I would look at itis like there's and again this
is general, but generallyspeaking there's two types of
patients.
There's patients withmetastatic cancer, meaning
cancer, like a cancer diagnosis.
They are a little more quoteunquote easier to get onto
hospice because it's a littlemore obvious.
We know this type of cancer, weknow where they are in the
(18:44):
progression of this cancer.
We're used to seeing it.
There's weight loss, there'sfunctional loss, there's pain,
there's shortness of breath, allthese different things that
we're looking at.
So it's a little more obvious.
Then there's the other type ofpatient that has life-limiting
chronic illnesses like COPD,which is a lung disease, chf,
(19:06):
heart disease, a stroke, withdifferent symptoms, and they've
been living with these symptomsfor a long time and now they're
not doing well.
Dementia, alzheimer's Dementiaand Alzheimer's are really
actually difficult.
It's difficult for people toget onto hospice because you can
live a long time with thosediseases Parkinson's, ALS,
things like that.
Those people with thosediseases.
(19:28):
We have specific criteria and Iwon't go through every single
one because it's just it's likemind-numbing.
That's like a mind-numbingthing for a hospice nurse, right
, you have to like know allthese things to know if they
meet the technical criteria tobe on hospice and that criteria
is supposed to gauge how closethis person truly is to death.
(19:51):
Because it's really hard toknow with those diseases,
because they ebb and flow somuch.
Does that make sense?
Michele Folan (19:57):
Yeah, so are you partnering with the doctor to
make that full assessment ofthat patient Correct?
Julie McFadden (20:04):
Yes, we're always partnering with the
doctor and all of us who work inthis field.
If you work long enough, youkind of know the criteria like
the back of your hand.
They give you booklets in thebeginning so you can kind of
learn.
But you and the doctor know thespecific criteria.
And of course there's timeswhen I see someone who's 98,
(20:25):
right, and they technicallydon't have a terminal diagnosis.
But here they are, they're noteating, they're not waking up,
they look very, very close todeath and I have to work with
the doctor and work with thefamily to kind of get a
diagnosis on our own so they canmeet criteria for hospice.
Because clearly they're 98,they're not eating, they're
(20:47):
barely drinking, they've beensleeping 24 hours a day for
three days straight.
We can put them on hospice.
But technically, per Medicareguidelines, we have to have some
kind of diagnosis that showsthis Right.
So there's a gray areacertainly.
Michele Folan (21:04):
Julie, I've always kind of wondered about
this, because when my mom wasill she went downhill pretty
quickly and we knew she was in ahospice situation, but we had
to leave her in the hospital.
She was too frail to be moved.
We had to leave her in thehospital.
She was too frail to be moved.
So we did hospice in thehospital.
No one, including me, ever saidMom, we are moving you to
(21:28):
hospice.
I didn't have the heart to havethat conversation with her and
that has haunted me since shepassed away.
And I'm wondering how much dowe tell our loved one when it
comes to that time?
Julie McFadden (21:45):
I think if they're alert and oriented, like
fully alert and oriented.
We be honest, as honest.
That's what I think you knowand we're not used to doing that
.
We're not used to.
We never learned how to do that.
I have had, like.
One of my best friends reallysays that his mom would do
(22:05):
better not knowing, and I'd haveto believe them.
So if a family member does tellme that, like I am telling you,
I know my mom or I know my dad,and they will not, they don't
have it in them to know thesethings right, it makes it a
little difficult because we haveto have them sign paperwork,
like saying they're going on tohospice.
So there's a little bit likewell, how are we supposed to do
(22:25):
this?
So I usually try to talk tolike the way I usually do it is
say like what do you think isgoing on here?
Like, how do you feel?
How do you feel about your body?
What do you think is going on?
And usually nine times out of10, the person will say I'm
dying.
So I do think people know theymay just not be saying it, but
(22:47):
generally speaking I also try togo with what the family says.
The family knows their loved onethe best, but I would say we do
need to work on just being ableto talk about it a little more,
and that's the whole reason whyI'm here.
I'm doing these things.
It's not your fault, I mean, Iget it.
Many people don't know how tobring it up or say it, or will
(23:07):
it make it better or will itmake it worse?
And it's a little easier for mebecause I'm the hospice nurse.
That's what I'm supposed to do.
When you're the daughter, itfeels harder and no one taught
you how to do it and I don'tknow, was your mom alert and
oriented, or did she?
Oh yeah.
Michele Folan (23:26):
She was alert and I think she knew it was
happening.
But I still feel like I owedthat to her, to have that
conversation with her, andthat's what's bothered me.
Yeah, cause she, she was veryalert and that was the hard part
.
It was her lungs that weregiving out on her, and so it's.
It was just one of those thingswhere, yeah, you always wonder
(23:48):
like what, what should I havesaid?
Julie McFadden (23:50):
I do want to reassure you not, and I really
mean this.
I mean I feel like you did thebest you could at the time.
I mean it's easy to look backit's always for anyone it's easy
to look back and say, oh, Ishould have done that, but at
the time you did the best youcould with who you were at that
time and yeah.
Michele Folan (24:11):
Okay, I feel a little better now.
Your book Nothing to Fear was ahuge success.
What inspired you then tofollow up with your fear journal
, Because you have that comingout here very soon.
Julie McFadden (24:26):
Yes, so the book to me was absolutely insane
because I just never knew Iwould write a book.
So to write a book and thenhave it be so well received was
amazing.
And the journal came about onebecause I'm a journaler, so I
love journaling.
I've journaled ever since I'vebeen a little girl.
(24:47):
I talk about it on my channel.
It's really, really helped methroughout my life.
So when my publishing companysaid, hey, we're thinking about
doing a sister book to your bookas a journal, I'm more excited
about that than the book,because I just love, I just
think journaling can be sohelpful and I think you could
read my book and it's definitelyvery helpful.
(25:10):
But it also could be like okay,now that I know all these things
, where do I start?
How do I start?
What do I do?
What questions do I ask?
Where can I put all of thesethings that I need to keep in
order?
And that's what the journal isfor.
So it's broken up into sectionswhere the first part's a little
bit about getting youcomfortable with exploring death
(25:31):
, exploring your own death,exploring immortality in general
, kind of like all theexistential stuff that can come
along with it, and then, as itgoes along, it gets into more of
the practical things where Ilove that.
I'm a girl who, if I feel outof control which a lot of people
do when someone's ill or whenyou yourself are ill I want to
(25:54):
know what can Like practicalthings.
So I feel in control and thatis what the back of the journal
is for.
The back of the journal is likethe practical things like start
here, do this, here's how youdo it, who do you call?
Like things like that.
So that to me is like chef'skiss, cause I know that's what I
(26:16):
want.
Michele Folan (26:17):
So and I think a lot of people like that as well-
yeah, and because we talkedabout the plan right and so many
of us know this time is comingSome don't, but many do so I see
where there would be a realbenefit in kind of getting the
house in order in terms of yourhead, your thoughts.
(26:39):
And then also there's the otherstuff.
The stuff that we hate havingto deal with is just all the
practical household things thatcan be so daunting.
Julie McFadden (26:54):
Yes, and you don't know what you don't know.
You know what I mean.
You forget, oh, I don't havethe password to the bank
statement, so I don't know whothe beneficiary is.
I don't know what you know.
So it's things, it's all thelittle things like that that I
know, cause I'm around it allthe time and I know what people
need to get an order.
That, um, it kind of helps youjust cue into things.
(27:16):
You need to check off the boxbefore it all goes down.
Now, if it's already gone down,it'll still help you because
you'll know what to do, like howto get things in order, who to
contact, what kind of lawyer doyou need?
If you do need a lawyer, how toget in touch with the mortuary,
things like that.
Michele Folan (27:36):
You know, and then this brings up you did
touch on it just a little bitbut there is this moment where
we're going to have to confrontour own mortality, right?
Yes, and maybe the mortality ofa spouse?
Yes, and some of my friendshave already been through that.
(27:56):
Yeah, how do you hope thejournal will support that
reflection?
Julie McFadden (28:01):
I would say that's the beginning part of the
journal, the whole existentialthings.
I feel like it sounds to meit's even hearing me say what
I'm about to say sounds cheesy,but I mean it with my whole
heart and I can't believe thatI'm this person now.
But my job and my work has kindof changed me.
I know for my own life thatcontemplating my own mortality
(28:25):
or my loved one's mortality, asmorbid as that sounds, has truly
helped me live in today andappreciate today.
That is one of my greatestgifts that I've gotten from
working in this field, thegreatest gifts.
And that's what the beginningof the journal is all about.
I'm trying to get people to alsobe able to tap into the things
(28:46):
that I feel like I have tappedinto because I can and I
practice.
It's literally a practice of mereally trying to understand
that, like this isn't alwaysgoing to be, my health is not
always going to be, my sisterwill not always be here and I
know even when I say it itsounds like oh God, thinking
about that, but there'ssomething about it that helps me
(29:08):
see it in a light of like.
But that's not today.
I am here today, my sister ishere today I can walk on these
legs today, I can drink thiscoffee and feel the sunlight
today, and I'm getting chillsjust thinking about it because
it brings me so much peace andjoy and brings me to the moment
of now.
To the moment of now.
(29:29):
That's the greatest gift I canhave.
So that's what I hope thejournal brings to people.
I hope that's what is kind ofportrayed in that first part of
the journal to get people there,because it's been one of my
greatest gifts.
Michele Folan (29:41):
That's the gratitude piece that we're
always told in the morning weshould be finding something to
be grateful for, and you're justgiving people a platform to
actually put it down on paper,which I think is really nice,
yeah.
Julie McFadden (29:59):
Yeah.
Michele Folan (30:00):
Before we started recording I asked you if we
could talk about this a littlebit, because I know there are
life after death type of momentsthat you have with these
patients as they transition andpass through.
That's the best way I can putit.
Can you tell me some storiesthat you've experienced with
(30:23):
patients and how that hasaffected your belief in life
after death?
Julie McFadden (30:30):
Yeah, so just to generally, I'll generally talk
about it and then I'll give acouple stories.
So my chapter six in my book isall about deathbed phenomena,
which is the longest chapter,because it happens so much in
this end of life realm whichreally surprised me as a
critical thinker, icu nurse.
(30:52):
It was like a huge shift for meand the only reason why I kind
of came around to the fact thatit happens is because I kept
seeing it all the time.
So it's like undeniable, youcan't really deny it, because it
just happens all the time.
We don't know why it happens,but it does.
And so deathbed visions happenwith almost everybody and it
doesn't happen right before theydie, it happens a few weeks
(31:12):
before they die, where theystart seeing dead relatives,
dead loved ones, old pets thathave died.
And the story that always sticksout to me for this is a family
called me in because their lovedone was confused.
A loved one who was on hospicewas confused.
They were saying some crazythings.
We need to come over andmedicate them.
(31:32):
And I come over and thepatient's like seems totally
fine in bed, totally alert andoriented, and I'm like a little
confused and they're like well,he's not doing it now, but he
was really confused earlier andI was like, okay, well, how do
you feel now?
Right, and he was like I feelfine and I'm asking dates and
making sure he was oriented andhe seemed great.
So they left for a second, thefamily left and the patient
(31:56):
grabbed my arm and goes listen,I'm seeing my parents.
I'm seeing my parents, they'recoming to me and they told me
that they're not coming yet, butthey're coming soon and, not to
be afraid, they'll take care ofme.
And that's why they think I'mcrazy.
But I'm not crazy.
I don't know why it's happening, but it is.
And I'm like I know and honestly, by this time I have seen it so
(32:20):
much that it actually wasn'teven surprising to me I just
sort of laughed and I was like Iknow, listen, you're not crazy,
this is something that happensat the end of life.
We don't know why it happens,we don't know why it's called
deathbed visioning.
It happens across all cultures,all faiths around the world.
We don't know why, but it does.
And as long as it's not scaringyou and as long as you're okay,
it's okay.
(32:40):
And he was like well, can youtell my family that?
Right, because he's whispering,he's afraid, he's afraid to say
can you tell my family that,because they think I'm crazy,
they're trying to knock me out?
I'm like I'll talk to him, it'sokay, right?
So then I go and then, ofcourse, I leave there and the
family grabs me whispering.
Listen, he's saying he's seeinghis parents, he's hallucinating
(33:02):
.
Something's really wrong, youknow, and I'm like you guys,
well, and I kind of just giggleand I'm like it's okay, this is
something called death bedvisioning.
It's very normal, it happens in, like most of our patients.
A lot of our patients don'teven talk about it, hence why we
don't know that it's evenhappening, but as long as he is
comfortable, it is okay.
Now, if he starts screaming andyelling and is agitated and is
(33:23):
going to hurt himself orsomething, yes, that is a time
we may want to medicate somebody, which I never actually I would
never consider bad visions.
Visioning Visions are abeautiful, comforting thing and
they look very different thansomething like delirium or
confusion or agitation.
(33:43):
They look very different.
The person is usually like thisman is very calm, very
collected, very alert andoriented and knows who they saw
and what they saw.
And I mean I literally havecountless stories like that
People who have seen Jesus,people who have seen other
deities, like it depends on whatyou believe in, right?
So like, if you're a Christian,like people can see Jesus but
(34:06):
they will see other deities.
If they're not Christian,they'll see what is true to them
, right?
People seeing different typesof angels, people reaching up
and smiling and saying hi, mom,you know you can just, and it's
wild to see.
It never really gets old, but Ido see it.
I do see it often, often andnow that I educate about it with
(34:31):
my families, because I thinkit's really important we don't
run into this mess of like youneed to get over here and
medicate my loved one becausethey're going nuts.
I try to educate, and when Ieducate, that's when people
start already telling me stories.
Oh, they're already doing that.
They've already been talking toour next door neighbor who died
a couple of years ago.
So it's fascinating.
So it's fascinating, it'scomforting to me.
Whether it's real or not real,it's still comforting to me.
Michele Folan (34:54):
Yeah, because it's comforting to them.
Does it comfort you when youthink about dying yourself?
Julie McFadden (35:01):
Yes, yes, I mean .
There's so many things thatcomfort me about dying, Like
even just the biological aspectof dying and how our bodies are
built to do it and know how todo it, and takes care of us at
the end of life, and our bodiesare biologically built to
systematically shut down andhelp us be not hungry and
thirsty and help us sleep more.
(35:22):
That's comforting to me too.
These things that areunexplainable are comforting,
but the things that areexplainable, like the biology of
death, is also comforting to me.
Michele Folan (35:33):
Can you talk about that a little bit, the
biology of death?
So you know, we all know whensomeone has gotten very
compromised and they always say,oh yeah, you know he's shutting
down, what does that reallymean, though?
Julie McFadden (35:47):
It usually means the organs, like you said, that
are kind of systematicallyshutting down.
So there's probably multipleorgans shutting down.
I do believe if someone isbecause I've seen it in the ICU
and it's not bad, it's justdifferent If someone has been
kept alive in the ICU for manymonths, their shutting down will
(36:09):
look a little different thansomeone who's on hospice and who
has been naturally kind ofshutting down over weeks at a
time, just because they havealready been kind of pumped full
of fluid and then diuresed andthen on this machine and that
machine.
So it's still very peacefulbecause we have medications to
make it peaceful.
But I don't think it doesn'tgive the body enough time to
(36:31):
truly shut down.
Whereas in hospice what I sawover and over and over again
when the body has time to reallysystematically go through it,
it helps you shut down thehunger and thirst mechanism that
purposely makes the persondehydrated because they actually
feel better.
The more dehydrated they are,and dehydrated because they
(36:54):
actually feel better, the moredehydrated they are, it kicks in
, usually higher levels ofcalcium, so you sleep all the
time and it's a slower, morenatural process that really
creates for a peaceful death.
But when someone says they'reshutting down.
That's what they mean.
All of the organs in the bodyare systematically shutting down
.
Michele Folan (37:11):
Okay, that little burst of life that people get
at the end.
And I'll give you a specificexample.
My father-in-law was in memorycare and we had seen him earlier
that evening and he sometimearound maybe midnight, maybe 11
(37:33):
o'clock, he got in hiswheelchair and kind of scooted
down to the nurse's desk and wasflirting, probably, with the
nurses, saying hello andchatting with them, and then he
went back to his room and atabout 2 am we got a phone call
saying that he had passed.
What the heck.
Julie McFadden (37:52):
I know.
Michele Folan (37:53):
Yeah.
Julie McFadden (37:53):
Right, yeah, so that is called terminal lucidity
and it happens in one third ofall people dying.
So one in three people willexperience something like that,
and we don't know why it happensAnother mystery, we don't know.
There's always theories.
People always say, oh, it's DMTbeing released, it's a bunch of
(38:15):
hormones being released.
All of that is fun to thinkabout, but we don't really know.
It's never been actuallystudied.
We just know.
Again, we just know whathappens.
And the thing that makes it verydistinct is that and I don't
know if you're I think you saidit was your father-in-law yeah,
I don't know if he was lookingill or was ill, but usually
(38:35):
someone is like ill and lookinglike they're going to die soon
and then suddenly, boom, theyhave this moment maybe a day,
maybe two days at max, wherethey look like they're doing
things they haven't done in solong Getting in a wheelchair,
going down, flirting with peopleasking for a cheeseburger.
My grandma, a few days beforeshe died, woke up, got out of
(38:59):
bed she hadn't walked in dayshad Thanksgiving dinner, you
know, complained to my mom thatthe food was too hot, which is
like her personality you knowlike this is the hotter and then
was like boop got back into bedand died a couple of days later
.
So it's the distinction was likeboop got back into bed and died
a couple days later.
So the distinction is likesomeone's very ill boom, this
like distinct burst of energy,and then they die shortly after.
(39:20):
So that's the distinction isthat they have to die shortly
after.
If they don't die shortly after, it's not terminal lucidity,
it's just them.
You know their disease, waxingand waiting.
But if they die shortly afterthat burst, that was terminal
lucidity, all right.
Michele Folan (39:37):
Yeah, because, yeah, I mean he had lost a lot
of weight.
You know, because when theyhave dementia, food isn't as
interesting to them and you knowwhatever.
But yeah, that was my example,that I was like I got to ask her
about this one because I knowI've talked to so many people
that have had that sameexperience as well.
(39:59):
Yeah, yeah.
Julie McFadden (40:01):
Okay, and it sounds to you a little bit like
he may have he sort of just saidmaybe his body just said I'm
done, this is enough, I'm done,this is enough.
Whenever someone dies, wheneverit's not really that slow
progression, they just sort ofdo it.
(40:22):
I'm like I feel now this isjust my opinion, there's no
scientific reasoning for this,but it just feels like their
body declares itself and justsays I'm done.
Michele Folan (40:27):
Yeah, that is perplexing, but so interesting,
right, how our body just knows.
Does that come from the brain?
Does the brain direct trafficthere that tells the organs that
it's time?
That's a great question.
Julie McFadden (40:47):
I mean, I think they're finding that all the
organs are kind of talking toeach other the spinal cord
because the spinal cord too is abig part of of working our body
and our gut talks to our brain,our brain talks to our gut.
So you know, uh, because I'vebeen a nurse for so long, I I
(41:07):
feel comfortable going.
I don't know.
I think probably.
Yes, there's definitely some ofthat, but I think there's more.
There's still mystery to like,what's running the show?
Is it the brain?
Is it the gut?
Is it all together?
The brain does a lot of things.
That's why, if you have diseaseto the brain, it can be hard
(41:27):
for the rest of the body.
Michele Folan (41:28):
But I don't know.
Okay, one other question.
I had this just popped in myhead.
Yeah, how do we make thedecision whether to do in-home
hospice or to do hospice in afacility?
Julie McFadden (41:42):
Oh, great question.
I would say only do in-homehospice if you are able to be
there you or someone, or you paysomeone else to be there most
of the time.
So at first, when you sign upfor hospice, your loved one who
is on hospice may not need24-hour care, right.
They may be able to havesomeone just pop in at night or
(42:05):
pop in in the morning orwhatever, right, but eventually
that person's going to need24-hour care and hospice will
not provide that.
So if you or your family canwork a system where you guys can
be there and your loved onewants to be home, then do that.
Or if you have the money to payfor a caregiver who can be
(42:26):
there, then do that.
But if you don't, I wouldrecommend a hospice, either in a
hospice home, if your city hasthat, or like a skilled nursing
facility, and then hospice willgo there.
Michele Folan (42:39):
Got it Okay, yeah .
Yeah, I wasn't sure how thatactually worked, but that's the
family's, up to the family andtheir decision how they do that.
Okay, what are some of thesmall mindset shifts you think
that we need to make today, orshould make today, to embrace
aging and the naturaltransitions of life?
(43:01):
Because when you, when it comesto losing a parent or maybe a
spouse, that accepting piece isjust not there.
Julie McFadden (43:15):
Not there.
Michele Folan (43:16):
It's got to be a horrible, dire situation for you
to say, okay, yeah, I'm okaywith this, right, yeah?
Julie McFadden (43:23):
I think there's not a quick and easy answer for
that.
I think there is.
It takes time, it's gray, it'snot black and white in the sense
of like I can't give you like a, do this and do this and then
you'll equal this.
I think it's like learning tolive in the uncomfortability of
like not knowing and feelinggrief, before someone even dies,
(43:47):
just knowing, like your friendwho's in his late 50s, I think
you said like his loved ones aregrieving now.
I mean they'll grieve later too, but like there's grief and
like this idea that, like I'mnot living this life that I
thought I was going to be living, like this isn't what I planned
for here.
So I think the first thing Iwould say is if you can talk
(44:11):
about it, and talk about ithonestly, don't give some frilly
thing of like well, I acceptthat it's like no, I mean the
people that I see that die well,live well and die well.
Are my patients who are willingto be like this.
Can I swear?
Are we swearing?
Yeah, oh, yeah, no, yeah.
Patients who are completely tobe like this Can I swear?
Are we swearing?
Michele Folan (44:30):
Yeah, yeah, no yeah.
Julie McFadden (44:31):
Patients who are completely like this fucking
sucks, I'm so angry, I'm soangry this shouldn't be
happening.
I'm scared, like all of thestuff.
Just say honest things andthere is something about that
that I have found that kind ofhelps release that grief, that
sadness, that anger, even forthat moment.
(44:52):
Right, and then you connectwith the person you're talking
with.
So, if you're the person sayingit, say the truth, the truth as
you understand it in thatmoment.
If you're the person listening,let them say their truth.
Right, don't go no, no, no,don't say that You're going to
be fine.
You don't need to make anyonefeel better.
(45:13):
It's about trying to connecthonestly.
If there's a thing, there's aprayer that I say every day,
that really helps me, and ifyou're not like into prayer, you
can call it something else.
Whatever you want to call it,but it's God or whatever you
call God.
Help me set aside everything Ithink I know about blank,
whatever that is, for an openmind and new experience.
(45:35):
Please, let me see the truth,and I love that because it just
helps me kind of release it alittle bit and hopefully see the
truth of it all.
And sometimes the truth is thisis wildly uncomfortable and
period.
Yeah, you know.
Michele Folan (45:53):
You know, I knew this was going to be a really
heavy topic, but again we got toface this stuff head on.
We can't sugarcoat it, it'slife.
Can't sugarcoat it, it's life.
(46:15):
And if this podcast can helpone person kind of navigate this
very, very difficult and sadsituation, I am happy, right, I
mean, that's one of those things.
So, on a little brighter, moremaybe personal note what is one
of your self-carenon-negotiables, the thing that
grounds you, no matter what?
Julie McFadden (46:34):
Well, I am sober , so I'm sober and I'm in a
12-step recovery program andnon-negotiables for me are
things I do in that recoveryprogram to keep me grounded and
keep me sober physically andemotionally.
Fantastic, and that's likenon-negotiable.
Michele Folan (46:52):
How long have you been sober to keep me grounded
and keep me sober physically andemotionally.
Fantastic, and that's likenon-negotiable.
How long have you been sober?
Nine years, congratulations.
Yeah, thank you.
We talk about alcohol all thetime on this podcast.
It comes up oh my gosh will we?
Julie McFadden (47:03):
I'll come back.
I'll come back, girl, because Ican.
That's a whole other book Iwant to write about the disease
of alcoholism and what it meansto me.
And I mean, my recovery hascompletely changed my life and
it's changed everything about mylife, including how I work, and
I think, yeah, it's beenamazing.
So that's the non-negotiable.
I do it every day.
(47:23):
I do something to maintain mysobriety, and not just my
physical sobriety, but myemotional sobriety, so I can be
free in the day that I'm in.
Michele Folan (47:34):
Yeah, do you still go to meetings?
Yeah, okay, yeah, fantastic,yeah, yeah, you know it comes up
all the time because this is ahealth and wellness podcast and
we've all heard the data.
And I know my my listeners arerolling their eyes because
they're like God.
She is talking about alcoholagain, but I am sorry.
(47:57):
Yeah, so I I still haveoccasional cocktails, so it, but
but I don't drink every night.
I don't like polish off abottle of wine.
I did during COVID, all thatstuff.
So that is in the rear viewmirror, that life, and I am so,
so grateful.
But what made you decide to getsober?
Julie McFadden (48:19):
Oh my gosh, I mean so many things.
I always knew I had something alittle bit of an issue with
alcohol.
Mine to me was a littleconfusing because I was quote
unquote like high functioning.
You know, I think a lot ofpeople misunderstand what
alcoholism is.
You know, I still had a job, Istill maintained friendships, I
never got DUIs, I never went tojail, like nothing like that.
(48:40):
My bottom with alcohol was anemotional bottom where I would
just thought I was getting inthe way of what I wanted to do
with my life.
It just felt like I was toohungover to do stuff.
And then I would say I'm notgoing to drink tonight because I
was too hungover this morningand I got to do stuff tonight.
I got to get out there andwhatever.
The stuff is right.
But then by the end of the dayI'd be like, nah, it's fine, and
(49:04):
I'd just open a bottle.
And then next thing, you know,I'm drinking a bottle of wine,
maybe a bottle and a half,depending on if I'm still awake,
and the cycle was all overagain.
Right, and I didn't do thatevery day, but I did start doing
it most days.
And what was really eye-openingto me was I eventually only to
spare.
This is still going to be long,but I'll try to make it shorter
(49:24):
, you know, to spare the lengthof the story.
I eventually stopped drinking onmy own.
I didn't call myself analcoholic because I didn't think
I was, but that's when I reallystarted seeing that I was an
alcoholic, because if you wantto know if you're an alcoholic,
try quit, quite, try stopstopping alcohol.
Right, and I could do it.
I did it.
I did not drink and I didn'tdrink for 11 months, which is a
(49:46):
long time, almost a year.
That is a long time, yeah, foralmost a year.
And my life, my internal lifeand my external life got worse
and worse and worse.
I didn't do the things Ithought I would do, I didn't
meet the friends I thought Iwould meet, my life got smaller,
my anxiety got higher, my innerworld was insane and I got much
more lost and confused insobriety.
(50:10):
And that really got me to mybottom because I thought, wow, I
did the thing.
I thought I, I did the thing, Istopped the thing and I thought
I was going to like fly, and Ididn't fly.
Yeah, I like sank, sank, sank,sank, sank.
And, through differentcircumstances, I ended up
meeting a friend who took me toa meeting and that just started
(50:30):
me on this journey of learningabout alcoholism and getting
help for what I would callalcoholism.
And yeah, it just helped me somuch when I got into a recovery
program and it helped me soquickly that I was kind of like
sold.
I was like this is kind of allI wanted.
I wanted to learn how to livesober and that's what it taught
(50:52):
me.
Michele Folan (50:53):
That's awesome and you hit.
It's that community, it's thatconnectedness.
Yeah, exactly I'm not alone,there are other people just like
me.
I mean, that's beautiful I loveit.
Julie McFadden (51:04):
Yeah, yeah, thanks for sharing that.
Michele Folan (51:06):
We didn't know we were going to go down that road
.
Yeah it.
Julie McFadden (51:08):
Thanks for sharing that we didn't know we
were going to go down that road.
Yeah, it's my greatest gift.
It's my greatest gift of mylife.
It's your superpower.
Yeah.
Michele Folan (51:14):
Yeah, yeah, and to be able to share that with
other people, to share yourjourney with other people, is a
gift, I think.
Julie McFadden (51:24):
Thank, you, thank you.
I'm passionate about that too.
Two things I'm passionate aboutsobriety and death.
That sounds so crazy, but Icould talk about those things
forever.
Michele Folan (51:35):
Oh, she's a wild one.
Julie McFadden (51:38):
Yeah right, everyone's like yikes.
Michele Folan (51:41):
Oh, julie's coming tonight.
Oh, geez Great.
Oh, that's so funny.
All right, Julie McFadden,where can the listeners find you
, your work?
You have a YouTube channel aswell.
Julie McFadden (51:56):
Yes, Thank you for bringing that up, because I
feel like, because TikTok iswhere I got started and that's
where I have my most followers.
I always talk about that, butreally my love is my YouTube
channel.
I love my YouTube channel.
I go live every Thursday there,so like we have a.
I'm all about community, as youknow, so we have a community
there.
All the same people show up.
(52:17):
It's just so beautiful.
So I have a YouTube channel.
All my channels are same nameHospice Nurse Julie.
So wherever you get your likesocial media, you can find me on
Facebook, instagram, tiktok,youtube same name Hospice Nurse
Julie.
And if you're interested ineither my book or my workbook,
it's called Nothing to Fear andyou can get it really anywhere
(52:38):
you get books.
I think the easiest place tolook is on my website,
hospicenursejuliecom, but itdoesn't help me more.
If you order it there orwherever you get, it will help
me, but that's just an easyplace to start
HospiceNurseJuliecom.
Michele Folan (52:54):
Okay, and and the Nothing to Fear journal comes
out in June, in June.
Julie McFadden (52:58):
Yes, okay, yes, I think mid June.
I should know the exact date,but I think it's somewhere
around mid June, perfect.
Michele Folan (53:04):
Wonderful Julie McFadden, or Hospice Nurse Julie
, thank you for being here today.
Julie McFadden (53:12):
Thank you so much for having me.
Michele Folan (53:13):
You've been great .
Hey, thanks for tuning in.
Please rate and review the showwhere you listen to the podcast
.
And did you know that Askingfor a Friend is available now to
listen on YouTube?
You can subscribe to thepodcast there as well.
Your support is appreciated andit helps others find the show.
Thank you.
Let's be honest, midlife can feel like a lot
shifting roles, changing bodies,aging parents and sometimes you
just need a safe space to talkit all through.
That's where therapy comes in.
It's not a sign of weakness,it's an investment in your
well-being and with BetterHelp,getting started is easier than
(00:21):
ever.
Betterhelp is entirely online,so it works with your schedule.
You fill out a briefquestionnaire and get matched
with a licensed therapist in aslittle as 48 hours and if it's
not the right fit, you canswitch.
No awkward breakup required.
Give yourself permission tofeel better.
Visit BetterHelpcom forwardslash.
(00:43):
Asking for a friend to get 10%off your first month of therapy.
That's BetterHelpcom forwardslash asking for a friend.
Health, wellness, fitness andeverything in between.
We're removing the taboo fromwhat really matters in midlife.
(01:05):
I'm your host, Michele Folan,and this is Asking for a Friend.
For many of us in midlife, thereality of aging parents,
shifting roles and our ownmortality starts to feel very
real.
Yet it's still one of the mostavoided conversations, whether
(01:26):
you're supporting aging familymembers, facing big questions
about your own future or simplycurious how to talk about death
without dread.
This episode is honest,empowering and full of heart.
Welcome to the show everyone.
On this week's episode ofAsking for a Friend, I'm joined
by the incredible Julie McFadden, a hospice and palliative care
(01:48):
nurse with over 15 years ofexperience, known to millions
online as Hospice Nurse, Julie.
Julie's mission is clear toreplace fear with understanding,
denial with peace and silencewith meaningful dialogue.
She's the New York Timesbestselling author of Nothing to
Fear and her newest project,the Nothing to Fear Journal,
(02:11):
offers a deeply personal,compassionate guide for
exploring what really matters atthe end of life and how we can
prepare, emotionally andpractically, starting now.
Julie McFadden, welcome toAsking for a Friend.
Julie McFadden (02:25):
Thank you so much for having me.
Michele Folan (02:34):
I'm excited to be here.
So, okay, first of all, beforeI roll into this conversation
because this conversation isvery meaty please share some
personal details about you, likewhere you're from, and anything
you want to share about yourfamily, like where you're from
and anything you want to shareabout your family.
Julie McFadden (02:50):
Okay, so yeah, my name is Julie.
I live in Los Angeles.
Now I've been here for about 13years, but I grew up in
Pennsylvania.
I'm 42.
My sister is also in Californiawith me, so her and I both live
in Los Angeles together.
The rest of my family's back inErie, Pennsylvania.
I'm a nurse.
I've been a nurse for 15, Ithink 16 years now and I'm also
a content creator.
Like you said, I go by HospiceNurse Julie online and an author
(03:13):
.
Now I mean, wow, all thesethings have kind of unfolded in
the past few years and it's beenreally exciting and kind of
mind-blowing that people want tolearn about death and dying and
hospice and palliative care,what that means, so it's been
really cool.
Michele Folan (03:29):
Well, so first of all, congratulations.
You know New York Timesbestseller and with the
popularity that you've gained onsocial media.
So kudos for all of that, thankyou.
That's fantastic.
Julie McFadden (03:44):
Thank you.
Michele Folan (03:55):
But you know, you're in a career that, first
of all, anyone like myself whohas known someone that has gone
through the hospice process, youall are angels, incredible,
incredible people.
So again, just a little pat onthe back there for you, for what
you're doing, and and and notjust for the patients but for
the families, because there'sthat interconnectedness there
(04:15):
that you have with them as well.
Yeah, yeah.
So take us back to thebeginning.
I'm I would love to know whatled you to becoming a nurse and
then, specifically, hospice andpalliative care.
Julie McFadden (04:28):
Yeah, I mean the journey to becoming a nurse to
me is like kind of immature, ifI'm honest.
In my early 20s I was a littlelost.
I had a degree in psychology.
I was working in a hospital assomething called a behavioral
tech, so I was working in like amental health floor where
(04:49):
people were going to get helpbecause of whatever mental
health issues were going onright and I was like running
groups and talking to peopleindividually and just doing
different things that someonewith a undergrad in psychology
would do right.
And one day a woman had aseizure right in front of me and
(05:12):
she fell and cracked her headopen and there was like blood
everywhere and really like itwas so shocking to my system in
the moment when it happened andI ran away, I yelled and I ran
opposite of this.
Michele Folan (05:29):
I didn't help this woman.
Julie McFadden (05:30):
I ran and I went to get the nurses.
So I did get help for her but Idid not help her.
And I remember being so shookup and having this image of all
these nurses running down thehallway to this woman and I
remember thinking it was like inslow motion.
I remember thinking like I wantto be like that, like how come
they can do that?
How did they?
Michele Folan (05:50):
do that, running to danger instead of running
away from it.
Julie McFadden (05:55):
They had to sit me down, other people had to sit
me down in a chair because Iwas about ready to be the second
patient, because I was so shookup by what I saw.
But that made me be like I wantto be that.
I want to know up by what I saw.
But that made me be like I wantto be that, I want to know how
to do those things.
And the woman ended up beingfine.
I saw her the next day.
I went to go visit her the nextday.
She ended up being fine, sothat all was great.
That kind of made me thinkwould I want to be a nurse, like
(06:17):
?
Instead of thinking like, oh, Icould never be a nurse, I
thought I want to learn how tolike run towards that when that
happens.
And then my friend was in anursing program.
So the school we went to had anaccelerated nursing program
where you could get yourbachelor's degree in three
months.
So it was this really intenseaccelerated program and at the
(06:39):
time, because I had already gonethrough school, like four years
of school, I was like I couldnot do another four.
I could not do another fouryears.
No, but this three semesterthing where you bust your butt
for three semesters.
I could maybe do so through abunch of.
It took a really long time andit was actually really hard to
get into the program, but Ieventually did.
And then I got my bachelor'sdegree in nursing and that
(07:01):
started my career out.
Michele Folan (07:03):
But your background in psychology I can
see being super helpful, thoughTotally, in what you're doing
now.
So, even though your careerpath wasn't linear, necessarily,
there was a purpose in all ofthis that you're now discovering
.
Julie McFadden (07:22):
Yes, of course I can look back on my life now
and be like, wow, look how itdoes all seem to flow.
It's like when you're in it itdoesn't feel like that, but
looking back it's easy to seelike, wow, I met this person and
this happened and because ofthat I did this and it feels
really cool.
Michele Folan (07:38):
Yeah, yeah.
And then when did youtransition into hospice?
Julie McFadden (07:42):
I think it took me about eight years of being a
ICU nurse, which do not do that,folks.
It was probably after two yearsof being an ICU nurse, I was
like I hate this.
I hate this.
I hate nursing.
I made the wrong choice.
This is not for me.
I can't do this anymore.
So it was probably like fouryears just strictly in the ICU
(08:05):
and then maybe another fouryears like being a travel ICU
nurse, then being an agencynurse and just trying to like
find my way in nursing, becauseit was like I worked so hard to
get this degree and here I amlike really not enjoying it.
And then finally, through myexperience of being an ICU nurse
, I finally was like you knowwhat?
(08:26):
The thing that's lacking hereis this idea of not discussing
that people will have an end oflife.
And I saw we did many wonderfulthings to keep people alive and
they did survive in the ICU,but there were many patients
where we took way too long tosay something to the family
about.
You know, this is probably theend.
(08:46):
This is, they are not going toget better.
And I just saw that.
You know, it took a while, but Ifinally saw that I could be an
advocate for people like thatand even though the advocacy was
them eventually dying, it feltbetter than trying to keep them
alive, like that, felt like wewere causing more pain and
suffering than anything.
(09:07):
So I thought I remember havingthis thought, like if people are
going to die, we all areeventually from one thing or
another.
You know there has to be abetter way to do this, and
that's what got me thinkingabout hospice, and it basically
just took me a million years totake the plunge and change and
change.
So don't do that If you have itin your heart already.
(09:29):
I probably had it in my heartlike three or four years into my
ICU setting, but then I tookanother four to actually take
the plunge.
Michele Folan (09:38):
Yeah, but some of that is that we just lack some
of that confidence to say, okay,because you're learning, you're
learning something new again,right, and you feel like you're
starting over in a sense.
So, yeah, and then so you dohospice, and then you decide to
take your message online.
(10:00):
Did you ever expect to become,I mean, really a social media
sensation?
I mean, I'm going to call youwhat you are with over.
Julie McFadden (10:11):
I honestly can't even.
It's so hard for me to takethat serious.
But thank you, I'm definitelyjust a normal.
I'm a normal girl over here.
I don't know what I'm doing.
That's the truth, but thank youyes go ahead.
Michele Folan (10:29):
Yeah, but you know many of my listeners
they're 50 plus.
They are navigating agingparents and caregiving.
What advice would you give themas they step into that role?
Julie McFadden (10:46):
Oh my gosh, there's so many avenues to take
there.
There's so many avenues, so one.
I think it's really importantto just talk about how hard it
is, because I think about it aslike new parents, right, when
new parents have babies andthey're like whoa, why didn't
someone tell us like this issuper hard?
Why do I feel like I'mconstantly failing?
Why does it feel like there'snothing out here to help support
(11:08):
me?
How is anyone doing this?
I'm not a parent, but all of myfriends are parents and they all
tell me this.
They all say we have a dualincome, we plan for children, we
did all the things and it stillseems so hard.
Right, how is everyone doingthis?
And I equate that to takingcare of aging loved ones or
(11:33):
someone who's terminally ill orhas a life-limiting disease.
It feels like that becausethat's what I hear from my
families on hospice andpalliative care.
Like no one told me I was goingto be in charge of everything.
No one told me I was going tohave to act like a nurse,
somewhat right, like no one toldme this.
This is so hard.
How does anyone do this?
And, honestly, I don't fullyhave answers to make it less
(11:57):
hard.
I have some tips and tricks,but also, like I like to just
normalize that you're not losingyour mind here.
It's actually that hard andthere are missing links in our
healthcare system and this isone of them.
So I like to just bring a voiceto that so people know that
they're not alone.
Everyone's thinking this You'redoing the best you can, and
(12:18):
that's the thing I want to drivehome is like whatever you're
doing, you're doing the best youcan.
And if you need more help, bethe squeaky wheel right, be the
advocate to the doctors you'reworking with, to the nurses
you're working with, to be likelisten, I need help, I need help
.
What else is there for me andmy loved one or my loved one
(12:39):
needs help.
And the last thing I'll say isto try your best to prepare as
much as you can, which it'sreally hard to prepare.
If you don't know what toprepare for, you're like but how
, what, what do I need toprepare?
I think that's where my videoscome in, my book comes in, the
journal comes in.
I hate to sound salesy, right,it's not about that.
(13:00):
It's about you do need someoneelse who knows how to do it, to
guide you through it.
Hence how the social mediathing developed.
I realized there isn't much outthere to support people.
So, yeah, you got to plan andyou got to know what to plan.
It'll help you.
Michele Folan (13:17):
Hey, Julie, we're going to take a quick break and
when we come back I'm going totalk a little bit about the
sandwich generation and some ofthat preparing that we need to
do.
You listen to the podcast.
You might even see my reels onInstagram.
Perhaps you've even clicked alink or two, but you still
haven't made a move.
You're still waiting for theright time to start.
(13:40):
But here's the truth.
There's no perfect time, butthere is today, and if you're
feeling stuck, low on energy andlike your body isn't responding
the way it used to, you are notalone.
That's why I coach womenthrough Faster Way.
We start with the basicsfueling your body with real food
, building strength and finallylearning how to support your
(14:02):
metabolism instead of fightingit.
No extremes, no restriction,just a support your metabolism
instead of fighting it.
No extremes, no restriction,just a smarter, proven approach
for women over 50.
If you're even a little curious,click the link in the show
notes or shoot me an email.
I'm happy to chat with nopressure, but maybe it's time to
stop watching and start doing.
(14:23):
Let's do this together.
Okay, we are back Before wewent on break.
I wanted to bring this up aboutthe sandwich generation because
so many women my age are takingcare of their aging parents and
(14:45):
they may even still have kidsat home.
And you know we talk aboutbeing prepared and it's like I
don't think anyone ever preparesyou for what this hospice
journey can be like, because itcan last a very, very long time,
(15:05):
right.
Julie McFadden (15:07):
Right, they can be on hospice.
I mean, depending on thedisease, right?
A lot of aging people are onhospice for dementia or
Alzheimer's or Parkinson'sdisease or congestive heart
failure, which is a long-lasting, life-limiting disease, so you
can kind of be on hospice, beoff hospice.
There's definitely a period oftime and this is the hardest
(15:30):
time, I think when you don'treally qualify for hospice but
you need help and there's noteasy answers for that.
This is what I mean by missinglinks in our healthcare system.
This, okay, this Aging peoplewho need extra help they don't
quite qualify for hospice.
Even if they did, hospice doesprovide things, but they still
(15:52):
don't really provide thecustodial care, which is like
the day-to-day care of someone,just to be there, to kind of
like watch them, make surethey're safe, make sure they're
getting the food they need,right?
That's not provided by hospice.
So it's the families that haveto step up, and most people
don't know that and most peoplearen't prepared for that.
Michele Folan (16:12):
Yeah, because it's maybe not a nursing home
type of situation, right?
So a friend of mine has abrother who has had some serious
health issues and he is inhospice now.
He's in his late 50s, I think,but he's in hospice now because
(16:33):
his weight got down to a certainplace where they just made him
eligible for hospice.
Is that state?
Julie McFadden (16:42):
by state.
No, all hospices in the USshould be acting under the same
guidelines because Medicare isthe one that funds hospice.
So, depending on what diseaseyou have, what disease you're
coming onto hospice with, thereare certain criteria for
specific diseases.
Now, every once in a whilethere's like strange outliers.
(17:03):
I'm not sure what disease hehas, but there's like I say
strange because it's like thereare little outliers of well,
they have this specific diseasethat's not technically terminal,
but they might be becausethey're so malnutritioned.
We basically have to prove toMedicare that they will likely
(17:23):
die in six months.
That's the main thing thehospice has to prove to Medicare
to make someone eligible.
So sometimes we'll look atfactors like malnutrition.
We'll look at their albuminlevel.
If it's below a certain numbermalnutrition We'll look at their
albumin level.
If it's below a certain number,that tells Medicare that this
person will likely die withinsix months.
Now will they?
(17:44):
That's who knows right andmaybe they'll be able to stay on
hospice for a year or two yearsif we can continue to tell
Medicare.
Hey look, they are stillshowing signs that this might
happen and some hospices arebetter at following guidelines
than others.
So there are some more lenienthospices that will take people
(18:05):
on, even though they may nottechnically meet criteria.
So it just depends.
Michele Folan (18:08):
Okay, so we're looking at organ function
basically, so like kidney, liver, that kind of thing, then in
determining how much longersomebody may live.
Julie McFadden (18:22):
No.
So the way I would look at itis like there's and again this
is general, but generallyspeaking there's two types of
patients.
There's patients withmetastatic cancer, meaning
cancer, like a cancer diagnosis.
They are a little more quoteunquote easier to get onto
hospice because it's a littlemore obvious.
We know this type of cancer, weknow where they are in the
(18:44):
progression of this cancer.
We're used to seeing it.
There's weight loss, there'sfunctional loss, there's pain,
there's shortness of breath, allthese different things that
we're looking at.
So it's a little more obvious.
Then there's the other type ofpatient that has life-limiting
chronic illnesses like COPD,which is a lung disease, chf,
(19:06):
heart disease, a stroke, withdifferent symptoms, and they've
been living with these symptomsfor a long time and now they're
not doing well.
Dementia, alzheimer's Dementiaand Alzheimer's are really
actually difficult.
It's difficult for people toget onto hospice because you can
live a long time with thosediseases Parkinson's, ALS,
things like that.
Those people with thosediseases.
(19:28):
We have specific criteria and Iwon't go through every single
one because it's just it's likemind-numbing.
That's like a mind-numbingthing for a hospice nurse, right
, you have to like know allthese things to know if they
meet the technical criteria tobe on hospice and that criteria
is supposed to gauge how closethis person truly is to death.
(19:51):
Because it's really hard toknow with those diseases,
because they ebb and flow somuch.
Does that make sense?
Michele Folan (19:57):
Yeah, so are you partnering with the doctor to
make that full assessment ofthat patient Correct?
Julie McFadden (20:04):
Yes, we're always partnering with the
doctor and all of us who work inthis field.
If you work long enough, youkind of know the criteria like
the back of your hand.
They give you booklets in thebeginning so you can kind of
learn.
But you and the doctor know thespecific criteria.
And of course there's timeswhen I see someone who's 98,
(20:25):
right, and they technicallydon't have a terminal diagnosis.
But here they are, they're noteating, they're not waking up,
they look very, very close todeath and I have to work with
the doctor and work with thefamily to kind of get a
diagnosis on our own so they canmeet criteria for hospice.
Because clearly they're 98,they're not eating, they're
(20:47):
barely drinking, they've beensleeping 24 hours a day for
three days straight.
We can put them on hospice.
But technically, per Medicareguidelines, we have to have some
kind of diagnosis that showsthis Right.
So there's a gray areacertainly.
Michele Folan (21:04):
Julie, I've always kind of wondered about
this, because when my mom wasill she went downhill pretty
quickly and we knew she was in ahospice situation, but we had
to leave her in the hospital.
She was too frail to be moved.
We had to leave her in thehospital.
She was too frail to be moved.
So we did hospice in thehospital.
No one, including me, ever saidMom, we are moving you to
(21:28):
hospice.
I didn't have the heart to havethat conversation with her and
that has haunted me since shepassed away.
And I'm wondering how much dowe tell our loved one when it
comes to that time?
Julie McFadden (21:45):
I think if they're alert and oriented, like
fully alert and oriented.
We be honest, as honest.
That's what I think you knowand we're not used to doing that
.
We're not used to.
We never learned how to do that.
I have had, like.
One of my best friends reallysays that his mom would do
(22:05):
better not knowing, and I'd haveto believe them.
So if a family member does tellme that, like I am telling you,
I know my mom or I know my dad,and they will not, they don't
have it in them to know thesethings right, it makes it a
little difficult because we haveto have them sign paperwork,
like saying they're going on tohospice.
So there's a little bit likewell, how are we supposed to do
(22:25):
this?
So I usually try to talk tolike the way I usually do it is
say like what do you think isgoing on here?
Like, how do you feel?
How do you feel about your body?
What do you think is going on?
And usually nine times out of10, the person will say I'm
dying.
So I do think people know theymay just not be saying it, but
(22:47):
generally speaking I also try togo with what the family says.
The family knows their loved onethe best, but I would say we do
need to work on just being ableto talk about it a little more,
and that's the whole reason whyI'm here.
I'm doing these things.
It's not your fault, I mean, Iget it.
Many people don't know how tobring it up or say it, or will
(23:07):
it make it better or will itmake it worse?
And it's a little easier for mebecause I'm the hospice nurse.
That's what I'm supposed to do.
When you're the daughter, itfeels harder and no one taught
you how to do it and I don'tknow, was your mom alert and
oriented, or did she?
Oh yeah.
Michele Folan (23:26):
She was alert and I think she knew it was
happening.
But I still feel like I owedthat to her, to have that
conversation with her, andthat's what's bothered me.
Yeah, cause she, she was veryalert and that was the hard part
.
It was her lungs that weregiving out on her, and so it's.
It was just one of those thingswhere, yeah, you always wonder
(23:48):
like what, what should I havesaid?
Julie McFadden (23:50):
I do want to reassure you not, and I really
mean this.
I mean I feel like you did thebest you could at the time.
I mean it's easy to look backit's always for anyone it's easy
to look back and say, oh, Ishould have done that, but at
the time you did the best youcould with who you were at that
time and yeah.
Michele Folan (24:11):
Okay, I feel a little better now.
Your book Nothing to Fear was ahuge success.
What inspired you then tofollow up with your fear journal
, Because you have that comingout here very soon.
Julie McFadden (24:26):
Yes, so the book to me was absolutely insane
because I just never knew Iwould write a book.
So to write a book and thenhave it be so well received was
amazing.
And the journal came about onebecause I'm a journaler, so I
love journaling.
I've journaled ever since I'vebeen a little girl.
(24:47):
I talk about it on my channel.
It's really, really helped methroughout my life.
So when my publishing companysaid, hey, we're thinking about
doing a sister book to your bookas a journal, I'm more excited
about that than the book,because I just love, I just
think journaling can be sohelpful and I think you could
read my book and it's definitelyvery helpful.
(25:10):
But it also could be like okay,now that I know all these things
, where do I start?
How do I start?
What do I do?
What questions do I ask?
Where can I put all of thesethings that I need to keep in
order?
And that's what the journal isfor.
So it's broken up into sectionswhere the first part's a little
bit about getting youcomfortable with exploring death
(25:31):
, exploring your own death,exploring immortality in general
, kind of like all theexistential stuff that can come
along with it, and then, as itgoes along, it gets into more of
the practical things where Ilove that.
I'm a girl who, if I feel outof control which a lot of people
do when someone's ill or whenyou yourself are ill I want to
(25:54):
know what can Like practicalthings.
So I feel in control and thatis what the back of the journal
is for.
The back of the journal is likethe practical things like start
here, do this, here's how youdo it, who do you call?
Like things like that.
So that to me is like chef'skiss, cause I know that's what I
(26:16):
want.
Michele Folan (26:17):
So and I think a lot of people like that as well-
yeah, and because we talkedabout the plan right and so many
of us know this time is comingSome don't, but many do so I see
where there would be a realbenefit in kind of getting the
house in order in terms of yourhead, your thoughts.
(26:39):
And then also there's the otherstuff.
The stuff that we hate havingto deal with is just all the
practical household things thatcan be so daunting.
Julie McFadden (26:54):
Yes, and you don't know what you don't know.
You know what I mean.
You forget, oh, I don't havethe password to the bank
statement, so I don't know whothe beneficiary is.
I don't know what you know.
So it's things, it's all thelittle things like that that I
know, cause I'm around it allthe time and I know what people
need to get an order.
That, um, it kind of helps youjust cue into things.
(27:16):
You need to check off the boxbefore it all goes down.
Now, if it's already gone down,it'll still help you because
you'll know what to do, like howto get things in order, who to
contact, what kind of lawyer doyou need?
If you do need a lawyer, how toget in touch with the mortuary,
things like that.
Michele Folan (27:36):
You know, and then this brings up you did
touch on it just a little bitbut there is this moment where
we're going to have to confrontour own mortality, right?
Yes, and maybe the mortality ofa spouse?
Yes, and some of my friendshave already been through that.
(27:56):
Yeah, how do you hope thejournal will support that
reflection?
Julie McFadden (28:01):
I would say that's the beginning part of the
journal, the whole existentialthings.
I feel like it sounds to meit's even hearing me say what
I'm about to say sounds cheesy,but I mean it with my whole
heart and I can't believe thatI'm this person now.
But my job and my work has kindof changed me.
I know for my own life thatcontemplating my own mortality
(28:25):
or my loved one's mortality, asmorbid as that sounds, has truly
helped me live in today andappreciate today.
That is one of my greatestgifts that I've gotten from
working in this field, thegreatest gifts.
And that's what the beginningof the journal is all about.
I'm trying to get people to alsobe able to tap into the things
(28:46):
that I feel like I have tappedinto because I can and I
practice.
It's literally a practice of mereally trying to understand
that, like this isn't alwaysgoing to be, my health is not
always going to be, my sisterwill not always be here and I
know even when I say it itsounds like oh God, thinking
about that, but there'ssomething about it that helps me
(29:08):
see it in a light of like.
But that's not today.
I am here today, my sister ishere today I can walk on these
legs today, I can drink thiscoffee and feel the sunlight
today, and I'm getting chillsjust thinking about it because
it brings me so much peace andjoy and brings me to the moment
of now.
To the moment of now.
(29:29):
That's the greatest gift I canhave.
So that's what I hope thejournal brings to people.
I hope that's what is kind ofportrayed in that first part of
the journal to get people there,because it's been one of my
greatest gifts.
Michele Folan (29:41):
That's the gratitude piece that we're
always told in the morning weshould be finding something to
be grateful for, and you're justgiving people a platform to
actually put it down on paper,which I think is really nice,
yeah.
Julie McFadden (29:59):
Yeah.
Michele Folan (30:00):
Before we started recording I asked you if we
could talk about this a littlebit, because I know there are
life after death type of momentsthat you have with these
patients as they transition andpass through.
That's the best way I can putit.
Can you tell me some storiesthat you've experienced with
(30:23):
patients and how that hasaffected your belief in life
after death?
Julie McFadden (30:30):
Yeah, so just to generally, I'll generally talk
about it and then I'll give acouple stories.
So my chapter six in my book isall about deathbed phenomena,
which is the longest chapter,because it happens so much in
this end of life realm whichreally surprised me as a
critical thinker, icu nurse.
(30:52):
It was like a huge shift for meand the only reason why I kind
of came around to the fact thatit happens is because I kept
seeing it all the time.
So it's like undeniable, youcan't really deny it, because it
just happens all the time.
We don't know why it happens,but it does.
And so deathbed visions happenwith almost everybody and it
doesn't happen right before theydie, it happens a few weeks
(31:12):
before they die, where theystart seeing dead relatives,
dead loved ones, old pets thathave died.
And the story that always sticksout to me for this is a family
called me in because their lovedone was confused.
A loved one who was on hospicewas confused.
They were saying some crazythings.
We need to come over andmedicate them.
(31:32):
And I come over and thepatient's like seems totally
fine in bed, totally alert andoriented, and I'm like a little
confused and they're like well,he's not doing it now, but he
was really confused earlier andI was like, okay, well, how do
you feel now?
Right, and he was like I feelfine and I'm asking dates and
making sure he was oriented andhe seemed great.
So they left for a second, thefamily left and the patient
(31:56):
grabbed my arm and goes listen,I'm seeing my parents.
I'm seeing my parents, they'recoming to me and they told me
that they're not coming yet, butthey're coming soon and, not to
be afraid, they'll take care ofme.
And that's why they think I'mcrazy.
But I'm not crazy.
I don't know why it's happening, but it is.
And I'm like I know and honestly, by this time I have seen it so
(32:20):
much that it actually wasn'teven surprising to me I just
sort of laughed and I was like Iknow, listen, you're not crazy,
this is something that happensat the end of life.
We don't know why it happens,we don't know why it's called
deathbed visioning.
It happens across all cultures,all faiths around the world.
We don't know why, but it does.
And as long as it's not scaringyou and as long as you're okay,
it's okay.
(32:40):
And he was like well, can youtell my family that?
Right, because he's whispering,he's afraid, he's afraid to say
can you tell my family that,because they think I'm crazy,
they're trying to knock me out?
I'm like I'll talk to him, it'sokay, right?
So then I go and then, ofcourse, I leave there and the
family grabs me whispering.
Listen, he's saying he's seeinghis parents, he's hallucinating
(33:02):
.
Something's really wrong, youknow, and I'm like you guys,
well, and I kind of just giggleand I'm like it's okay, this is
something called death bedvisioning.
It's very normal, it happens in, like most of our patients.
A lot of our patients don'teven talk about it, hence why we
don't know that it's evenhappening, but as long as he is
comfortable, it is okay.
Now, if he starts screaming andyelling and is agitated and is
(33:23):
going to hurt himself orsomething, yes, that is a time
we may want to medicate somebody, which I never actually I would
never consider bad visions.
Visioning Visions are abeautiful, comforting thing and
they look very different thansomething like delirium or
confusion or agitation.
(33:43):
They look very different.
The person is usually like thisman is very calm, very
collected, very alert andoriented and knows who they saw
and what they saw.
And I mean I literally havecountless stories like that
People who have seen Jesus,people who have seen other
deities, like it depends on whatyou believe in, right?
So like, if you're a Christian,like people can see Jesus but
(34:06):
they will see other deities.
If they're not Christian,they'll see what is true to them
, right?
People seeing different typesof angels, people reaching up
and smiling and saying hi, mom,you know you can just, and it's
wild to see.
It never really gets old, but Ido see it.
I do see it often, often andnow that I educate about it with
(34:31):
my families, because I thinkit's really important we don't
run into this mess of like youneed to get over here and
medicate my loved one becausethey're going nuts.
I try to educate, and when Ieducate, that's when people
start already telling me stories.
Oh, they're already doing that.
They've already been talking toour next door neighbor who died
a couple of years ago.
So it's fascinating.
So it's fascinating, it'scomforting to me.
Whether it's real or not real,it's still comforting to me.
Michele Folan (34:54):
Yeah, because it's comforting to them.
Does it comfort you when youthink about dying yourself?
Julie McFadden (35:01):
Yes, yes, I mean .
There's so many things thatcomfort me about dying, Like
even just the biological aspectof dying and how our bodies are
built to do it and know how todo it, and takes care of us at
the end of life, and our bodiesare biologically built to
systematically shut down andhelp us be not hungry and
thirsty and help us sleep more.
(35:22):
That's comforting to me too.
These things that areunexplainable are comforting,
but the things that areexplainable, like the biology of
death, is also comforting to me.
Michele Folan (35:33):
Can you talk about that a little bit, the
biology of death?
So you know, we all know whensomeone has gotten very
compromised and they always say,oh yeah, you know he's shutting
down, what does that reallymean, though?
Julie McFadden (35:47):
It usually means the organs, like you said, that
are kind of systematicallyshutting down.
So there's probably multipleorgans shutting down.
I do believe if someone isbecause I've seen it in the ICU
and it's not bad, it's justdifferent If someone has been
kept alive in the ICU for manymonths, their shutting down will
(36:09):
look a little different thansomeone who's on hospice and who
has been naturally kind ofshutting down over weeks at a
time, just because they havealready been kind of pumped full
of fluid and then diuresed andthen on this machine and that
machine.
So it's still very peacefulbecause we have medications to
make it peaceful.
But I don't think it doesn'tgive the body enough time to
(36:31):
truly shut down.
Whereas in hospice what I sawover and over and over again
when the body has time to reallysystematically go through it,
it helps you shut down thehunger and thirst mechanism that
purposely makes the persondehydrated because they actually
feel better.
The more dehydrated they are,and dehydrated because they
(36:54):
actually feel better, the moredehydrated they are, it kicks in
, usually higher levels ofcalcium, so you sleep all the
time and it's a slower, morenatural process that really
creates for a peaceful death.
But when someone says they'reshutting down.
That's what they mean.
All of the organs in the bodyare systematically shutting down
.
Michele Folan (37:11):
Okay, that little burst of life that people get
at the end.
And I'll give you a specificexample.
My father-in-law was in memorycare and we had seen him earlier
that evening and he sometimearound maybe midnight, maybe 11
(37:33):
o'clock, he got in hiswheelchair and kind of scooted
down to the nurse's desk and wasflirting, probably, with the
nurses, saying hello andchatting with them, and then he
went back to his room and atabout 2 am we got a phone call
saying that he had passed.
What the heck.
Julie McFadden (37:52):
I know.
Michele Folan (37:53):
Yeah.
Julie McFadden (37:53):
Right, yeah, so that is called terminal lucidity
and it happens in one third ofall people dying.
So one in three people willexperience something like that,
and we don't know why it happensAnother mystery, we don't know.
There's always theories.
People always say, oh, it's DMTbeing released, it's a bunch of
(38:15):
hormones being released.
All of that is fun to thinkabout, but we don't really know.
It's never been actuallystudied.
We just know.
Again, we just know whathappens.
And the thing that makes it verydistinct is that and I don't
know if you're I think you saidit was your father-in-law yeah,
I don't know if he was lookingill or was ill, but usually
(38:35):
someone is like ill and lookinglike they're going to die soon
and then suddenly, boom, theyhave this moment maybe a day,
maybe two days at max, wherethey look like they're doing
things they haven't done in solong Getting in a wheelchair,
going down, flirting with peopleasking for a cheeseburger.
My grandma, a few days beforeshe died, woke up, got out of
(38:59):
bed she hadn't walked in dayshad Thanksgiving dinner, you
know, complained to my mom thatthe food was too hot, which is
like her personality you knowlike this is the hotter and then
was like boop got back into bedand died a couple of days later
.
So it's the distinction was likeboop got back into bed and died
a couple days later.
So the distinction is likesomeone's very ill boom, this
like distinct burst of energy,and then they die shortly after.
(39:20):
So that's the distinction isthat they have to die shortly
after.
If they don't die shortly after, it's not terminal lucidity,
it's just them.
You know their disease, waxingand waiting.
But if they die shortly afterthat burst, that was terminal
lucidity, all right.
Michele Folan (39:37):
Yeah, because, yeah, I mean he had lost a lot
of weight.
You know, because when theyhave dementia, food isn't as
interesting to them and you knowwhatever.
But yeah, that was my example,that I was like I got to ask her
about this one because I knowI've talked to so many people
that have had that sameexperience as well.
(39:59):
Yeah, yeah.
Julie McFadden (40:01):
Okay, and it sounds to you a little bit like
he may have he sort of just saidmaybe his body just said I'm
done, this is enough, I'm done,this is enough.
Whenever someone dies, wheneverit's not really that slow
progression, they just sort ofdo it.
(40:22):
I'm like I feel now this isjust my opinion, there's no
scientific reasoning for this,but it just feels like their
body declares itself and justsays I'm done.
Michele Folan (40:27):
Yeah, that is perplexing, but so interesting,
right, how our body just knows.
Does that come from the brain?
Does the brain direct trafficthere that tells the organs that
it's time?
That's a great question.
Julie McFadden (40:47):
I mean, I think they're finding that all the
organs are kind of talking toeach other the spinal cord
because the spinal cord too is abig part of of working our body
and our gut talks to our brain,our brain talks to our gut.
So you know, uh, because I'vebeen a nurse for so long, I I
(41:07):
feel comfortable going.
I don't know.
I think probably.
Yes, there's definitely some ofthat, but I think there's more.
There's still mystery to like,what's running the show?
Is it the brain?
Is it the gut?
Is it all together?
The brain does a lot of things.
That's why, if you have diseaseto the brain, it can be hard
(41:27):
for the rest of the body.
Michele Folan (41:28):
But I don't know.
Okay, one other question.
I had this just popped in myhead.
Yeah, how do we make thedecision whether to do in-home
hospice or to do hospice in afacility?
Julie McFadden (41:42):
Oh, great question.
I would say only do in-homehospice if you are able to be
there you or someone, or you paysomeone else to be there most
of the time.
So at first, when you sign upfor hospice, your loved one who
is on hospice may not need24-hour care, right.
They may be able to havesomeone just pop in at night or
(42:05):
pop in in the morning orwhatever, right, but eventually
that person's going to need24-hour care and hospice will
not provide that.
So if you or your family canwork a system where you guys can
be there and your loved onewants to be home, then do that.
Or if you have the money to payfor a caregiver who can be
(42:26):
there, then do that.
But if you don't, I wouldrecommend a hospice, either in a
hospice home, if your city hasthat, or like a skilled nursing
facility, and then hospice willgo there.
Michele Folan (42:39):
Got it Okay, yeah .
Yeah, I wasn't sure how thatactually worked, but that's the
family's, up to the family andtheir decision how they do that.
Okay, what are some of thesmall mindset shifts you think
that we need to make today, orshould make today, to embrace
aging and the naturaltransitions of life?
(43:01):
Because when you, when it comesto losing a parent or maybe a
spouse, that accepting piece isjust not there.
Julie McFadden (43:15):
Not there.
Michele Folan (43:16):
It's got to be a horrible, dire situation for you
to say, okay, yeah, I'm okaywith this, right, yeah?
Julie McFadden (43:23):
I think there's not a quick and easy answer for
that.
I think there is.
It takes time, it's gray, it'snot black and white in the sense
of like I can't give you like a, do this and do this and then
you'll equal this.
I think it's like learning tolive in the uncomfortability of
like not knowing and feelinggrief, before someone even dies,
(43:47):
just knowing, like your friendwho's in his late 50s, I think
you said like his loved ones aregrieving now.
I mean they'll grieve later too, but like there's grief and
like this idea that, like I'mnot living this life that I
thought I was going to be living, like this isn't what I planned
for here.
So I think the first thing Iwould say is if you can talk
(44:11):
about it, and talk about ithonestly, don't give some frilly
thing of like well, I acceptthat it's like no, I mean the
people that I see that die well,live well and die well.
Are my patients who are willingto be like this.
Can I swear?
Are we swearing?
Yeah, oh, yeah, no, yeah.
Patients who are completely tobe like this Can I swear?
Are we swearing?
Michele Folan (44:30):
Yeah, yeah, no yeah.
Julie McFadden (44:31):
Patients who are completely like this fucking
sucks, I'm so angry, I'm soangry this shouldn't be
happening.
I'm scared, like all of thestuff.
Just say honest things andthere is something about that
that I have found that kind ofhelps release that grief, that
sadness, that anger, even forthat moment.
(44:52):
Right, and then you connectwith the person you're talking
with.
So, if you're the person sayingit, say the truth, the truth as
you understand it in thatmoment.
If you're the person listening,let them say their truth.
Right, don't go no, no, no,don't say that You're going to
be fine.
You don't need to make anyonefeel better.
(45:13):
It's about trying to connecthonestly.
If there's a thing, there's aprayer that I say every day,
that really helps me, and ifyou're not like into prayer, you
can call it something else.
Whatever you want to call it,but it's God or whatever you
call God.
Help me set aside everything Ithink I know about blank,
whatever that is, for an openmind and new experience.
(45:35):
Please, let me see the truth,and I love that because it just
helps me kind of release it alittle bit and hopefully see the
truth of it all.
And sometimes the truth is thisis wildly uncomfortable and
period.
Yeah, you know.
Michele Folan (45:53):
You know, I knew this was going to be a really
heavy topic, but again we got toface this stuff head on.
We can't sugarcoat it, it'slife.
Can't sugarcoat it, it's life.
(46:15):
And if this podcast can helpone person kind of navigate this
very, very difficult and sadsituation, I am happy, right, I
mean, that's one of those things.
So, on a little brighter, moremaybe personal note what is one
of your self-carenon-negotiables, the thing that
grounds you, no matter what?
Julie McFadden (46:34):
Well, I am sober , so I'm sober and I'm in a
12-step recovery program andnon-negotiables for me are
things I do in that recoveryprogram to keep me grounded and
keep me sober physically andemotionally.
Fantastic, and that's likenon-negotiable.
Michele Folan (46:52):
How long have you been sober to keep me grounded
and keep me sober physically andemotionally.
Fantastic, and that's likenon-negotiable.
How long have you been sober?
Nine years, congratulations.
Yeah, thank you.
We talk about alcohol all thetime on this podcast.
It comes up oh my gosh will we?
Julie McFadden (47:03):
I'll come back.
I'll come back, girl, because Ican.
That's a whole other book Iwant to write about the disease
of alcoholism and what it meansto me.
And I mean, my recovery hascompletely changed my life and
it's changed everything about mylife, including how I work, and
I think, yeah, it's beenamazing.
So that's the non-negotiable.
I do it every day.
(47:23):
I do something to maintain mysobriety, and not just my
physical sobriety, but myemotional sobriety, so I can be
free in the day that I'm in.
Michele Folan (47:34):
Yeah, do you still go to meetings?
Yeah, okay, yeah, fantastic,yeah, yeah, you know it comes up
all the time because this is ahealth and wellness podcast and
we've all heard the data.
And I know my my listeners arerolling their eyes because
they're like God.
She is talking about alcoholagain, but I am sorry.
(47:57):
Yeah, so I I still haveoccasional cocktails, so it, but
but I don't drink every night.
I don't like polish off abottle of wine.
I did during COVID, all thatstuff.
So that is in the rear viewmirror, that life, and I am so,
so grateful.
But what made you decide to getsober?
Julie McFadden (48:19):
Oh my gosh, I mean so many things.
I always knew I had something alittle bit of an issue with
alcohol.
Mine to me was a littleconfusing because I was quote
unquote like high functioning.
You know, I think a lot ofpeople misunderstand what
alcoholism is.
You know, I still had a job, Istill maintained friendships, I
never got DUIs, I never went tojail, like nothing like that.
(48:40):
My bottom with alcohol was anemotional bottom where I would
just thought I was getting inthe way of what I wanted to do
with my life.
It just felt like I was toohungover to do stuff.
And then I would say I'm notgoing to drink tonight because I
was too hungover this morningand I got to do stuff tonight.
I got to get out there andwhatever.
The stuff is right.
But then by the end of the dayI'd be like, nah, it's fine, and
(49:04):
I'd just open a bottle.
And then next thing, you know,I'm drinking a bottle of wine,
maybe a bottle and a half,depending on if I'm still awake,
and the cycle was all overagain.
Right, and I didn't do thatevery day, but I did start doing
it most days.
And what was really eye-openingto me was I eventually only to
spare.
This is still going to be long,but I'll try to make it shorter
(49:24):
, you know, to spare the lengthof the story.
I eventually stopped drinking onmy own.
I didn't call myself analcoholic because I didn't think
I was, but that's when I reallystarted seeing that I was an
alcoholic, because if you wantto know if you're an alcoholic,
try quit, quite, try stopstopping alcohol.
Right, and I could do it.
I did it.
I did not drink and I didn'tdrink for 11 months, which is a
(49:46):
long time, almost a year.
That is a long time, yeah, foralmost a year.
And my life, my internal lifeand my external life got worse
and worse and worse.
I didn't do the things Ithought I would do, I didn't
meet the friends I thought Iwould meet, my life got smaller,
my anxiety got higher, my innerworld was insane and I got much
more lost and confused insobriety.
(50:10):
And that really got me to mybottom because I thought, wow, I
did the thing.
I thought I, I did the thing, Istopped the thing and I thought
I was going to like fly, and Ididn't fly.
Yeah, I like sank, sank, sank,sank, sank.
And, through differentcircumstances, I ended up
meeting a friend who took me toa meeting and that just started
(50:30):
me on this journey of learningabout alcoholism and getting
help for what I would callalcoholism.
And yeah, it just helped me somuch when I got into a recovery
program and it helped me soquickly that I was kind of like
sold.
I was like this is kind of allI wanted.
I wanted to learn how to livesober and that's what it taught
(50:52):
me.
Michele Folan (50:53):
That's awesome and you hit.
It's that community, it's thatconnectedness.
Yeah, exactly I'm not alone,there are other people just like
me.
I mean, that's beautiful I loveit.
Julie McFadden (51:04):
Yeah, yeah, thanks for sharing that.
Michele Folan (51:06):
We didn't know we were going to go down that road
.
Yeah it.
Julie McFadden (51:08):
Thanks for sharing that we didn't know we
were going to go down that road.
Yeah, it's my greatest gift.
It's my greatest gift of mylife.
It's your superpower.
Yeah.
Michele Folan (51:14):
Yeah, yeah, and to be able to share that with
other people, to share yourjourney with other people, is a
gift, I think.
Julie McFadden (51:24):
Thank, you, thank you.
I'm passionate about that too.
Two things I'm passionate aboutsobriety and death.
That sounds so crazy, but Icould talk about those things
forever.
Michele Folan (51:35):
Oh, she's a wild one.
Julie McFadden (51:38):
Yeah right, everyone's like yikes.
Michele Folan (51:41):
Oh, julie's coming tonight.
Oh, geez Great.
Oh, that's so funny.
All right, Julie McFadden,where can the listeners find you
, your work?
You have a YouTube channel aswell.
Julie McFadden (51:56):
Yes, Thank you for bringing that up, because I
feel like, because TikTok iswhere I got started and that's
where I have my most followers.
I always talk about that, butreally my love is my YouTube
channel.
I love my YouTube channel.
I go live every Thursday there,so like we have a.
I'm all about community, as youknow, so we have a community
there.
All the same people show up.
(52:17):
It's just so beautiful.
So I have a YouTube channel.
All my channels are same nameHospice Nurse Julie.
So wherever you get your likesocial media, you can find me on
Facebook, instagram, tiktok,youtube same name Hospice Nurse
Julie.
And if you're interested ineither my book or my workbook,
it's called Nothing to Fear andyou can get it really anywhere
(52:38):
you get books.
I think the easiest place tolook is on my website,
hospicenursejuliecom, but itdoesn't help me more.
If you order it there orwherever you get, it will help
me, but that's just an easyplace to start
HospiceNurseJuliecom.
Michele Folan (52:54):
Okay, and and the Nothing to Fear journal comes
out in June, in June.
Julie McFadden (52:58):
Yes, okay, yes, I think mid June.
I should know the exact date,but I think it's somewhere
around mid June, perfect.
Michele Folan (53:04):
Wonderful Julie McFadden, or Hospice Nurse Julie
, thank you for being here today.
Julie McFadden (53:12):
Thank you so much for having me.
Michele Folan (53:13):
You've been great .
Hey, thanks for tuning in.
Please rate and review the showwhere you listen to the podcast
.
And did you know that Askingfor a Friend is available now to
listen on YouTube?
You can subscribe to thepodcast there as well.
Your support is appreciated andit helps others find the show.
Thank you.
Popular Podcasts
Fudd Around And Find Out
UConn basketball star Azzi Fudd brings her championship swag to iHeart Women’s Sports with Fudd Around and Find Out, a weekly podcast that takes fans along for the ride as Azzi spends her final year of college trying to reclaim the National Championship and prepare to be a first round WNBA draft pick. Ever wonder what it’s like to be a world-class athlete in the public spotlight while still managing schoolwork, friendships and family time? It’s time to Fudd Around and Find Out!
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.