Working in end-of-life care brings a mix of overwhelming sorrow and unexpected beauty. While watching someone take their final breaths is undeniably emotional, it can also be an experience filled with wonder, especially when moments arise that defy explanation. One hospice nurse, Katie Duncan from Maryland, has shared an observation she’s witnessed repeatedly throughout her years of caring for the dying—a quiet, mysterious gesture many people make just before passing away that has left a deep impact on her and countless others.
Katie, a nurse practitioner and “death care coach,” has worked in hospitals, hospices, and long-term care facilities, supporting individuals and their families through life’s final chapter. Through this work, she began noticing a pattern: in their last moments, many patients reach their arms or hands upward, as if trying to grasp something—or someone—just beyond view. In a recent TikTok video, Katie described this phenomenon as one of the more “mystical” parts of the dying process. “It’s very common,” she shared. “You’ll see someone who hasn’t moved in days suddenly reach up, almost like they’re trying to hold a hand or touch something invisible in the air.”
This upward reaching is sometimes paired with what medical professionals call end-of-life visions—patients seeing loved ones who have passed, beloved pets, angels, or brilliant lights. Some speak aloud and describe what they’re seeing, while others stay silent, simply stretching their arms with a peaceful look on their face. There is no medical or scientific explanation for why this happens, but for those in palliative care, it’s widely acknowledged as a serene part of the process. According to Katie, these moments rarely involve fear or distress. On the contrary, patients often appear calmed, even joyful, as if the presence they’re sensing is reassuring them. “It’s something we can’t fully explain,” she said, “but as caregivers, it feels like a gift to witness.
It’s humbling to be there for someone’s final moments and see them comforted by something we can’t see.” The video quickly resonated online, drawing heartfelt responses from viewers who had watched the same thing unfold with their own loved ones. One person wrote, “My dad reached up with both hands, and he hadn’t been able to move them for days. He looked so peaceful, like someone was taking him home.” Another commenter said, “My grandmother raised her arm, smiled, and whispered my mom’s name—who had passed a decade earlier. It was like she saw her.” Others described the moment as sacred, saying they didn’t want to interfere. “It felt like heaven was in the room,” one wrote. “I didn’t want to disturb him—it was beautiful.”
For grieving families, these gestures often bring unexpected peace. In the pain of loss, it can be reassuring to believe that a loved one is not leaving alone, but is instead being guided, perhaps even welcomed, by something far greater than we can comprehend. It shifts the narrative of death from one of isolation to one of connection—something spiritual, even divine. Katie emphasized that while not everyone may witness such a moment, those who do are often changed by it. “When someone reaches up, it’s not just a reflex,” she explained. “It feels intentional, like they’re responding to a presence we can’t understand. It reminds us that death isn’t just a clinical event—it’s a deeply personal, spiritual journey.” These final gestures, simple yet profound, continue to touch caregivers and families alike. They serve as subtle reminders that while the body may be fading, something else—something beyond explanation—might be waiting. Whether it’s a reunion with loved ones, a passage into peace, or simply a sign that the journey doesn’t end here, these upward-reaching hands offer hope and a sense of wonder in the face of the unknown.
