Working in end-of-life care often brings moments of deep sorrow, but sometimes, it reveals something quietly extraordinary. Hospice nurse and death care coach Katie Duncan has witnessed one such mystery over and over again: a gesture made by many patients just before they die—a motion both inexplicable and oddly comforting.

Katie, a nurse practitioner from Maryland, has spent years supporting people through their final days, whether in hospital ICUs, long-term care homes, or at bedside in hospice. In a recent TikTok video, she opened up about what she calls one of the “mystical” parts of dying: the reaching.

According to Katie, it’s a gesture she’s seen many times—patients extending their arms or hands upward, as if trying to grasp something invisible in the space above them. “You’ll literally see someone reach up,” she said. “It’s like they’re trying to hold someone’s hand, or touch something in the air.”

She explained that this is sometimes accompanied by end-of-life visions—people talking to loved ones who have already passed, describing bright lights, pets, even angelic figures. “They might say, ‘Mom is here,’ or smile at a corner of the room no one else is looking at. Other times, they say nothing, but their body moves in that direction—upward.”

Though there’s no medical explanation for these occurrences, they’re well known in hospice circles. And far from being alarming, Katie emphasized that these experiences usually bring comfort. “They don’t look scared,” she said. “They look at peace. These visions, whatever they are, seem to help.”

She called it one of the great privileges of working in end-of-life care—witnessing this final, mysterious moment of transition. “We don’t fully understand it,” Katie said, “but it’s beautiful. It humbles you.”

Her video resonated with thousands, sparking a flood of emotional responses from viewers who had seen the same thing in their loved ones’ final moments.

“My mom reached up and smiled,” one user wrote. “She hadn’t moved for hours before that.”

“My grandpa kept saying, ‘I see them! They’re waiting,’” shared another. “He looked so happy.”

One person commented simply, “It’s heaven they’re reaching for.”

Another added, “I didn’t say a word. I just held his hand and watched. It felt sacred.”

For many families, these upward-reaching gestures become quiet, unspoken reassurances—that their loved one is not alone, that something, or someone, is waiting. In a time so often marked by fear and grief, these moments offer a sliver of peace, a final exhale that says: it’s okay now.

And for Katie Duncan and others in hospice care, it’s a reminder of why their work matters—not just in keeping people comfortable, but in honoring the mystery of what it means to say goodbye.