Working in end-of-life care can be filled with moments of profound sadness, but also ones of quiet wonder. One hospice nurse has shared an experience she’s witnessed time and again in her work with the dying: a simple yet mysterious gesture many patients make just before they pass.

Katie Duncan, a nurse practitioner and “death care coach” from Maryland, has spent years helping people find peace and dignity at the end of their lives. With experience across intensive care units, home hospices, and long-term care settings, she’s observed a pattern she finds both inexplicable and deeply moving.

In a recent TikTok video, Katie described what she calls one of the “mystical” parts of the dying process: many patients begin reaching upwards, as if trying to grasp something unseen above them.

“In my experience, it’s very common,” she said in the video. “You’ll literally see someone reach up, like they’re trying to hold someone’s hand or touch something in the air.”

Sometimes, this gesture is accompanied by what are known as end-of-life visions. “People often say they’re seeing someone, a loved one, a pet, even an angel or a bright light,” Katie explained. “Other times, they don’t speak at all, but still reach up, as if sensing a presence.”

While there’s no scientific explanation for this phenomenon, many in palliative care consider it a peaceful part of the transition. Importantly, Katie noted, patients typically don’t appear to be in distress when it happens. “If anything, they seem comforted,” she said. “These visions, whatever their origin, often bring people a deep sense of calm.”

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She added: “It’s one of the more mysterious aspects of death that we’re lucky enough to witness as caregivers. It’s humbling.”

Katie’s video struck a chord online, with many commenters sharing their own powerful memories.

“My dad reached up with both arms,” one person wrote. “Before that, he hadn’t been able to lift them at all.”

Another commented: “It’s the in-between. What a privilege to witness.”

Others echoed the sentiment: “It’s heaven they’re reaching for,” wrote one. “I didn’t want to disturb him, it felt sacred,” said another.

For many families and caregivers, these gestures serve as quiet reassurance that their loved one is at peace, gently guided by something, or someone, just out of sight.