Nothing to Fear: Demystifying Death to Live More Fully

by Julie McFadden

What if we didn’t consider death the worst possible outcome? What if we discussed it honestly, embraced hospice care, and prepared for the end of our lives with hope and acceptance?
In this compassionate and knowledgeable guide, TikTok star Julie McFadden—known online as “Hospice Nurse Julie”—shares the valuable lessons she’s learned in her fifteen years as an RN in the ICU and in hospice. Expertly interweaving emotional insight and practical advice, Nothing to Fear demystifies end-of-life care for both patients and caregivers, covering topics including:
the biological details of dying
which medical interventions help and which only make things worse
the otherworldly beauty of deathbed phenomena
financial and logistical preparations for death
facts and myths about hospice care
the most important conversations to have before you die
the grieving process, before and after death
Sure to be a go-to resource for years to come, McFadden’s first book proves a better death goes hand in hand with a better life.

Genres: Nonfiction, Death, Self Help, Grief, Health, Psychology, Medicine

240 pages, Hardcover

Published June 11, 2024

About the author

Julie McFadden, BSN, RN, is a hospice/palliative care nurse with more than fifteen years of experience. Passionate about normalizing death and dying, she has more than one million followers on TikTok as @hospicenursejulie. She has been featured in Newsweek, USA Today, the Atlantic, Business Insider, the Patient Story, and many other media outlets worldwide. McFadden lives and works (and films and edits videos for social media) in California.

Reviews

[Sarah ♡ · Rating 5 out of 5]

Nothing To Fear: Demystifying Death to Live More Fully is an honest and open look into hospice, end-of-life, care by Julie McFadden - her Tiktok @HospiceNurseJulie - is filled with informative and interesting videos, which made me want to check this book out for further details and information.
”What if we didn’t consider death the worst possible outcome? What if we discussed it honestly, embraced end-of-life care, and prepared for the end of our lives with hope and acceptance?” These are some of the questions posed in Nothing To Fear, as the subject of death is handled with such care, as the patients are given such dignity and respect.
Death is much larger than just being clinical and medical, it is purely human. We are wired, designed, to run away from death. But we need to remember that it will be the end of all our paths.
It is completely normal to fear death, but Julie McFadden wants to normalise conversations around it to help many people - the dying, the bereaved with their grief - comes to terms with the inevitable.

This is a very well-written book, one that will help many people. You never know, I may end up returning to it one day if ever I need to.
How strange that when I was around halfway through reading this, I received news that one of my friends sadly passed away. This book really did help me to process things, even though her death was shocking and sudden.

5 stars

[Marie · Rating 5 out of 5]

We are all going to die. Death is a part of our human experience and none of us can avoid it forever. What this book does is take away the fear of dying .
I started following Nurse Julie on Instagram a couple of years ago. She explains the dying process and answers questions about the different experiences before, during , and after. Before I started following her , I wrote down what I’d want in the event I was dying. I said I’d want food and hydration right up until the end because I didn’t want to starve to death. Julie lays out why that isn’t necessary , pointing out that it could actually make the end needlessly painful for the person who is dying.
This book addresses death from terminal illnesses such as cancer, ALS, dementia, etc. many of us don’t want to talk about it because it’s a difficult conversation to have. While the subject is death from medical problems, it still makes me less afraid of death. I also know that while I’m relatively healthy, at 60 years old it’s time to think about end of life decisions I can make now so my loved ones don’t have to agonize over what they think I want. The title of the book is “ Nothing to Fear” and this book can help to allay some of the anxiety and fear of death.

[Lauren Curtis · Rating 5 out of 5]

Hospice nurse Julie has put words to so many of the things I encounter daily as a hospice nurse. She eloquently breaks down why talking about death is essential in making it less scary, and gives so much wisdom and education about the death process. It has shed light on why I love what I do, and reminds me of the purpose behind my job which is beautiful, full of so much multitasking, and oh so bittersweet. I have never loved more deeply than I do encountering death in the ways she describes in this book. I would recommend it to anyone who works in healthcare, has a declining loved one, or who is considering a career in hospice.

[Erika · Rating 5 out of 5]

Nurse Julie’s YouTube/instagram really helped me be there for my 102 year old grandmama as she transitioned from her life on Earth to her next great adventure as I call it. I was so happy to read this book via Audiobooks from Apple. She did such a beautiful job reading the book and I highly recommend it. Thank you Nurse Julie for all of your support!!

[Teo · Rating 4 out of 5]

I really appreciate these kinds of books for someone who wishes death positivity was more mainstream. McFadden does a great job broaching a highly sensitive and virtually not talked about (when do you ever hear about hospice?) subject with such compassion and gentleness. It’s refreshing to hear someone also advocate for the patient’s right to choose their treatment and how they die, as well as how caregivers need to give them space and let them guide them, even though that’s a really tough position to be in. This opened my eyes to a lot of things regarding end-of-life care that will definitely be useful to me and others I know as we grow older :)

Highly recommend to every single person! 

[Katie · Rating 5 out of 5]

This book changed my outlook on death for the better. I never realized all of the techniques we take in the ICU to stay alive and how it can make death so much more painful. This book comforted me as my dad is on hospice, and what I can expect in his death and my own someday. I can’t thank nurse Julie enough for writing this. If you or your loved one is dying, please read it ❤️

[Jodie Van Dyk · Rating 5 out of 5]

I promise I don't only read books about death lol. But I would 10/10 recommend this for EVERYONE to read. We will all inevitably see someone we love die and Julie does a great job at explaining what that looks like and what to consider. The greatest gift we could give is a peaceful death for our loved ones.

[Caitlin DeMara · Rating 5 out of 5]

As someone who has worked in hospice care, I've never read such a comprehensive, compassionate, and well rounded explanation of what it means to have a good death, and ultimately a good life.

[Emily · Rating 5 out of 5]

No, I am not dying, nor do I know anyone personally who is (at the moment), though as the author, a Hospice Nurse named Julie points out, we're all dying - just maybe not in six months, which is one of the qualifying criteria for Hospice care. I chose to read this book because my mother is 90, and even though she's in very good health for her age, no one lives forever. I always have a level of background anxiety about her eventual decline and death, since I count her among my best friends and can't even imagine not having her in my life. This helpful, informative, and honest book helped me feel less anxious about her demise, when the time comes.

Julie chose to move into Hospice nursing from working in a busy ICU, where extraordinary means are performed to keep dying patients alive as long as possible. She didn't agree with people who have terminal illnesses having to submit to invasive, uncomfortable, and dehumanizing procedures just to prolong their lives a small amount even though the end result would be the same as if they were allowed to die a more comfortable, peaceful, and dignified death at home.

I listened to the audiobook and Nurse Julie has such a calming voice it really helped me relax about this "taboo" topic. She wants everyone to be able to more easily talk about death and use the actual words "death", "dying", "dead" instead of euphemisms (passed away, went to be with Jesus, and so forth). She provides much practical information on what Hospice is, what it isn't, what to do as a caregiver when a loved one is dying or when one is dying oneself. What to say, what not to say, what "active dying" and "the rally" are. What other experiences the dying person may have, like seeing dead loved ones. She also provides many additional resources in the final chapter, including other books, podcasts, and websites.

Nurse Julie has written an immensely valuable book that should be read by everyone. Dying is universal, but doesn't have to be a terrible thing -- it's a natural part of life.

[Georgia Neindorf · Rating 4 out of 5]

4.25 ⭐️
I would highly recommend this book to anyone and everyone - a great introduction to death, dying, hospice, palliative care, etc.
Truthfully I wish I had read this book around this time, 5 years ago, as it would’ve gone a long way in preparing me for my brother’s death. Unfortunately a topic we all shy away from discussing, even though we will all experience this at some point.

[Kristen Thomason]

Those who read my little interviews will remember my existential dread surrounding death and my review earlier this year of “Embraced by the Light” which unfortunately made this dread worse.

This book however was a completely different experience. With first hand accounts and expert knowledge, Julie McFadden outlines her perspectives on death after years as a Hospice nurse. This stood as an excellent grief tool with my continual struggle surrounding the deaths of my grandfathers, and also helped address my devestating fear of the end of my life.

While McFadden does address ideas surrounding spirituality, this book is overall neutral in her discussions of it, and you can tell she is a wonderfully accepting person in all forms of philosophy surrounding death. Where McFadden stands proudly though, is her insistence on a rewriting of the societal conversations surrounding our own deaths and the deaths of others. She pushes for ethical, educated end of life care, and outlines what to expect with death from her personal experiences and the realm of science.

A very calming book for my very anxious heart.

[Jen · Rating 5 out of 5]

Definitely a must read.

[Jessica · Rating 5 out of 5]

I thought at first that this book was going to cover the same ground as Being Mortal — focusing on quantity of life can come at the cost of quality of life — but McFadden quickly takes it in another direction. After explaining her own switch from ICU nurse to hospice nurse, she goes deep on specifics about what is normal to see in someone whose body is actively dying and the ways that are and are not helpful to respond to that. In detailing everything from the way the dying body naturally stops wanting to eat and drink to how common it is for dying people to see visions of deceased loved ones and beautiful light, McFadden paints a picture of death as just one more step on everyone's journey of life and not something to be feared or avoided at all costs. She also tries to educate about options, including debunking myths about hospice care and sharing information on how Death with Dignity works, and repeatedly encourages readers to have honest conversations acknowledging the reality of death. The book is specifically targeted at those who have received a terminal diagnosis and their loved ones, but given that that could be any of us at any time, I would recommend this widely. I am not familiar with McFadden's TikTok channel, so I'm very glad this one came across my radar another way.

[Vanessa Ya Lopez · Rating 5 out of 5]

A gem!

As a Certified Child Life Specialist who has worked with so many dying children, this book hits the nail on the head. It’s everything I know and advocate for.

Thank you Julie for putting this beautiful resource now out in the world. I hope you inspire so many to learn. We need to put death into our everyday conversations and you did it with ease and slight repetition.

The most powerful part of this book is how it allowed me to process my dad’s death this year and his 2 months on hospice. We did everything in our power to create a peaceful ending and it was honestly gut wrenching but beautiful. The exact ending my dad wanted was the gift we gave him. Myself, his sister and his best friend held space for his sacred transition out of this world.

[Amanda up North · Rating 4 out of 5]

Hospice Nurse Julie McFadden writes with all the compassion, kindness and honor I would want for myself or my loved ones at any stage in life. I learned some good things from her book.

A very special friend of mine is turning 106 in a few weeks. She's declining. She's on hospice.
After visiting her the other day, I left with a lot of questions. When I arrived, she was trying, struggling, and failing to feed herself a bowl of icecream covered in strawberry syrup. She wanted help. I wasn't sure if I was "supposed" to help, what the latest rules from her caretakers and long distance family were. (Which, if I'm being honest, have not always aligned in the past. The caretakers tend to give her any help she requests, while some family are adamant she do things herself to maintain her independence.) I was the only one there, and helping when asked felt like the right thing to do. With my help, she eagerly relished nearly the whole big bowl.
I am reassured by Nurse Julie. My dear friend really wanted that icecream. Helping, when her hands simply weren't up to the task, was the right thing to do.
My biggest takeaway from the book is "Let your loved one be your guide." Let them guide you in how to take care of them. "Honor your loved one by allowing them to guide the process in all the ways they're able."
Respect their wishes.
Let them make personal choices for themselves.
When they no longer want the icecream, honor that, too.

The book answered questions I wouldn't have known specifically how to ask.

Nurse Julie includes useful scientific / medical information about end of life, as well as helpful information that will make end of life easier for the person dying, and their loved ones. There are task lists to help arrange affairs, make decisions known, have wishes fulfilled.

This is a book about death and dying, but it's also about living. Living the life we have as well as we possibly can - before dying as well as we possibly can.

There's a chapter titled Advice For the Dying that may as well be titled Advice for Living:

• Tell your family and friends you love them.

• Ask forgiveness from people you've hurt.

• Exercise healthy boundaries around your space, which might mean excluding people who may be harmful to you.

• Ask yourself what brings you the most joy and then do it.

[Cathy Senecal-Rice · Rating 5 out of 5]

After getting this book from the library, it made such an impact that I intend to purchase it and refer to it when necessary. Julie has a very down to earth style and talks about everything involving death the way I’d want a medical professional to do. Highly recommend as she also gives advice on how to fill out power of attorney, living will etc. She’s amazing!

[Sierra Schreiber · Rating 5 out of 5]

I have been following Hospice Nurse Julie for quite some time on social media. She is amazing, and I was so excited for this book. Although some of the messages were familiar for me due to working in palliative medicine, she does such a great job of explaining some of the more difficult topics surrounding death. I definitely will be incorporating some of her messages in to my practice. Anyone and everyone should read this book.

[Kara · Rating 5 out of 5]

An honest yet gentle overview of death and how to navigate it. Julie explains several aspects around death such as palliative care, hospice, the process of dying, grief, and how to navigate the feelings and decisions that come with it. Death is still stigmatized in our society but it doesn't have to be and Julie is a compassionate teacher. Though this was a difficult read after experiencing multiple family deaths in the last year, I'm glad I read this to better understand some of the things that happened and to ease my mind. Everyone should read this book.

[Beth · Rating 5 out of 5]

This book, written by a hospice nurse, is about death and dying. And it’s SO good. It really does help with the fear of dying, or of losing a loved one. Dying doesn’t need to be a taboo topic, and this book helps demystify it.

[Jess Seeland · Rating 4 out of 5]

Read this when I had non stop thoughts about death and it helped a lot! Still so fucking depressing but helpful

[Katie Moran · Rating 4 out of 5]

Well written and really accessible for not only professionals, like Julie, but also the general public, patients, their families and loved ones.

[Emily Diaz · Rating 4 out of 5]

Im currently a newly hospice nurse and this has helped me realize so many of the changes I’ve seen at the SNFs and also currently in my career. It all make sense. It has helped me understand the stages of death and how to cope with death on my own and also explaining things to family members who don’t understand the process. Great book.

[Sara · Rating 5 out of 5]

Perhaps a bit unfortunate that this was the first book I read in the new year, but I found this book exactly when I needed it. Truly a perfect read if you have a loved one approaching hospice or in hospice.

[Morgan · Rating 3 out of 5]

3.5 stars, I think this book would have been better titled “Nothing to Fear: an Introduction to Hospice.” There are some death stories in here, but this book contains a lot of anecdotes from Julie’s YouTube that I have heard. This book is best for anyone interested in learning about what hospice is, for those who don’t or are afraid of death I think you could gain some good info from this. Julie read well in the audiobook

[Julie · Rating 4 out of 5]

an easy and valuable read; I finished it in a few sittings between a few days. I came across Nurse Julie through viewing a story of someone I follow on the 'gram. I never had really heard someone talk about death like she did nor did I really think about death for reasons likely most other people don't think or talk about death: it's morbid, taboo, depressing, etc. I know it sounds unsettling to say "I'm reading a book about death and thinking about death!" but after following Nurse Julie's content for a bit as well as reading her book, I can see why she advocates for a different approach to death whether it is your own or a loved one.

generally, the culprit for a poor understanding of death in the US is the wretched healthcare system, not the health practitioners within it as they are trained, taught, and forced to comply with the unfeeling currents of the US healthcare system. Nurse Julie points out through her long time working as an ICU nurse, families are often misled into what is best for their loved one as it's an ICU's job to keep a patient alive and again, the healthcare system does not permit much space for the practitioners within it to be honest or forthcoming concerning what's best for someone nearing end of life. rather than letting someone's last days, weeks, months of life be harshly sustained in an ICU Nurse Julie strongly advocates for hospice where someone can live their last days as they choose with pain managed and being "clean, safe, and comfortable," Nurse Julie's mantra. thus while there are some tips in this book about how to handle death in the emotional sense (and Nurse Julie makes prudent note she is not a certified counselor and points to counseling resources), it's more of a book that encourages readers to consider if uncompromising sustainment in an ICU or the "refusal to let go" otherwise is the way to let someone you care about die. the book also teaches about what physically happens to someone when they die so readers can know what to expect.

Nurse Julie shares many stories of families who chose hospice that were so filled with love, tears came to my eyes a few times. alternatively she also shares stories not so fortunate which returns us to her mission of educating the masses on different options like hospice for death as well as the body's natural processes that signal it is preparing for death. she also briefly touches on medically assisted death and what happens in that process and also where it's currently legal. finally, she leaves her readers with many great resources to help plan and process death at the end of the book.

[Denise Marie · Rating 5 out of 5]

I have followed Julie on IG for quite awhile and find her to be straightforward, while extraordinarily compassionate. She speaks of the dying process very frankly and while she doesn’t eliminate all fear of death in this book, she eases the apprehension. I had an aunt, who was very dear to me, die in a hospice setting a little over four years ago. The nurses were fantastic, but, they offered very little in the way of explaining the sounds and sights. It was scary and so very sad. I wish I had known about Julie then and that I had read this book! While the sadness would have remained, the abject terror would have been avoided. I think this is a must read for all, really, as there is no avoiding death. At birth, our bodies know how to function once born. It’s much the same while we are dying. Our Creator installed fail safes. What we, the onlooker, perceive(s) as a struggle or discomfort, simply isn’t. I lost my dad 16 days ago and I still can’t breathe. With that said, I am confident he was comfortable. Thanks Julie.

[Christie Bane · Rating 5 out of 5]

Everyone, and I mean EVERYONE, should read this book. If you'd rather not think about death, fine. But that won't keep it away, and you will still have to deal with it at some point. For me personally, I would rather be prepared, since things are automatically less frightening when you know something about them. The author is a hospice nurse, so she is very familiar with people dying, and also with people who are dealing with somebody dying. She has tons of practical advice for everyone involved in the situation. Through her work, she has come to experience the end of life as a beautiful tradition. Because of this book, I'm inspired to get back to hospice volunteering. And since I just had my dog certified as a therapy dog, this is a great time!

[Courtney Marsh · Rating 5 out of 5]

Hospice nurse here! 🙋🏻‍♀️

This book is incredibly informative in so many aspects and I’d recommend it for everyone to read at some point in their lives. There is such a stigma around death and dying, but it can truly be such a beautiful experience. Learn how to talk about it, have the hard conversations, have your affairs in order, learn about what natural death looks like, learn about interventions and resources that are there to help you including hospice care, and learn about the grieving process. Death and end of life in general does not have to be scary and complicated and painful. It can and should be peaceful and comfortable.

[Robyn Obermeyer · Rating 5 out of 5]

Having just lost my 40 year old son to brain cancer and the one year journey rite to the bitter end, i wish I had read it sooner. We tried the the recommended standard of care and I did my best to be there for him sadly the outcome was awful. I am numb and raw all at the same time about this. I am grateful for some comforting ideas and experience shared in this book. We may be built to die ,but i still don't get it why I had to lose my son. struggling with this loss I search for any deeper or scientific information I can gather .

[Kim · Rating 5 out of 5]

This book was recommended by a friend who currently has a family member receiving hospice care. I do not have direct personal experience with hospice but this book made me so grateful to know that it exists. It is written by a hospice nurse who also has experience working in the ICU. It was really interesting to read about the differences between those two jobs and how their intentions can be at odds depending on what is happening with the patient. ICU workers try to keep the patient alive no matter what and hospice workers try to keep the patient comfortable no matter what. I appreciated being able to understand that difference. The author speaks about death very frankly and honestly, and with a great deal of compassion. It is very obvious how much she values her work with dying patients. She thoroughly describes what active dying looks like and what kinds of things a doctor might say that would let a person know it might be time for hospice care. Though it was sometimes hard emotionally to read this book, it was very straightforward and accessible about its topic. I think anyone would benefit from reading it.