A hospice nurse with 16 years of experience has gone viral after revealing a little-known skin change that can appear just days before death.
Julie McFadden, who runs the YouTube channel Hospice Nurse Julie, posted a video explaining the Kennedy ulcer, a terminal stress response she called a “huge indicator” that a person is at death’s door. She admitted she had been reluctant to discuss the topic because she did not want to cause panic among viewers.
The lesion often surfaces on the sacrum, the area around the tailbone, and can sometimes take a butterfly shape just above the buttocks. McFadden emphasized that its defining characteristic is speed: it emerges suddenly rather than developing gradually like a standard pressure wound.
“The Kennedy ulcer is very specific because it’s not there, then boom, it’s there, and then boom, they die. That’s how quick the Kennedy ulcer thing is,” she explained in the video.
McFadden described the phenomenon as a final warning sign that occurs when the body redirects blood flow to vital organs, leaving the skin starved of oxygen and causing rapid tissue breakdown. She noted it is frequently observed in ICU and hospice patients during their last days, signaling that circulation to nonessential areas is failing.
The lesions may be small, round or purple, and can be painful with occasional light bleeding. McFadden stressed that they develop rapidly unlike chronic ulcers and may appear alongside other end-of-life indicators.
“So the person could also start looking like they’re going to be actively dying soon,” she said.
She was careful to clarify that the ulcer is not evidence of neglect, pushing back against accusations she said are often leveled at hospice staff. The condition arises solely because the body is shutting down, she explained, not from any failure in care.
On managing the condition, McFadden said pain control is the immediate priority, typically involving low doses of morphine. She advised caregivers to clean the skin gently and keep it as dry as possible, since tissue becomes fragile and easily torn once the ulcer appears.
McFadden opened her video with a direct warning to viewers: “There is one thing that can be on someone’s skin that could really be a sign that your loved one is days away from death.”
She concluded by urging families not to view the sign as cause for alarm. “I don’t want it to be an alarm bell and make everyone panic,” she said, adding: “It doesn’t mean your loved one can’t have a peaceful death.”
McFadden built her following by discussing end-of-life matters on her YouTube channel, where she regularly shares insights from her nursing career to help families recognize and understand the dying process.
McFadden continues posting educational content to Hospice Nurse Julie on YouTube.