Death rattle is the scary sound a person often makes in the hours or sometimes days before death. It is fluid that accumulates in the lower throat. The person is not swallowing. The saliva and fluid in the lungs, due to lack of normal body processing (the body is shutting down and nothing works right), is accumulating in the lower part of the throat. That fluid is too deep to really be reached by a suction machine although that is the first thing we think of to get rid of it. The death rattle is not always present. Those people that have more fluid or are more hydrated as they approach death, are the ones most likely to experience this natural phenomenon.
Human beings tend to be “fix it” personality types and we particularly expect medical professionals to fix any situation. The death rattle is a normal, natural part of the dying process. It is harder on us, the watchers, than on the person who is dying. By the time a person is experiencing a death rattle they are very much removed from their bodies, generally non responsive and are busy in the process of letting go of their bodies. The congestion is part of that letting go.
For the “fix it” personalities a Scopolamine Patch is sometimes effective in reducing the secretions as is Atropine 1% drops. Generally, simply repositioning the person from side to side and keeping them off of their back will help reduce the rattle as much as anything.
What really helps is that we know that what is happening is very much a part of the normal dying process, that nothing bad is happening. It is scary because we are not used to the sound, it sounds uncomfortable and like it shouldn't be happening so we want it to stop. This is our discomfort. This is part of our fear and grief in the experience.
If we understand how the body naturally releases it’s hold on life, fear of the experience for us (the watchers) can be reduced. We can share more comfortably in the gift of being with a loved one who is dying.
Our presence at the bedside, of love, support, and touch, is the comfort that is needed during this last experience of our loved one, not medical intervention.
Something More... about The Death Rattle (medically known as Terminal Secretions)
So many families are alone in the final day, hours, minutes before their loved one dies even if they are in hospice care. We have a guide for families called The Eleventh Hour: A Caring Guideline for the Hours to Minutes Before Death. Our DVD Kit, NEW RULES for End of Life Care is helpful for families to watch as it explains what will happen when death approaches and how best to care for the dying loved one. If you know someone who is approaching death you may want to look at the End of Life Guideline Series.
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Tuesday early afternoon, my husband and I did a welfare check on my mother in law. We found her in her bed. We suspect she passed monday, She looked peaceful. HOWEVER she had lots of blood I mean lots! We were told she my have had an aneurysm or it was from her liver releasing. It was bright red and very dark red. She didn’t look like she suffered. She just looked sleeping. I am struggling with the view. I want to know why this happened? Was it natural decomposition or had she had an aneurysm? She had a blockage in her neck, diabetic, blood pressure issues, liver disease, pancreatic problems, she was on blood thinners. No autopsy because we knew it was natural causes.
Thank you for any explanation.
Hi Gail, I can see how disturbing watching all that fluid come out of your father’s mouth and nose was, not knowing what or why it was happening. First, nothing bad was happening, scary for you but not bad for him. I don’t know what his disease was but with the death rattle and all of that fluid he was probably not dehydrated (IV fluids?) The more dehydrated a person is as death gets closer the less rattle and fluids. Think of the little chick working to get out of its body, messy but doing what it is made to do. So it is getting out of our body., It is generally “messy", unpleasant to watch, but is how the human body is made to end. Your father, and all of us as we die, are so removed from our physical bodies we are not experiencing physical sensation in the same manner we would if we were not dying. You said your father was otherwise non responsive, that is very normal. We will all be non responsive to our body’s actions as well as the world around us in the days to hours before we die.
I hope this clarifies your concerns.
My blessings are with you. Barbara
I am extremely distraught after watching my father pass away. He had the death rattle for more than 24 hours. He was unresponsive by the time I arrived at his bedside. After I was there for a few hours, dark brownish – pink tinged and thickish fluid started to bubble up and flow out of his mouth and nose. The closer he got to death the more it happened. It started changing colors on and off. Greenish as he was taking his last breath. There was so much coming out of his nose and mouth. He never had any kind of reaction as it was happening. I don’t think he even knew it was happening. There was no reaction from his body. I just kept flowing like lava.
Last week I was called to my mother’s bedside after being told she was transitioning to death. She had the death rattle. But it sounded like the rattle was from the lungs. She was fully not responsive. I got a bright light so I could see into her mouth and saw immediately that she was not swallowing and that fluid was accumulating in her full mouth making her exhale through this liquid with a gurgle and inhale through her noise. So it was air in through the noise and air out through the mouth filled with liquid………..it scared me badly as she could have inhaled the liquid into her lungs at any time as she was unconscious. and she would have drowned. I got her head turned sideways and pointing downward immediately and propped it like that with some pillows so all her mouth fluid drained from her mouth and throat onto a disposable diaper on the bed I put under her mouth. The gurgle went away at that time and her breathing cleared up. She was no longer in danger of drowning on her on fluids and I was very happy she could then relax breathe easily and die peacefully with no pain and no strain just the way she wanted to go. I’d always promised her I would help her all I could and I now know that I did help her with the dying process which was important to her.
Hi Katie, it is so hard to watch someone we love going through the labor to get out of their body. Just think of the little chick working to get out of its shell. That is what your grandmother is doing now, working to get out of her body. Her body is shutting down and can’t pull the fluid out of her lungs—so hard to watch and listen to. Even though she is non responsive talk to her, tell her how much you love her, what she has meant to you in your life. Encourage each of your family to spend alone time with her and talk to her from their hearts. She can hear you.
My blessings are with you, your grandmother, and your family. Barbara
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