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.
65 comments
Dear Barbara thank You for answering my questions so patiently. Sadly my father was not under hospice care and his GP refused a house call. So I was home alone with my dad. He had heart failure and advanced dementia but didn’t have much leg edema and had low blood pressure and was dyhadrated- that’s why the doctor didn’t prescribe a diuretic. My dad seemed calm and relax but I am haunted by a vision of his filling in with fluid and him suffocating. Is it possible to have much fluid in the lungs and oxygen saturation between 91-93 (after pneumonia)? Could you also tell me what You would do after suspecting pulmonary edema in your patient who is dyhadrated and has low blood pressure but shows no signs of respiratory distress? Should morphine be given anyway? Do you think dementia can mask respiratory distress signs? Thank You for Your reply in advance.
———
BK Books replied:
Alicja, to answer your questions: most people die dehydrated That’s part of the body’s way of letting go. The calcium in the blood elevates and they just go to sleep and not wake up. A very gentle way to die. From what you described edema and suffocating was not really an issue. He was relatively comfortable, dehydrated (which was a good thing). Dementia would not mask bodily functions or distress. What I’m suspecting is you are distressed by the way your father died. Wondering if something bad was happening. From what you have described and the questions you’ve asked I can see nothing out of the ordinary happened . Your father’s body was dying and this is how it was doing it. The experience was scary for you watching and very very sad but what you described is often what dying looks like. If you can, let go of the how he died and let how well you live your life going forward be your gift to him. Blessings! Barbara
Dear Barbara,
there is still something that bothers me a lot about my father’s passing. Could you explain to me what is the standard procedure on hospice with a patient dying from heart failure- let’s say some fluid collects in his/her lungs but the patient is calm and does not seem to suffer. Are diuretics given in such cases as well or are they given only to patients experiencing respiratory problems or distress. I would be so grateful for Your answer- maybe it would bring some peace to my heart. Thank You in advance.
———
BK Books replied:
Alicja, about your question of drug protocol for hospice patients. Medications are given as they pertain to individual circumstances. There is a “no one size fits all” when it comes to care for hospice patients. The particular disease, where a person is in the dying process, and their medical history all contribute to what medications are used. I know this doesn’t really answer your question. You could ask your physician or the physician that was caring for your father why he received the care and medications he did. Blessings! Barbara
Hi Barbara, thank you for all of the information in your article. I read through a few of the responses and feel somewhat at ease with my situation. My dear grandma passed away, alone in her home, four days ago. I am so devastated by her sudden, and unexpected death, as I had just spoken to her less than an hour before her passing. When I arrived at her home, I found my grandmother was unresponsive and I immediately jumped into action to preform CPR and yelled to my mom to call 911. In my mind the reality struck, I knew she was gone. However, in that moment I felt that I could bring her back and wanted to do so more than anything at that very moment.
I did experience the “death rattle”, to which lead to me believe she was breathing and gave me this sense of hope that she was still with me. I screamed and was so angry when the paramedics arrived at the scene, because I wanted them to help bring her back to life. Once I collected my thoughts and emotions, I realized there was nothing more any person could do. I recall my grandma having this greyish, white, saliva like fluid on the side of her mouth. Your post gives me closure in a way, knowing that what you explained may be what I saw and experienced. Although, I, along with all of my family and friends are in disbelief, feel as though she had a peaceful passing. She was in her home, where she always loved being, sitting on her comfy sofa, warm, as if she was resting her eyes while waiting for my mom and I to arrive for our Saturday morning breakfast dates.
———
BK Books replied:
Hi Ana, from what you described about your grandmother’s death was really how most of us want to die; in our home and quickly. She did a good job. The white fluid was nothing to be worried about. Since you didn’t get to say goodbye write her a letter. Put everything on paper that you would have said to her if you had had the opportunity. Burn the letter and scatter the ashes to the wind. Let how well you live your life be the gift of love that you now give her. Blessings! Barbara
My father passed March 1st from congestive heart failure and 2 months and 7 days later mom went from end stage renal failure. When mom passed she was mostly unresponsive for a week but in the last 36 hours her eyes opened most of the way and a few hours before passing she had a white very light foam come from her mouth almost resembling feathers because it was so light. I was beside them both for the end and struggle to understand some things that occurred. But thanks for this outlet.
———
BK Books replied:
Hi Steve, my parents died within 5 months of each other so I know some of the feelings you are experiencing. About how your mother died; most people die with their eyes partially open. I don’t know why. Maybe it takes energy to keep them closed and energy to hold them open so the natural place is partially open. I don’t know but that is how most people die. About the white, feathery fluid from her mouth, again, so common. I think that is part of the letting go. There is no muscle effect to hold anything in—-pee, poop and stomach or lung fluids just come out when there is no control to hold them in. Hope this adds a bit of clarity for you. Blessings! Barbara
Hello Barbara,
I happened upon your website by mistake and I feel so blessed that I did. I read a lot of your comments from readers and your responses which I found helpful. I lost my brother August 1, 2022 while he was under his daughter’s care in NC. I live in Charleston, SC. This daughter had the other daughter call my neice 8 days after he passed and then my niece called me. I was hysterical as I had always been very close to him. He passed with Alzheimer’s and unfortunately had gotten upset with me and told all of our friends and family that I had taken $300 from him every time I went to see him in Atlanta which was absolutely not true. I think his daughters believed him which was unfortunate as they did not let me know he was sick for months before passing.
The reason I’m writing is because I have no closure and I still grieve my brother terribly. I’m so sad and I’m regularly wanting to pick up the phone to tell him something, hear his deep, loud voice, listen to him tell me a joke for the 10th time. As I sit here and cry, I just want you to know that I’m going to try your advice of writing him a letter and tell him how much I love him, how fun he was, how much I miss him, and how I’ll see him on the other side. Then I’ll tear it up and throw in the wind. Then I’ll pick up the pieces, because I don’t like to litter and I’ll recycle them! God Bless.
Jeanette
———
BK Books replied:
Jeanette, I’m so sorry you didn’t get to say goodbye to your brother. Yes, do write him a letter. Write all the things you mentioned and be sure to write about the misunderstanding too. Imagine his reaction and respond to what he might say. Also you can burn the letter and scatter the ashes. That way you don’t have to worry about littering. Blessings to you Barbara
Leave a comment