The Death Rattle (medically known as Terminal Secretions)

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.
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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.
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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.
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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.
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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
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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

Hi Barbara. Your article has helped me a lot as I am very concerned that something bad happened to my father when he was dying. He had advanced dementia, heart failure and asthma and was home after being hospitalized for pneumonia for two weeks. He has been discharged free from pneumonia however his oxygen saturion was lower than before getting ill-it was about 93. I didn’t agree to a feeding tube. My dad was eating less and less (his appetite problems started few months before). In the week before his death he had three brief episodes of dynamically “throwing up” “mucus” that looked like saliva-it was clear, transparent. Apart from that he seemed perfectly OK and calm; there was no wheezing, no death rattle; his breath seemed normal. His oxygen saturation was always above 90. He died after one of such episodes- he “threw up” once and started losing conciousness. I positioned him to help him clear the airways and called the doctor. I am very afraid he had lung congestion/fluid on lungs and I should have reported that to his doctor so that he could have gotten a diuretic (No doctor visited us that week and I was waiting for home hospice admission next week). I am scared that somehow he was suffering from shortness of breath and congested lungs and I missed that as there were no alarming signs like difficulties breathing or restlessness. Is there a possibility he wouldn’t have been suffering even if he had fluid on lungs? (He was receiving heart medicines-besides diuretics- and was nebulised with Berodual and glicocorticosteroids 3 times a day.)
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BK Books replied:
Dear Alicja, from what you have described your father died very normally. It was not because of anything you did or didn’t do. With all of his medical abnormalities his body was dying. My guess it was not one thing that he died from but the combination of a body that was no longer functioning. You might write him a letter. Put your thoughts, fears, tears, and everything you would tell him if you could down on paper. Burn the letter and scatter the ashes to the wind Let how well you live your life now be the tribute of your love for him Blessings! Barbara

Hello all of your responses have been so helpful I’ve only found references to purge fluid after death that sounds like what I was wondering. My mom passed 8 days ago on hospice. The last day and a half she was unconscious unmoving just heart beat n breathing but she had yellowish gray secretions begin coming out her mouth and nose large volumes. She had liver cirrhosis and was very swollen from water retention on stomach and legs. Is this the purge found in articles or due to her disease? I’m thankful she didn’t suffer long but this has me thinking she did suffer was she in pain during this? It’s such a hard process seeing your loved one at those end days. Thank u for this area to ask questions
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BK Books replied:
Hi Vanessa, when the liver is not doing its job all kinds of bodily fluids accumulate. Fluid builds up in the arms, legs, stomach. Because the fluid is not released it can come out of the skin, nose, mouth. All this fluid just says the body is shutting down. Is this painful? If my body was relatively healthy and functioning and I had edema (fluid) in your legs or hands they would feel “tight”. When the body is dying I’m guessing the body would also feel but I don’t know what. Being non responsive they can’t tell us so we the watchers have to look at body language (agitation, restlessness, verbal sounds) to tell us if a person is uncomfortable. You said your mother was “unmoving” which says to me she was not in pain. My guess; her body felt heavy and oh so tired. It sounds, from what you have described, your mother gently left her body. You might write her a letter. Put all your thoughts, love, tears, everything you would want her to know, on paper. Burn the letter and scatter the ashes to the wind. Let how well you live your life be the gift you give her. You may find my booklet My Friend, I Care helpful as you walk this journey of grief. Blessings! Barbara

My father passed away a couple weeks ago from gastric cancer. I was there when he passed. Shortly after his last breath a lot of blood/liquid came out from his mouth. I say from his mouth but it was so unexpected and happened quickly I’m really not sure. I was so quick to get towels to cover it and clean off my mom who was beside him. Is this normal? I was with my grandma as she passed in hospice and this did not happen with her death so again I was very surprised.
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BK Books replied:
Hi Christy, when the body does that it can be so unnerving. It happens every so often. Nothing bad, just surprising. I’m guessing that fluid/blood was in his throat and when all the muscles had no tension in them it came out, just like with pee and poop. Blessings to you. Barbara

Hi Barbara, thank you for all the knowledge and support you give us, My mother died two weeks ago at home and she had a death rattle but on the second day it turn to something brown,almost black , she she was not conscious, she was in a coma for 3 days, it took that long until she left the body, I’m just interested to know in what is that the black-brown substance that appeared on her mouth
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BK Books replied:
Hi Davor, the brownish-black could be old blood coming from who knows where, mouth, stomach, lungs. It is not uncommon. I have seen it frequently, all part of the labor of dying. Blessings to you. Barbara

Hi Barbara, thank you for this important information. I have a question I have wondered about. My 5-year-old died at home, of brain cancer. Fortunately—and unfortunately for us— our hospice didn’t have any experience with kids, who seemed to die very differently than adults. At one point, we were told she had hours. She lived four more weeks. She had the death rattle near in her last few days. Nothing came out of her mouth, but she had such strong secretions, that we had one traumatic moment where I thought she would suffocate on them. She was conscious. I spoke to hospice on the phone, as well as the children’s hospital, and they were surprised to hear of this kind of difficulty. Another cancer mom advised me to ask for a suction machine. I did, and it sucked out thick mucus. It looked like yellow snot—nose or mouth. I can’t remember if it came out of one more than another. Someone postulated that perhaps she had gotten sick with a cold. Is that probably the case? Or were those secretions because of her impending death? I understand it’s hard to say—I’m just wondering if terminal secretions could manifest as thick mucus like that. Our hospice was confused by it, and that is why I am wondering.
Thank you so much
Audrey
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BK Books replied:
Hi Audrey, in regards to your question about thick mucus at end of life: I also do not have much expereince with children at the time of death. I can count on one hand the times I worked with children but here is what I think. Our body is programed to die, young or old, it is the body that begins the process, months before death arrives changes begin. The key is to know that nothing works in the normal way any more. The body is a battery losing its charge, is shutting down. With that in mind then anything we consider abnormal, anything we think is out of the ordinary, is possible. About hospice telling you hours and then your child living another 4 weeks: sometimes we get to death’s door, we stop and are just not ready, there is still something to learn or there is something someone else still has to learn, and we pull back, (for a limited time). What a gift you all had, an extra month with your child. About the mucus, it saddens me to hear that another mother had to suggest a suction machine and not those that were suppose to have the knoweldge and where with all to help (also why wasn’t hospice there, in your home, helping you?) back to mucus. I doubt it was a cold. Mucus comes in many forms as death approaches depending on hydration, dehydration, disease process, positioning. Mucus is very much a part of the dying process. I see nothing out of the ordinary in your discription. I hope this gives you a bit of understanding. If it just brought more questions please let me know and I’ll try to address them. barbara@bkbooks.com. You are in my thoughts. Blessings! Barbara

Dear Karthik, I’m so sorry. From your description it sounds like your uncle is very close to death. My blessings are with you and your family during this challenging time. Barbara

My uncle is suffering with glioblastoma from last 13 months .
From yesterday he is suffering sound from body it’s very difficult sound
He is not responding for any kind of moments we do .

Hi Diane, for some of us our labor to leave our body is more difficult than for others. Your father is having a hard labor. I view the suctioning as a comfort measure. Telling me that he has cancer of the throat gives the reason for all the discharge through his tracheostomy. I wonder how much fluid and nourishment he is receiving along with his pain meds through his feeding tube? Fluids will increase the secretions and lung congestion. At this point all he really needs is the pain medicine. Nourishment and fluids will actually cause more discomfort than comfort. If I can be of further help use my personal email barbara@bkbooks.com. My blessings to you, your father and your family. Barbara

I was told by hospice that my father has been in the dying process for over 3 weeks now he has lost body fluids where the thick brown stuff running out of his nose and mouth along with having diarrhea he has throat cancer so he has a traca and I suction him when I hear the rattle he also has a feeding tube that is how we give him his pain medications he is nonresponsive but I know when he is crying I want to know if I am prolonging his suffering by suctioning him? His vitals are still ok I don’t understand. He had an infection and they gave him a

An elderly lady I care for and live is presently in the dying process. She was mostly unresponsive but I did hear her whisper “yes please” today when I asked her if she just wanted to sleep. It’s hard watching her sink deeper and deeper into a non responsive state. But I talked with her and prayed for her as though she was hearing everything I said. This article was so well written and helpful. Thank you for it. Thankfully she has a loving family at her side at home. I think tonight was probably my last time to work with her. ☹️

Hi Nuala, I do not have enough medical information about your Dad to know if he has entered the dying process. From what you describe he certainly has the typical Parkinson deterioration. Why the roof of his mouth is black; I just don’t know. What does his doctor say about why it is discolored? Parkinson is a long hard road with many challenges. My blessings are with you. Barbara

Hi, my dad is at the end stages of parkinsons and he is bed bound taking thickened fluids and pureed food which he finds hard to get down, he has a bit of a rattle but inside roof of his mouth is black us this a sign?

Hi Barbara

This information was very helpful. I happened to read it a day before my dad passed away. I was on the bedside and had the strength to deal with the situation as I knew what to expect. May God bless you 🙏

Cathy, it is so hard watching our loved one suffer and not being able to relieve the suffering. I’m glad hospice sedated him to bring some comfort. The “foaming” you mentioned was probably the fluid that was accumulating in his lungs finally erupting and pouring out. You might write your husband a letter. Put all your thoughts, concerns you had for him, tears, anything you wanted but didn’t get to say on paper. Burn the letter and scatter the ashes to the wind. My blessings are with you and your family during this time of grief. Barbara

I recently held my husband as he died. Due to the nature of his cancer he was unable to swallow for over a week before he died. The death rattle, as I now know it was called. He would try to talk but was drowning in fluid. I learnt quickly to understand him. This went on for a week to nine days until they sedated him to unconciousness. As he passed he made a loud humming noise and a dark blood brown foam leaked from his mouth as his hands clutched the blankets & his head pressed into the pillow. I heard the nurse say ’he’s foaming’. I don’t think I will ever get over his passing. It certainly wasn’t peaceful & painless for him. He deserved better.

Hi Norma, The operative words to your question of why there was so much blood involved with your mother-in-law’s death are “blood thinners”. I don’t know enough of her medical history and disease process to offer what was bleeding or why. I can say from your description, she had a gentle death (and isn’t that what we want for our loved ones?) She went to sleep and didn’t wake up. From your description she didn’t even know what was happening. I call that a good way to die. There is a labor to dying from disease and old age. Using that analogy it is like “the baby just popped out”. You might write your mother-in-law a letter. Write your concerns, write whatever is in your heart that you need to say to her. Burn the letter and scatter the ashes to the wind. Blessings! Barbara

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

My grandmother faced an aneurysm today, she lost consciousness and a pulse before she was on the ground. My grandfather was able to resuscitate, however she never gained consciousness. She is not practically brain dead, we had to take her off the ventilator today as well.. she has the death rattle and it’s terrifying. She also has fluid from her respiratory come up that she chokes on often, she has to be suctioned a lot. It’s truly the worst thing another human can watch a loved one go thru.

Hi Kathy, how frightening and confusing it must have been having your father die that way. From what you have told me I probably would have done what your mother did and said "we will see how you are in the morning”. I don’t think the gurgling was the death rattle. I don’t know what was going on in his body but it sounds like something beyond circulation not pulling fluid from the lungs. You asked if your father died quickly? Sometime during that 3 hours he died and yes, that is quickly. From what you described he didn’t get up again or try to wake your mom. If she was in the same bed or even room and he was in distress she would have awakened like she did at 2 AM. I’m guessing he just stopped breathing. Kathy, dying quickly and unexpectedly is very hard on us the survivors but for the person dying it is much easier—no prolonged illness, pain, suffering. You and your mother didn’t get a chance to say goodbye which makes grieving harder. You might consider writing your dad a letter. Put everything you would have said if you had had the opportunity— the good and the difficult things about your relationship, on paper. Write to him from your heart then burn the letter and scatter the ashes to the wind. It would be good for your mom to do the same. . Let go of the guilt and what ifs, they serve no purpose. My blessings are with you and your mom. Barbara

My dad went to bed feeling fine. He woke up at 2 AM saying his stomach felt strange. He got up and used the bathroom..loose bowels. He went back to bed and the gurgling or rattling noise of saliva began. Liquid came out of the side of his mouth. He said he was ok and closed his eyes. 3 hours later when my mom woke he had passed. He was cold and his mouth had dried blood coming out of it. My mom keeps thinking she should have called for help when he woke at 2 AM. To me there was nothing that could have been done or would even have known to contact anyone from what he did. Was this the death rattle? Did he pass quickly? Why blood coming from mouth?

Hi Susie, did you not read further down in this blog and see the medical recommendations?
“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.”
Of course we do what we can to make the person comfortable, to relieve as much of the congestion as possible. We just won’t be able to get rid of all of it because it is part of how people die. When we understand the normal, natural way people die (congestion and the noise associated with it being part of the way people die) we bring less fear and are able to support our loved one through the experience. Watching a loved one die is sad, upsetting and scary. Knowing what is normal helps eliminate some of the confusion.
Blessings! Barbara

Hi. This is the sort of stuff that makes it dangerous to trust other people.
You say there is no problem. Its just a part of the dying process. HELLOOOO. They are about to die. that is pretty bad.

The obvious solution is to tilt the person so saliva doesnt accumulate in those areas and strangles the patient. My guess is that this solution has not been tried because people resign to the status quo. would be interesting to see if this has been tested in the literature. bet it hasnt.

Its a question of money and incentives. Dont sign me up.

Cheers.

Suze, I have been out of the country until last night hence my slow response to your question. It does sound like your mom has entered the dying process. It is not so much that she stopped treatment but that the cancer has taken over her body and her body can no longer function. Treatment for cancer is not generally a fix it and it is gone kind of thing but a maybe we can buy a bit more time. I suggest you go see your mom now for the opportunity to say goodbye. Even if she does not respond or converse back with you tell her how much you love her and anything else you need to say to her. In the process of letting go of her body she will eat less, sleep more and gradually become non responsive to you. Her breathing will change and get slower. She may make a facial grimace just before her last few breathes. Watching someone we love in the moments of dying can be frightening. Just think of her as a little chicken working very hard to get out of its shell. She is working to get out of her body. Nothing bad is happening. She is doing what we do when we die. My thoughts and blessings are with you and your mom. Barbara

Hi Barbara,

Thank for your time and this blog.

I have a question. My mom is 53 y.o. and she was diagnosed at the end of Aug with stage 4 lung cancer that has spread everywhere. This news hit very hard on me, since i just lost my gramma not even 1 month before.
My mom had radiation done and she did chemo 1x and then she said no more and quit any and all treatments. I was so sad and mad at the time to find that out, and how she was giving up. Now my mom is in a care center where when i saw her earlier this month she was able to get up and walk to the bathroom, talk a bit but she would most of the time just listen to you speak. I just got news that she went drastically downhill in the past 3 days. That she didnt eat for 2 days now and she is sleeping most of the time. Since she cannot really swallow they gave her a patch for pain and other fluid medications she needs to take. We live in separate states, i was wondering if you can give me any information on what is to follow next. What is happening now ti her that all of a sudden everything changed over night. Last week she was texting me and this week i am told she cannot text or hold her phone. I try to talk to my family but mostly i get that this is the process this is how it goes.
Any information you can give will be so helpful. I read things online but not much that explains how it all works once a person stops all treatments, doesnt want any doctors.
Best regards.

Hi Ana, in response to your question of whether I think your lady is suffering from having the “death rattle”. I don’t really have enough information to make a positive statement. If she is in the labor of dying and has congestion then she is like the little chick working to get out of it’s shell and that is work and a struggle but a normal part of dying.. If she is not actively dying than yes, she is having difficulty. If she is not actively dying (days to hours) then check with her doctor about medication that can help “dry up” the secretions. Blessings! Barbara

I’m a caregiver and my patient is doing the gurgling she been having high fever she suffers from Parkinson’s disease she’s still young she chokes with water or any baby food we give her do u think she suffering from the death rattle

Kylie, I am so sorry you and your family are having to experience the passing of your mum. It will never be okay for someone we love to leave us. Even though it may appear she does not hear you, she does. Talk with her, tell her how much you love her, tell her you are having difficulty seeing her like this and you may not be there when she finally lets go of her body. Have your father tell her how important it is that he be with her. We have limited control over the time that we die and if she knows from a point of love what everyone is thinking and feeling it will help her. My blessings are with you and your family. Barbara

I have taken some comfort in reading these comments. At this moment my dear mum is in palliative care and she has had the death rattle since early this morning. It was very confronting to arrive and hear her like this- and to think it can go for days. My dad has not left my mums room all day and I’ve told him it would be good to go home and have a shower and rest but he is worried that he will miss her passing, I think we all would like to be there with her but I for one am finding the sound so sad and have said my good bye to her even though I feel I am not ready. She is 69 years old and has pancreatic cancer

Hi Lisa, I do not think what your mother is experiencing is the “death rattle”. From the description you have given me I would say the “gurgling” is part of the cancer of lung as is the shortness of breath. The rest of the descriptions you have given me about your mother makes me think she has not entered the “labor” of dying (she is up and about, eating and drinking, alert). I don’t know your mother’s medical details but the “gurgling” as part of the disease process could be a factor that will evidently affect her breathing to the point of death. Hospice will know medications that can “dry up” some of the fluid but they won’t be able to “fix” it. I will keep you and your family in my thoughts and blessings! Barbara

Thanks for your site and blog. My mother was recently diagnosed with Stage 4 lung cancer. She went to the ER for back pain and after an x-ray, found 3 masses in her lungs, advised stage 4, terminal. She is very petite and based on the location of the tumors, they do not feel surgery is feasible. She has decided no treatment or second opinions. My father passed from lung cancer about 4 years ago, so this hits home and has just been shocking to us. She has chosen home hospice. She lives in Florida, my siblings and I all live in different states, so we stayed with her for 2 weeks, but had to get back to our jobs and families.

We have aunts and family helping her now. She has had some good days, but this week, hasn’t been able to sleep much. She says the pain in her back is extremely painful at night. They have her on morphine and Adavin but she struggles to sleep. We aren’t sure if it’s the pain from the cancer, or the pain from her not being able to breath well from the tumors.

We have also heard, off and on, gurgling. This week, the gurgling was really bad and she was wheezing and very hoarse. The hospice nurse came and said her lungs sound fine. Now, after a night of good sleep, the gurgling is gone. We are confused by this and researching today to find more information. My siblings and I are so torn. We do not know how much longer she has and since she still gets to the bathroom on her own, etc., we thought she had a bit of life still. She doesn’t eat or drink much, but that is pretty common for her. But this gurgling is concerning to us…is it the death gurgling we are hearing? Does that come and go..and would her lungs be clear when the nurse listens to them? We want to be with her during her last days, but the unknown is so hard at this point.

Thank you in advance for any information that may be provided!
Lisa

Hi Erika, I do not believe you have a “death rattle”. You are not dying. You are sick though and I suggest you go to your doctor so he can prescribe a medication to help clear up the congestion. Also when you sleep at night, until this is cleared up sleep with a lot of pillows to keep your head and back up (instead of laying flat). Sleeping in a recliner is good. My blessings are with you. Barbara

I have severe sinus infection and very chesty cough and this
What I as a nurse call death rattle for the sthird night when lying down to go to sleep a few times each night,however in the day I manage much better and do not experience such sounds. I am 83 apart from that , i have great apitite just fighting this infection wchich I will have checked to make sure it has not gone on to my chest.
As I am not in an way bed ridden and manage all self care ,drive my car , housework and gardening.
Does a person making this sound always have to die ? I am so scared .
Thank you

Hi Donna, yes, pulling tubes out can be part of the normal dying process. I think it is part of the restlessness that occurs that often signals death is one to three weeks away. Picking at the air, their clothes, the sheets and anything on their body (catheter, oxygen,) is very much a part of the normal process. How much longer can this go on? I don’t know, it could be days. We each die in our own way and in our own time. Think of a little chicken pecking its way out of the shell—some have to work harder and takes longer than others. Your husband is working to get out of his body, to release its hold on the earth. What can you expect now—more of the same. Don’t worry about food or water. As he is probably sleeping with his mouth open gently swab it as it will be dry. Keep him dry but I wouldn’t try putting the catheter back in (he will probably just pull it out again). He will be less and less responsive to you and words. He will have his eyes partially open, may be talking or muttering but not really responsive to you. Watch for his breathing to get slower and slower and then gape like breathing. Donna, know that he can hear you even if it appears he is non responsive. Talk with him, tell him how much you care for him, how much he means to you. I hope this reaches you in time to be of help. My blessings are with you and your husband. Barbara

My husband is in day 2 of the death rattle. I read somewhere, that as their body is shutting down, they pull out tubes from their body. He has pulled his catheter out and urinated through five blankets and two large pillows and he did not feel it. That was yesterday and now today he has not drank any water to speak of. What can I expect now and about how much longer does he have?

Hi Tori, in response to your sharing the night of your father’s death and wondering if he could hear and was trying to respond to you: I do believe a person can hear in the days, hours even minutes before death even though they are non responsive. From what you are telling me I believe your father was responding to you in the only way his body could. When a person is in the labor of dying I think they hear as if from afar, sound is off in the distance. Think of a little chicken trying to get out of its shell, how hard they work to free themselves. That is what the labor of dying is; trying to get out of this shell of a body. Your father was releasing from his shell and the love of you and your family was supporting him, loving him through it. I don’t see anything bad happening in your description. I see him responding to your love and support and finally releasing.
My thoughts and blessings are with you. Barbara

My father just passed 3 days ago. In regards to the dying person’s stimuli, I would like comfort in knowing if my father’s responses to touch and certain comments were actually him trying to communicate with us or if it was his body’s or brain’s reactions. During the first 5-7 hours of the doctors taking him off of the ventilator he had this death rattle. When my sister rubbed his head he would raise his eyebrows. While rubbing his hand with my thumb he would do it also, although it was in a slower motion than mine. When we would squeeze his hand, he would squeeze ours. When we would talk to him it seemed as though he was opening his eyes as a response to what we were saying (he was completely blind because of his massive stroke so we knew he couldn’t see us). During the last couple of hours of this death rattle all of these responses stopped. Was this him communicating during the first few hours of the death rattle or was this just his brain or nerve firings causing this? I’m still trying to cope with what we went through during the most horrific night of our lives.

Hi Allison, in regard to your two questions, one being about “flesh” in the suction tube and the other about your niece waiting for you to leave. One: I don’t know what was in the suction tube. It could have been colored mucus. If her mouth was very dry the suction could have peeled some skin. If there was no sign of blood I would say there was no harm done by the suctioning.
We do have limited time over the time that we die. Your aunt could have been protecting you and waited until you were gone.

My niece just passed on January 28th. I was present every day for the two months hospital stay. Towards the end, I noticed the great amount of fluid in her mouth and throat. When one of her visitors suctioned, she said she saw flesh inside the tube. Could that be? Also my niece passed away as soon I left for the evening. Could it be that she waited for me to leave?

Hi Suzie, thank you so much for sharing your experience with me. Although your mother’s death was disconcerting for you what you have shared sounds very normal. I don’t see anything pathological or abnormal in what occurred. The urine, stool, secretions and congestion were all part of the natural way we die.
Volunteering for Hospice, maybe with a No One Dies Alone program, would be a good way to give back. Having been at the bedside when death came gives you a perspective of dying that many don’t have.
Blessings to you. Barbara

I write this for others who are going thru it, My Mom passed from stage 4 pancreatic cancer late April. She was told to get her affairness in order when she was diagnosed, formally early February 2017 but really in January bc of blood work and they saw something on initial tests but no name given. Within 2 weeks from the end, she fell twice and I rushed her to the hospital for fluids. Her last week, 4 days prior she was agitated and needed a bedside potty tho there isn’t much to come out of the body at that point, yet they feel & say they will have a normal BM. Tiny amount of urine and one clay colored stool, the size of a half dollar was the last she passed 4 days prior. She was receiving her liquid comfort pack to sleep and keep pain at a low. level. AT that point she could no longer swallow fluids , so you must use a syringe to inject the prescribed drug under her tongue. Tho I knew about the death rattle, she never really had one but heavy breathing only sometimes, which sounds like any of us sleeping. What did happen and Hospice never described it as a possibility, was walking into her bedroom one evening to find black purplish gook mushrooming from one nostril as she slept. I freaked out. She was at that point unresponsive, and I dialed Hospice right away. These are very body secretions being released as discussed by the Author of this page. Earlier that day, she opened her eyes when the nurses came to move her to her side…but no verbal responses. She passed the following day when again the nurses arrived around 1230pm, to take her vitals (which still were low but ok). She passed when they moved her body to its side, with one last breathe, she was gone and her body shut down.

It is almost a year, and only now I can process and wanted to go over all the notes I took in a notebook as to amounts she ate, the day’s daily happenings. I hope in my retirement years, to have the time, to volunteer for Hospice and help those in their last days by readings to them, getting what they need etc.

Hi Carol, you are wondering if your dad suffered, was aware of his surroundings and if he was scared as he approached death in his last few days. Not knowing specifics I can’t give you a definite answer. Here is what I have observed and learned from others: most people in the days to hours before death, no matter their disease or symptoms, are non responsive. That means they do not respond to what is going on around them. They are not thinking or reacting in the way we normally would. Their body and mind is shutting down. They have withdrawn from what is happening around them. Just think of a little chick working to get out of its body. It has a job to do and is diligently working to get out of its shell. So we too, as we are dying, are working to release ourselves from the physical shell that has contained us while on earth. Are we suffering? If pain was an issue during the disease process then yes pain will still be there and we need to continue to give pain medicine. Dying itself is not painful. Disease causes pain. If the disease was not painful then now, as death approaches, the body feels heavy, very tired and achy all over but not what we interpret as causing suffering. It is us the watchers that interpret what we see as painful.
Was your father scared? In the months before death, when we are alert and have been told we can’t be fixed, yes we are scared. All of us will be frightened to some degree as we approach death. Death is the unknown and no matter our belief system we will be frightened as we face the unknown. In the days and hours before death are we scared? I don’t think so, at least not scared to the degree we were months earlier. We are so removed from this world we aren’t thinking about anything. Our mind is not active like a healthily mind is. I equate it to being almost asleep and hearing talking from a distance but you just don’t care as you drift off to sleep.
I hope you have found some comfort in these words. My blessings are with you. Barbara