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.
66 comments
Barbara Karnes
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
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
Barbara Karnes
Hi Shallen, In regards to your question of do I think your mother is experiencing a “death rattle”, no I do not. I think the congestion she is experiencing is part of the cancer in her lungs. Actually my mother died from lung cancer and experienced what your mother is experiencing for months. Cough syrup and prednisone are often helpful for awhile but know the cancer is progressing no matter what we do. All that we do is to help with the symptoms but at some point everything will stop helping. I don’t think the medications are slowing down the dying process. They are attempting to provide some comfort. Your mother is up and about although slowly so it does not appear she actively dying (1 to 3 weeks). If you have not read Gone From My Sight you may find it helpful. https://bkbooks.com/collections/all-products/products/gone-from-my-sight-the-dying-experience
My blessings are with you and your mother. Barbara
Hi Shallen, In regards to your question of do I think your mother is experiencing a “death rattle”, no I do not. I think the congestion she is experiencing is part of the cancer in her lungs. Actually my mother died from lung cancer and experienced what your mother is experiencing for months. Cough syrup and prednisone are often helpful for awhile but know the cancer is progressing no matter what we do. All that we do is to help with the symptoms but at some point everything will stop helping. I don’t think the medications are slowing down the dying process. They are attempting to provide some comfort. Your mother is up and about although slowly so it does not appear she actively dying (1 to 3 weeks). If you have not read Gone From My Sight you may find it helpful. https://bkbooks.com/collections/all-products/products/gone-from-my-sight-the-dying-experience
My blessings are with you and your mother. Barbara
Carol
My dad has passed away two days ago . However the rattle was for days and he couldn’t communicate . I was scared for him and how he must have been feeling . Was he aware was he scared was he suffering …. I am suffering just thinking about it ?
My dad has passed away two days ago . However the rattle was for days and he couldn’t communicate . I was scared for him and how he must have been feeling . Was he aware was he scared was he suffering …. I am suffering just thinking about it ?
Shallen
My mom has lung cancer and has had for years. Shes getting weaker and eating and drinking less. She sleeps a lot now sometimes all day. Sometimes she can get up and do a few things around the house but it takes everything out of her. 2 weeks ago her lungs started rattling, really bad. They put her on steriods, z-packs and some kind of cough pill. They have given it two her twice now. It doesnt seem like its helping. I want to think there just slowing down the process. When my grandma had the death rattles she was dead with in a few days. She coughs but it doesnt come up. Do you think she has the death rattles? It sounds like it to me but this has been going on for two weeks now. Cancer is a epidemic now, the new plague. My daughter who was 3 passed last year from leukemia. I really hope you can answer my question and give me your thoughts. Thankyou!
My mom has lung cancer and has had for years. Shes getting weaker and eating and drinking less. She sleeps a lot now sometimes all day. Sometimes she can get up and do a few things around the house but it takes everything out of her. 2 weeks ago her lungs started rattling, really bad. They put her on steriods, z-packs and some kind of cough pill. They have given it two her twice now. It doesnt seem like its helping. I want to think there just slowing down the process. When my grandma had the death rattles she was dead with in a few days. She coughs but it doesnt come up. Do you think she has the death rattles? It sounds like it to me but this has been going on for two weeks now. Cancer is a epidemic now, the new plague. My daughter who was 3 passed last year from leukemia. I really hope you can answer my question and give me your thoughts. Thankyou!
Barbara Karnes
Sadness, I received your comment on my blog asking about how to keep your mum comfortable. From a physical stand point elevate the bed a bit, turn her from side to side to see if either side reduces the congestion. Sometimes just positioning will ease the congestion. If she is having what appears to be difficulty breathing, oxygen may help. Don’t be surprised if it doesn’t. Rubbing her hands and feet gently is often comforting. When she is on either side gently rub her back with lotion. That is for her physically. Emotionally talk with her. Don’t expect a reply but tell her your comings and goings.ALso tell her how much she has meant to you, how much you love her, what a great mum she is. Maybe play softly music that she enjoys. Spend quiet time with her just being there, holding her hand or just sitting by the bed. This is a special time, a gift you have been given. My blessings are with you and your mum. Barbara
Sadness, I received your comment on my blog asking about how to keep your mum comfortable. From a physical stand point elevate the bed a bit, turn her from side to side to see if either side reduces the congestion. Sometimes just positioning will ease the congestion. If she is having what appears to be difficulty breathing, oxygen may help. Don’t be surprised if it doesn’t. Rubbing her hands and feet gently is often comforting. When she is on either side gently rub her back with lotion. That is for her physically. Emotionally talk with her. Don’t expect a reply but tell her your comings and goings.ALso tell her how much she has meant to you, how much you love her, what a great mum she is. Maybe play softly music that she enjoys. Spend quiet time with her just being there, holding her hand or just sitting by the bed. This is a special time, a gift you have been given. My blessings are with you and your mum. Barbara
Sadness
My mum has the rattle, this is Day 2/3. She is still communicating with little sentences but isn’t really eating or drinking. The doctors said weeks but my dad thinks it will be a matter of days. Does anyone have any advice on how to make my mum as comfortable as possible in her final days
My mum has the rattle, this is Day 2/3. She is still communicating with little sentences but isn’t really eating or drinking. The doctors said weeks but my dad thinks it will be a matter of days. Does anyone have any advice on how to make my mum as comfortable as possible in her final days
Partha
Thanks a ton my freind!
My mum has left me when I was 3.5 yr
My grandma has taken utmost care of me and now I am 22..
She left me yesterday..
I was cursing self as I could nit help him but let him die..
But after going through it …
I feel better…
Thanks again
Thanks a ton my freind!
My mum has left me when I was 3.5 yr
My grandma has taken utmost care of me and now I am 22..
She left me yesterday..
I was cursing self as I could nit help him but let him die..
But after going through it …
I feel better…
Thanks again
Uriel
My dad has had this rsttle for days… At this time I think he is unconscious… Thank you for the article
My dad has had this rsttle for days… At this time I think he is unconscious… Thank you for the article
Barbara Karnes
Hi Sacha, In regard to your mother having “the rattle” for seven days know that what we call “ the death rattle” is really just a lot of congestion in the lungs. Have you tried positioning? Sometimes something as simple as that reduces it. Sometimes a scopolamine patch or atropine eye drops will help.
Know her body is shutting down, nothing works right and she is probably not as uncomfortable as she appears.
Think of a little chick trying to get out of its shell, how hard it works to be free. That is what our labor to leave our shell is all about.
My thoughts and blessings are with you during this challenging time. Barbara
Hi Sacha, In regard to your mother having “the rattle” for seven days know that what we call “ the death rattle” is really just a lot of congestion in the lungs. Have you tried positioning? Sometimes something as simple as that reduces it. Sometimes a scopolamine patch or atropine eye drops will help.
Know her body is shutting down, nothing works right and she is probably not as uncomfortable as she appears.
Think of a little chick trying to get out of its shell, how hard it works to be free. That is what our labor to leave our shell is all about.
My thoughts and blessings are with you during this challenging time. Barbara
Sacha
My mum is in hospice care and is now on day 7 if the rattle. We were told 5 days ago she only had hours left and she is still here. She is completely unresponsive. It’s heartbreaking.
My mum is in hospice care and is now on day 7 if the rattle. We were told 5 days ago she only had hours left and she is still here. She is completely unresponsive. It’s heartbreaking.
Jeanette
My husband has the rattle sound as I post,he is at the hispital at the moment.I know he is in his last days and I pray that he goes in peace without suffering.
My husband has the rattle sound as I post,he is at the hispital at the moment.I know he is in his last days and I pray that he goes in peace without suffering.
Trudy Johnson
My mother started the death rattle last night. She is in hospice care . Her nurse said she would pass within days. This afternoon even.
We’ve called her siblings as well as her 87 yr old mother.
This is heartbreaking to witness and listen to, but she knows we are all here. I’ve played her fav songs from the oldies since I got here
Thank you for your time
My mother started the death rattle last night. She is in hospice care . Her nurse said she would pass within days. This afternoon even.
We’ve called her siblings as well as her 87 yr old mother.
This is heartbreaking to witness and listen to, but she knows we are all here. I’ve played her fav songs from the oldies since I got here
Thank you for your time
LaVon
I find the article Very comforting. The touching and talking comes naturally to me.. If she hears me, I’m so glad to show my love. If not, I’m still glad to show my love. My first inclination is to get suction. Makes sense to me. Thank you.
I find the article Very comforting. The touching and talking comes naturally to me.. If she hears me, I’m so glad to show my love. If not, I’m still glad to show my love. My first inclination is to get suction. Makes sense to me. Thank you.
Barbara Karnes
Scott, I can’t prove that a person can hear although I have many examples of thinking a person was non responsive and suddenly have them open their eyes, or squeeze a hand—not often but occasionally. My suggestion to talk and touch comes from the idea that since we don’t know for sure we have nothing to lose by talking and touch and an opportunity is lost if we don’t. Also there are situations where a person was non responsive, in a “coma” for years, wakes up and relates what people said and did during the time they were non responsive.
About the person not being uncomfortable, of being “removed from their physical body”, I believed we are less aware of and less attached to our body and surroundings. Nothing in our body is working right as it disconnects. That said, I also believe in medicating for pain, if it has been part of the disease process, right up to the moment of death. Again, not knowing for sure, I will err on the side of comfort.
Scott, I can’t prove that a person can hear although I have many examples of thinking a person was non responsive and suddenly have them open their eyes, or squeeze a hand—not often but occasionally. My suggestion to talk and touch comes from the idea that since we don’t know for sure we have nothing to lose by talking and touch and an opportunity is lost if we don’t. Also there are situations where a person was non responsive, in a “coma” for years, wakes up and relates what people said and did during the time they were non responsive.
About the person not being uncomfortable, of being “removed from their physical body”, I believed we are less aware of and less attached to our body and surroundings. Nothing in our body is working right as it disconnects. That said, I also believe in medicating for pain, if it has been part of the disease process, right up to the moment of death. Again, not knowing for sure, I will err on the side of comfort.
Peggy
You’re article is providing our family comfort during this difficult time.
You’re article is providing our family comfort during this difficult time.
Scott
I am writing this as my mom is in Day 2 of the rattle. What is hard for me to rationalize in this article is the dying person is both so unaware of the rattle yet are aware they are being touched. I don’t see how both are true or how we’d really know. For my comfort I’ll pretend I believe the entire article.
I am writing this as my mom is in Day 2 of the rattle. What is hard for me to rationalize in this article is the dying person is both so unaware of the rattle yet are aware they are being touched. I don’t see how both are true or how we’d really know. For my comfort I’ll pretend I believe the entire article.