What Is a Death Rattle?

What is the death rattle? If you care for a loved one in the last days of life, you might be upset after learning about the “death rattle” or other alarming breath sounds that you may hear when death is near.

This article will go over what the death rattle means, why the death rattle is a common symptom of impending death, and what you should know if you’re caring for a loved one at the end of their life.

What Death Rattle Means

Since a dying person can no longer swallow or cough, phlegm and saliva can build up in the back of the throat and upper airways. The "death rattle" is the name for the sound the fluid makes a sound as air passes through it."

The death rattle appears to be slightly more common in females but can appear in people of any age dying of any cause. 

Studies have shown that the death rattle is heard to some degree in roughly half of dying people.

Is It Uncomfortable?

The death rattle can be very hard for a dying person’s loved ones to hear but it is a normal end-of-life event that is not uncomfortable for the person who is dying, even if they are partially awake as it’s happening. 

The death rattle does not mean the person is "drowning" or having a "bad" death.

People with a death rattle while dying do not have any more trouble breathing than those who do not have one.

Likewise, the quality of the death rattle sounds you hear—how loud they are, for example—is not a measure of how much breathing distress there is. Even some treatments for a death rattle won't necessarily change the sounds.

The death rattle can be very upsetting for loved ones and caregivers. One study found that at least 66% of loved ones of a dying person found listening to the death rattle highly distressing.

Is There a Treatment?

There are ways to dry up excess fluid that causes a death rattle, but remember that it is a normal and common step in dying. Your loved one does not feel like they are suffocating because they are breathing this way.

You can try a few things if the death rattle makes you anxious. They include:

• Medications for fluid buildup: If you have a hospice comfort kit, it likely has a medication for drying up the fluids. This is usually either atropine or scopolamine.
• Changing your loved one's position: The death rattle may seem worse when someone lies flat on their back. Simply rolling your loved one over a bit may help. You can also try placing your loved one's head higher than their body and turning it to one side to help the fluids drain.

How Near Is Death?

Many people wonder how long it will be until death when a loved one develops a death rattle. 

The timing varies from person to person, making it hard to predict exactly what the rattle means about impending death.

At the end of life, a person may seem agitated and confused. Others become unexpectedly calm during this time. Providers refer to these changes at the end of life as terminal restlessness and it is a normal part of the dying process.

It’s not uncommon for a dying person to speak of seeing loved ones who have died, which is often comforting and may even make them smile.

Try to resist correcting your dying loved one during this time and instead, just focus on being present with them.

Being Present

Being with your loved one while they are dying is hard, but it is a loving gesture. When people talk about their greatest fears, they often fear that they will die alone. Your presence is the greatest gift you can ever give to someone you love who is going through the dying process.

Don't stop talking to your loved one, even if you do not think they are aware of what’s happening around them. It's thought that hearing is the last sense to disappear, and even if they seem unconscious, your loved one may still sense your presence and be able to hear what you are saying.

At the same time, you must take care of yourself during this process. Take a break when you need to and make sure that you are tending to your own needs.

Summary

The "death rattle" is a sign that a person may die soon, maybe even in a matter of hours. The sound of the death rattle is very common when someone dies.

The gurgling sound is caused by fluid your loved one can no longer swallow. It is hard to hear, but knowing it does not hurt or harm your loved one can provide you with some reassurance and help you stay present with your loved one at the end of their life.