Definition and Overview of the Death Rattle

What Does the Death Rattle Mean in Dying?

older woman on oxygen at end of life
What is the death rattle?.

Definition: Death Rattle

The so-called "death rattle" refers to a gurgling sound that individuals often make during the dying process. When people are no longer able to swallow or cough, saliva builds up in the back of the throat and the airways causing a "rattling" sound when air passes through.

What Causes the Death Rattle?

The death rattle occurs due to a build-up of wet secretions at the back of a patient's throat.

When the muscles in the face, throat, and chest become too weak to clear the secretions, they linger in the throat

Is The Death Rattle Uncomfortable?

While the death rattle can be very hard for family members to listen to, it is a normal end-of-life event that is not uncomfortable for those who are dying. If family members are distressed, there are medications that can be used to dry up some of the excess secretions that contribute to the death rattle.

What Does the Death Rattle Mean?

The death rattle likely means that death is very near and that the body has begun to shut down. While in the past we thought of death as "just happening" we are now learning that death is an active process - the body goes through a number of steps in its process of shutting down.

Is There Anything That Can Be Done

Listening to the death rattle can be very unnerving for family members. Even if you tell yourself that it is normal and that it is not uncomfortable for your loved one, it can still make you feel anxious.

Unlike the one who is dying, it can be uncomfortable for those who are present. If the death rattle is making you uncomfortable there are a few things you can try:

  • Medications for Secretions - If you have a hospice comfort kit you will note that there is a medication for drying up secretions which may help. This is usually either atropine or scopolamine
  • Changing your loved one's position - Often simply rolling your loved one over a bit can reduce the rattle which is often more pronounced when patients are lying flat on their backs. You can also try elevating their head and turning it to one side to help drain the secretions.

How Near is Death?

Many people wonder how long it will be until death when someone develops a death rattle. Unfortunately, it varies a lot from person to person making it hard to predict exactly what the rattle means to you specifically. You may be wondering what else you can expect in the final stages of death. Something called terminal restless is common at this time, and your love one may appear very restless.  There is also the concept of near death awareness and she may tell you she is dying. Many people at this point speak of seeing loved ones who have died before, and some people even begin to smile. Don't try to correct your loved one, just love her.

What Should You Know About the Dying Process?

Being with your loved one while they are dying is incredibly challenging, but is the most loving thing anyone can do for a loved one. When people talk about their greatest fear in life, it is often that they will die alone.

Your presence is the greatest gift you can ever give.

Yet even with knowing that, it's important that you take care of yourself. Everyone needs a break once in awhile, and in the setting of death, this is more important than ever.

Don't stop talking to your loved one. It's thought that hearing is the last sense to disappear, and even if she appears deeply comatose, she may still sense your presence or hear what you are saying. You don't need to say anything in particular - just let her know you are present. Some people fear taking a moment for themselves fearing their loved one will die while they are gone.

Take care of yourself as your loved one would wish. In fact, it seems that some people wait for a moment when their loved ones step out to take their last breath.

Alternate Spellings: death-rattle


Wee, B., and R. Hillier. Interventions for noisy breathing in patients near to death. Cochrane Library. 01/23/08.

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