The rattle can occur when a dying person is no longer be able to swallow, cough, or otherwise clear saliva and mucus from the back of the throat, and because secretions in the respiratory tract may be increased.
The sound varies. It may be a crackling, wet noise that is amplified as the person breathes. In other cases, it may sound like a soft moaning with each breath, or a very loud gurgling or snoring.
While the sound may be unpleasant, the person emitting the death rattle usually feels no pain or discomfort.
The death rattle signals that death is very near. On average, a person usually lives for 23 hours after the death rattle begins.
What are the causes?
A person nearing death may be unable to clear secretions from the back of their throat, causing the death rattle.
The death rattle happens because the person can no longer remove secretions, such as saliva and phlegm, from the back of the throat.
People normally clear these secretions without any trouble, but a person nearing death may not have the strength.
Breathing patterns change as someone nears death.
Breaths may alternate from quiet to very loud.
A dying person may draw a sharp breath, then not breathe for several moments. This labored breathing may amplify the death rattle.
The death rattle is a sign that a person is approaching death. With each breath, a person may make a moaning, snoring, or rattling sound.
The following can also occur as a person nears death:
- lung congestion
- frequent yawning to draw more oxygen into the body
- a change in the pattern of breathing or difficulty breathing
- a difference in the odor of a person
- dark bruising
- cold and bluish extremities
- drifting in and out of consciousness
- mottled skin
The death rattle can sound like the person is choking. However, no evidence suggests that the dying person is aware of the sound or experiences any related pain or unease.
How is it managed?
A nurse or medical professional can provide advice on easing the sound of a death rattle.
The death rattle is not painful. However, it may be upsetting for the dying person's loved ones. A nurse may do the following to ease the sound:
- turn the person on their side
- raise the head so the secretions can drain
- moisten the mouth with damp swabs
- use suction to drain secretions from the mouth
- limit fluid intake
- administer medication to clear the secretions
Proposed treatments are unlikely to prevent a death rattle, emphasizing that it is a natural stage of dying.
Medical professionals caring for a dying person will explain the noise to any loved ones present.
Addressing the grief and needs of loved ones may help everyone to be more comfortable during the dying process.
When a terminally ill individual has a death rattle, it often means that death is very near.
The noisy breathing can be distressing to family and other loved ones witnessing the death, but there is no evidence that the dying person experiences pain or discomfort.