Death Rattle When Someone Is Dying

What is the death rattle? If you are caring for a loved one in the last days of life, you may be upset after hearing about the death rattle that may one day come. Or you may hear alarming breath sounds now and wonder if this is the end.

Let's talk about what the death rattle means. This article explains how the death rattle affects loved ones, why the dying person isn't frightened by it, and things you can do to try and make it better.

Woman on oxygen in a hospital bed with man in the background looking at her
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What Death Rattle Means

The "death rattle" is a kind of gurgling sound that you may hear when people are dying. It happens because they are no longer able to swallow or cough, so saliva builds up in the back of the throat and upper airways. The fluid causes the rattling sound when air passes through.

It appears to be slightly more common in women but otherwise can appear in people of any age who are dying of any cause.​ The "death rattle" occurs to some degree in roughly half of people who are dying.

People have wanted to know more about death and dying, and science has shown that it's an active process. There are steps in how the body shuts down, just as there were steps at birth, during the teen years, and in other stages of life. The death rattle is one of those steps and it likely means that death is very near.

Is It Uncomfortable?

The death rattle can be very hard for family members to hear. Still, it is a normal end-of-life event that is not uncomfortable for those who are dying, even if the person seems partially awake. It does not mean that the person is "drowning" or having a "bad" death.

People who have 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 of the treatments for a death rattle won't necessarily change the sounds.

Death rattle sounds can be noisy, but they are not upsetting to the person who is dying.

In contrast to the dying person, however, the death rattle can be very upsetting for loved ones and caregivers. In one study, at least 66% of loved ones of a person dying found that listening to the death rattle is highly distressing.

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

Is There a Treatment?

If the death rattle is making you anxious, there are a few things you can try. 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 is lying flat on their back. Simply rolling your loved one over a bit may help. You can also try placing the head higher than the 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 someone develops a death rattle. It varies a lot from person to person and makes it hard to predict exactly what the rattle means in terms of time.

You may wonder what else to expect in the final stages of death. Terminal restlessness is common at this time, and your loved one may appear very agitated.

They also may express near-death awareness and tell you they are 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 them.

Being Present

Being with your loved one while they are dying is challenging, but it is the most loving thing anyone can do. 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.

Don't stop talking to your loved one. It's thought that hearing is the last sense to disappear, and even if they appear unconscious, they may still sense your presence or hear what you are saying.

At the same time, you need to take care of yourself as your loved one might wish. Everyone needs a break once in a while, and this is more important than ever. The death rattle is just one sign that time is short. Don't be afraid to take a moment to step away if you need to.

Summary

The "death rattle" is one sign that the end is quite near, perhaps in a matter of hours. It is very common when someone dies. The gurgling sound is caused by fluid that your loved one can no longer cough up or swallow. It is hard to hear, but it is good to know that it does not hurt or harm your loved one.

A Word From Verywell

Sometimes knowing a thing doesn't make it any easier to experience. That may be true as you listen to a loved one with a death rattle, knowing in your head that it's a common part of the dying process but still feeling the distress in your heart. That's common too. Don't be afraid to talk it over with a family member, the hospice team, or someone else you trust to share these feelings with.

Frequently Asked Questions

  • Is gurgling the same as a death rattle?

    Gurgling most often describes the sound of fluid in the lungs. It can occur as part of the death process. "Death rattle" usually refers to the noise of saliva pooling in the back of the throat.

  • How can you tell a loved one is near death?

    Cold skin, noisy breathing, and loss of consciousness are among the signs that death may be near. Not everyone will exhibit all of them, but it's good to know them so you're able to support your loved one without showing fear or alarm.

  • How long will a person live once they develop a death rattle?

    Typically, a death rattle will begin when a person is hours away from dying, although some people may continue to live for a day or two.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. van Esch HJ, Lokker ME, Rietjens J, et al. Understanding relatives’ experience of death rattleBMC Psychol. 2020;8(1):62. doi: 10.1186/s40359-020-00431-3

  3. Boland JW, Boland EG. Noisy upper respiratory tract secretions: pharmacological managementBMJ Supportive & Palliative Care. 2020;10(3):304-305. doi: 10.1136/bmjspcare-2019-001791

  4. Blundon EG, Gallagher RE, Ward LM. Electrophysiological evidence of preserved hearing at the end of lifeSci Rep. 2020;10(1):10336. doi:10.1038/s41598-020-67234-9

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