According to Wikipedia, a “death rattle is a gurgling or rattle-like noise produced shortly before or after death by the accumulation of excessive respiratory secretions in the throat. Those who are dying may lose their ability to swallow, resulting in such an accumulation. While it is medically established that the death rattle is a strong indication that someone is near death, it can also be produced by other problems that cause interference with the swallowing reflex. It is sometimes misinterpreted as the sound of the person choking to death. In terminal care, drugs may be used to reduce secretions and minimize this effect.”
A study reported in Palliative Medicine was done to see how the death rattle sounds impacted hospice staff and volunteers. Most expressed negative feelings about hearing the sounds. Many felt the need to intervene to end the sounds using a therapeutic option. The study concluded that “doctors and nurses need to consider why, when and how they intervene and the consequences of that intervention.” You can read more about this study here.
It would be interesting to read firsthand information from hospice workers, healthcare staff members, and other caregivers regarding their personal experiences with a patient during a death rattle experience.
Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble Internet stores.
Hi--I am a hospice nurse with 15 years experience. Usually I medicate dying patients who have the death rattle with atropine or scopolomine simply because the sound upsets the family so much. Many families ask fearfully "Is that the death rattle?" and I just explain what causes it and how we will treat it. Knowledge can take away fear.
ReplyDeleteThanks for that information, Karen.
ReplyDeleteHello......not sure you will have an answer BUT, my mother in law is having a difficult time dying. In a hospice setting for 6 weeks.
ReplyDeleteSome coherence but only briefly. She is on 17.8 fentanyl by microdrip and
Ativan .25.....which makes her just zonked out......at times on the Ativan we hear what sounds like the death rattle. We are wondering if the Fentanyl is making it more difficult to work through the pain and then to die on her own. She wants to die, has resolved anything and everything, ready for this at 83. She expresses the desire to die.
Can you suggest any other helpful ways to approach this for her. Thank you.
I wish I could help you, but, as you suspected, I am not qualified to comment on this medical matter. I can only suggest that you seek further assistance from others who can. You are fortunate that your mother has "resolved anything and everything" before her death. I hope you find the answers you seek.
ReplyDeletei usually suggest turning patients side to side prior to any medicine and explain to the family what is going on internally with regard to the uvula relaxing air going thru etc
ReplyDeleteHilde, thanks so much for sharing that. Through the years, this post continues to get many hits. Apparently, a I lot of people are interested in death rattle sounds.
ReplyDeleteWe are experiencing these sounds from my mother-in-law right now and are trying to get her into the hospice care center. Although we understand what causes theses sounds, we are more concerned that she may be feeling pain or discomfort totally unrelated to them. We know the staff at the care center can do a much better job at keeping her totally comfortable than we can at home.
ReplyDeleteThank you for sharing your experience. I wish you all the best on your mother-in-law's journey.
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