Death Rattle, Families, Signs of Dying (Research, Video 3:27)

A crackling, gurgling sound emanating from a dying person’s throat can distress onlookers who have not been prepared for this occurrence. Overwhelmed with fear and guilt, they often assume a loved one is choking to death. Caused by terminal secretions, these rattle-like breathing sounds which occur near death are commonly referred to as the death rattle. 

The level of consciousness in patients who appear to be actively choking while experiencing the death rattle is usually so low that it is generally assumed that they are not in pain. Death rattle research advises healthcare providers to reconsider the use of drugs to treat death rattle symptoms. Some of the drugs involved have negative side effects. Caregivers and loved ones should be educated regarding the death rattle experience and reassured about the unlikelihood of patients’ pain.

Supporting this need for more education is additional death rattle family research focused on bereaved family members who had witnessed the anxiety of watching a death rattle experience. This study involved 663 questionnaire surveys conducted in 95 palliative care units, Among family members who participated, 46% of respondents had witnessed the death rattle. Of these participants, 66% reported high distress levels, and 53% perceived a strong need for improved death rattle care.

This research concluded that family distress could be reduced by having medical staff lessen patients' symptoms with comprehensive and supportive care strategies. These strategies would include decreasing secretions and uncomfortable smells along with alleviating torment of family members through education.

Like every life, every death is also unique. This video explains other end-of-life signs of approaching death and gives a more complete description of what to expect. 

VISIT THIS LINK for more information about the death rattle impact on hospice workers and more than 40 comments from readers. 

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.
Hospice and Nursing Homes Blog

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Hospice Elders Need Control Opportunities During Dying Process

Control, we all crave it on some level. When it’s not there when we want it, our spirits feel stifled. Even toddlers will assert themselves when they feel their power slipping away. What about control needs of terminally ill elders in hospice care? Do they strive to exercise control over aspects of the dying process? Research says they do.

The School of Social Work at the University of Wisconsin-Madison explored this issue through in-depth face-to-face interviews with 84 terminally ill elders receiving hospice care. Interestingly, all 84 elders used at least one primary control strategy.  83 of them practiced one primary control strategy in combination with anther primary or compensatory secondary control strategy. Aspects of the dying process that they sought to control were these: Decision making, independence, mental attitude, instrumental activities of daily living, activities of daily living, and relationships

Although over half of the elders wanted more control, they felt their illnesses prevented them from having it. How frustrating might that be? What do these results say to caregivers of terminally ill elders? They say that these elders are just like everyone else in wanting to feel empowered. These results remind us of how important it is to be sensitive to control needs of terminally ill hospice patients. Even as they are dying, they still need opportunities to be proactive in their everyday living.

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”