One of the more well-known –  and frequently misunderstood – end-of-life signs is terminal respiratory secretions. This symptom has come to be known in layman’s terms as “a death rattle” or “noisy breathing.” Helping families understand what a death rattle is can help alleviate their concerns.

What is a death rattle?

Terminal respiratory secretions occur when saliva and mucous build up in a patient’s throat. As a terminally ill person becomes weaker or loses consciousness, they may lose the ability to swallow or clear their throat. The result is a wet, crackling sound as the secretions move in time to the patient’s breathing.

Caring for a patient with a death rattle.

While terminal respiratory secretions do not indicate respiratory distress in the patient, the sound can be very concerning to family members.  Medication including Hyoscyamin (Levsin) or Atropine may be administered to decrease saliva production. Repositioning the patient on their side and elevating the head of the bed can be done to help keep the patient comfortable and to aid in performing mouth care.

“The sounds of terminal respiratory secretions, “the death rattle,” can be difficult for the family to hear, but the patient is not in distress.  They are transitioning naturally to the final stage,” says Crossroads Clinical Director Irene Rifkin. “Family members can continue to talk to their loved one, continue to hold their hand, and continue to offer comfort.”

When the Crossroads Hospice & Palliative Care team see these types of signs and symptoms that indicate the patient is near death, our EvenMore Care© program is activated. A member of the Crossroads team will remain with the patient to provide care and support the family.

Crossroads has been ranked in the top five of hospices nationwide by the Centers for Medicare and Medicaid Services (CMS) for the number of hours our team spends with patients in their last seven days. If you have questions about end-of-life signs and symptoms or wish to schedule a hospice consultation, please call us at 1-888-564-3405.