In many cases of people in palliative care, their breathing is accompanied by a gurgling sound, known as the “death rattle.” Although it can disturb the listener, the sound is a sign that the person is relaxed and is already losing consciousness.
Witnessing the death of a loved one can be a deeply emotional and upsetting experience. Among the many signs of body decline is “death rattle,” a term that can evoke fear but often means that the dying person is in a state of deep, unconscious rest.
In the days leading up to death, individuals often have prolonged episodes of unconsciousness, as reported by Cancer Research UK. Sleep becomes more frequent and conscience fades as the body approaches its final moments.
Paradoxically, some individuals may experience terminal lucidity – a sudden burst of energy or clarity. This phenomenon has been observed in people who briefly recover the ability to speak or even remember memories that were thought to be lost due to illnesses such as dementia or strokes, explains .
Physical changes are also common during this phase. Loss of intestinal control, changes in breathing patterns and the characteristic death rattle are some of the signs that the body is shutting down.
This death rattle, in particular, is caused by accumulation of mucus and fluid in the throat and chest, creating a gurgling or noisy sound during breathing. Although it is distressing for bystanders, experts emphasize that it often reflects deep unconsciousness rather than discomfort.
Dr. Kathryn Mannix, palliative care specialist and author of With The End In Mind: How to Live and Die Well, explains that this noise indicates relaxation, not distress. “The death rattle is an unnerving noise…but it tells me that this person is deeply, deeply unconscious“, he said. The body is so at ease that normal reflexes, such as coughing or swallowing to clear the throat, are no longer active.
Despite its clinical explanation, the death rattle can be deeply disturbing for family members. A 2020 study highlighted that many family members considered him stressfulwith some describing it as “horrible”. This emotional impact has prompted calls for more research into medical interventions to alleviate the sound, potentially reducing the suffering of loved ones.
