People who work in palliative care, the kind of care given to people in the final stages of life, are very familiar with a certain sound that often signals that a person has less than a day left to live. This sound is known as the “death rattle.”
Those who care for people nearing the end of their lives witness many physical signs that the body is slowly shutting down. These signs can appear weeks or even months before death.
A person may begin sleeping more, losing their appetite, and drinking less. As death gets closer, their energy fades, and their body gradually slows down.
A few days before death, some patients experience what is called “the rally.” During this brief period, they may suddenly seem much better they eat more, talk more, and appear more alert.
This can give families and loved ones hope that they’re recovering. Sadly, this improvement doesn’t last. It’s simply the body’s final burst of energy before it declines again. Shortly after, in the final hours of life, the death rattle often begins.
People who have heard the death rattle describe it as a wet, crackling, or gurgling sound that happens when the person breathes. Some compare it to heavy snoring or bubbling.
While the sound can be distressing for family members to hear, doctors and nurses explain that the person making the sound is not in pain. It happens because they can no longer clear fluid or saliva from their throat. Once the death rattle starts, most people have around one day left to live, though in some cases, it can last slightly longer.
According to medical experts, the sound comes from mucus or saliva collecting in the back of the throat. Normally, a person could cough or swallow to clear it, but as the body weakens near death, it loses that ability.
A hospice nurse named Julie explained that this buildup of saliva is a natural and expected part of the dying process. It doesn’t mean the person is choking it’s simply a sign that the body is shutting down.
For loved ones, hearing the death rattle can be very emotional and even frightening, as it may sound like the person is struggling to breathe. However, at this point, the best thing caregivers can do is to keep the person comfortable.
Nurses often turn the person onto their side, raise their head slightly to help drain the fluid, keep their mouth moist, and reduce how much fluid they are given to prevent further buildup.
These small adjustments might reduce the sound, but they usually don’t stop it completely. The main focus in these final hours is to ensure peace and comfort, not to try to reverse the process.
