Can a dying person feel the secretions in their throat?
A dying person may not feel throat secretions if they are deeply sleepy or unconscious, but comfort still needs to be checked.
The rattling sound can be much more distressing for family than for the person who is dying. Secretions can still matter. If the person looks frightened, tense, breathless or uncomfortable, you can ask the care team to assess them or try repositioning them.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Why they may not feel it
Near death, many people are very drowsy or unconscious. They may swallow less often and cough less strongly. Saliva and secretions can pool in the throat or upper airways without the person being awake enough to notice or clear them.
There is no evidence that noisy breathing from secretions distresses the person experiencing it, though it can distress family and carers. You can try to think of it as similar to snoring.
Why families hear it so clearly
The sound can be loud, wet, gurgly or rattly. It can those hearing it feel as if the person is drowning or choking, even when the person is not showing signs of distress.
That fear is understandable. Ask the treating team to explain what they see. A useful question is: "Do they look distressed, or is the sound more distressing for us?"
Signs the person may need help
Ask for review if the person has:
- a frightened face
- gasping with panic
- blue lips with distress
- moaning, grimacing or tense muscles
- repeated restlessness
- coughing or choking after food or fluid
- breathing that suddenly becomes much harder.
These signs may mean pain, breathlessness, choking, delirium or another problem needs treatment.
What may help
Positioning may reduce the sound. Most of the sound usually comes from saliva or spit in the back of the throat - often by turning them slightly or tilting their head you can allow the saliva to move to other areas. You can also try raising the head of the bed. Find positions that they would find comfortable.
Mouth care should continue. Medicines may be used in selected cases to reduce saliva, but they can make the mouth very dry, and do not always help.
Avoid trying to suction deep in the throat unless trained staff advise it. It can cause distress and in some cases harm, and may not actually improve comfort.
When to get help now
Contact the palliative care team, GP, nurse or aged care staff urgently if the person seems distressed, choking, severely breathless, frightened, or if the sound has changed suddenly and worries you.
Call 000 if this is sudden choking or breathing distress in someone not expected to be dying, or if there is no end-of-life plan and you need emergency help.
You may also want to read
- What is the death rattle?
- Does the death rattle mean the person is choking?
- Are they suffering when breathing becomes noisy, irregular or stops for periods?
- Why does a dying person's breathing suddenly change?