Does the death rattle mean the person is choking?
The death rattle usually means secretions are pooling in the throat, not that the person is choking in the usual sense.
The death rattle usually means secretions are pooling in the throat, not that the person is choking in the usual sense. A dying person may be too weak or sleepy to swallow saliva or cough it away. Air moving through the fluid makes the sound.
It can be awful to hear. It often worries family more than the dying person, especially when the person is unconscious. Still, ask the care team to assess the person if they look distressed.
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.
Choking and death rattle are different
Choking usually means food, fluid or another object is blocking the airway and the person is trying to cough, breathe or clear it.
The death rattle is usually different. It happens when saliva or secretions collect because the person is weak, very sleepy or unconscious. The person may not be trying to cough because their body is shutting down.
How to tell if they may be distressed
Look at more than the sound. Ask for help if the person:
- looks frightened or panicked
- is gasping with distress
- has blue lips with distress
- is coughing or choking after food or fluid
- is restless and cannot settle
- is grimacing, moaning or tense.
If the face and body are relaxed, the person may not be troubled by the sound.
What may help
Ask the nurse or palliative care team about turning the person slightly to the side or raising the head of the bed. Mouth care can help keep the mouth comfortable.
Medicines may be used in some situations to reduce secretions. They do not always work, and they can make the mouth drier. The team will weigh up whether they are likely to help.
Do not try to force coughing. Do not put food, drink or tablets into the mouth if the person is drowsy or unable to swallow.
Should suction be used?
Sometimes fluid can be gently cleared from the mouth. Deeper suctioning is not always helpful and can be distressing. Ask the team before trying anything.
If you are at home, the care plan should tell you who to call. You should not be expected to manage frightening breathing changes alone.
When to get help now
Contact the palliative care team, GP, nurse or aged care staff urgently if the person appears to be choking, coughing after fluids, frightened, blue with distress, severely breathless, or you are unsure what to do.
Call 000 if this is a sudden choking or breathing emergency and there is no end-of-life plan telling you what to do.
You may also want to read
- What is the death rattle?
- Can a dying person feel the secretions in their throat?
- Can I give water to someone who is having trouble swallowing?
- Are they suffering when breathing becomes noisy, irregular or stops for periods?