People may have noisy throat or chest secretions in the last days and hours of life. They are unlikely to cause the person any pain, but you may find them upsetting if you’re with them or caring for them.
What are noisy chest secretions?
In the last days of someone’s life, secretions (saliva and mucous) may build up in their mouth, throat or airway. It can cause a wet, gurgling or rattling sound when they are breathing in and out. It happens because they have become too weak to cough and clear the fluid from their mouth and throat. Chest infections and gastric reflux can also cause too much fluid to build up.
Speak to the person’s healthcare team if you are worried that one of these may be affecting someone’s breathing.
What is the death rattle?
The death rattle is a term for the noisy breathing caused by throat and chest secretions towards the end of life. Some people call this the death rattle because it often happens in the last days and hours of life, although other people find this term upsetting.
Are noisy chest secretions painful or uncomfortable?
Noisy chest secretions are unlikely to be painful or distressing for the person. They are normal when someone is approaching the end of life, so you do not need to be alarmed.
But it can be upsetting or worrying for you to hear these noises. If you’re concerned, speak to their doctor, nurse or care home staff.
If you’re finding it upsetting to listen to, try to take regular breaks. You might feel more comfortable if the radio was on or you listened to some music so you can focus on something else.
How long will someone live when they have noisy chest secretions (the death rattle)?
Most people who experience noisy breathing (the death rattle) at this stage will die within a few days. Everyone is different – some people will live longer and others will die more quickly. Speak to their doctor, nurse or care home staff if you want to know more about how long they might live for.
Changing someone’s position in bed
Changing someone’s position can help with noisy chest secretions. Ask their doctor, nurse or care home staff about changing their position.
They will usually try to position the person in a way that makes it easier for the fluid to drain away. This might mean moving them so that they are resting on one side and with their head and chest raised. They may use pillows to prop them up more in bed or, if they’re in a hospital (profiling) stye of bed, by raising the head of the bed.
If you are able to help, the healthcare team may show you how to move someone safely. But it’s important that you do not try to do this without being shown in case you hurt yourself or the person.
Medicines for noisy chest secretions
If someone seems distressed by their secretions and repositioning them is not helping, their GP or specialist nurse might prescribe medicines to help.
The medicines they may prescribe are called antimuscarinic medications. They include hyoscine butylbromide, hyoscine hydrobromide and glycopyrronium. They work by reducing saliva production to dry out the secretions. They are normally given through a syringe driverix, but they can also be given as a tablet or by an injection under the skin (subcutaneous injection).
If the person has a drip for fluids, the doctor or nurse might stop this in case it is making the secretions worse.
It’s important to know that it is not always possible to control these secretions completely. Try to remember that they’re unlikely to be causing pain, and to speak to the healthcare team about any worries.
When to ask for help
Speak to the person’s doctor or nurse if this noisy breathing is new or if you think it is making your family member or friend uncomfortable.
If they are working hard to breathe (laboured breathing) or seem uncomfortable, tell their doctor, nurse or care home staff.
Our Support Line can also provide emotional support, or they can arrange for you to speak to an Information and Support Nurse for practical information. You can call our free Support Line on 0800 090 2309 or email support@mariecurie.org.uk.