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Palliative Medicine
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The sound of death rattle I: are relatives distressed by hearing this sound?

Bee L Wee

Sir Michael Sobell House, Oxford Radcliffe Hospitals NHS Trust and University of Oxford, Oxford, bee.wee{at}hmc.ox.ac.uk

PG Coleman

Health and Life Sciences, University of Southampton, Southampton

R Hillier

St Joseph's Hospice, London

SH Holgate

Health and Life Sciences, University of Southampton, Southampton

Background: Death rattle is the noisy, rattling breathing that occurs in many dying patients. Health professionals intervene because the sound is said to distress attendant relatives. We found no formal study to confirm or refute relatives’ distress, so we decided to ask the relatives. Method: Face-to-face semi-structured interviews with 27 bereaved relatives to investigate their experience of terminal care and what their response had been to the sound of death rattle if this had occurred. Interview transcripts were subjected to thematic content analysis. Results: We found that almost half of the 12 relatives who had heard the sound of death rattle had been distressed by it. The others were either neutral about the sound or found it a helpful signal of impending death. Conclusion: We confirmed that some relatives do find it distressing to hear the sound of death rattle. However, our expectation that relatives are universally disturbed by this sound was unfounded. There is no justification for a ‘blanket’ approach to therapeutic intervention when death rattle occurs. A better understanding is required of how relatives make sense of the sound of death rattle.

Key Words: bereaved relatives • death rattle • ethical dilemma • terminal care

Palliative Medicine, Vol. 20, No. 3, 171-175 (2006)
DOI: 10.1191/0269216306pm1137oa


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B. Wee, P. Coleman, R Hillier, and S. Holgate
Death rattle: its impact on staff and volunteers in palliative care
Palliative Medicine, March 1, 2008; 22(2): 173 - 176.
[Abstract] [PDF]