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Palliative Medicine
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research-article

Death rattle: its impact on staff and volunteers in palliative care

BL Wee

Senior Lecturer in Palliative Medicine, Associate Director of Clinical Studies and Fellow of Harris Manchester College, Manchester, Sir Michael Sobell House, Oxford Radcliffe Hospitals NHS Trust and University of Oxford, Oxford

PG Coleman

Faculty of Medicine, Health and Life Sciences, University of Southampton, Southampton

R Hillier

Medical Director, Sue Ryder Care, UK

ST Holgate

Infection, Inflammation and Repair, AIR Division, Faculty of Medicine, Health and Life Sciences, University of Southampton, Southampton

Background: Hospice staff and volunteers frequently hear the sound of death rattle and offer explanations and reassurance to relatives and other patients. This paper describes our study into the impact of hearing the sound of death rattle on hospice staff and volunteers, part of our wider investigation into death rattle. Methods: Seven focus group meetings were held, involving a total of 41 participants from medical, nursing, chaplaincy, housekeeping and volunteer backgrounds. Meetings were audio-taped and the transcripts analysed using thematic analysis. Results: Most participants expressed negative feelings about hearing the sound of death rattle and felt that relatives were also distressed by it. Medical and nursing participants reported diverse views on why they intervene. Some acknowledged the influence of their own emotional response to the sound. Others felt that intervention was part of their professional role or that the existence of a therapeutic option made it necessary to intervene. Conclusion: Death rattle has a negative impact on staff and volunteers who work with dying patients. This effect may influence their decision to intervene when death rattle occurs. Doctors and nurses need to consider why, when and how they intervene and the consequences of that intervention.

Key Words: death rattle • decision-making • health professionals • volunteers

Palliative Medicine, Vol. 22, No. 2, 173-176 (2008)
DOI: 10.1177/0269216307087146
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