Breathing Changes During the Dying Process

There are a few different ways that breathing changes during the dying process. This is usually a later sign and indicates changes in the body's ability to regulate its most basic functions. These changes usually happen after the person who is dying has become less responsive and aware of what is happening.

One breathing pattern experienced by dying patients is often called the "death rattle." The death rattle is often caused by accumulation of lung secretions. This breathing pattern can be identified by:

• Shallow, irregular breathing with periods of no breathing (apnea) for five to 30 seconds or longer
• Noisy, rattling or gurgling breathing
• Panting type breaths

Most individuals experiencing this breathing pattern are comfortable and unaware of their surroundings or their noisy breathing. This type of breathing does not cause added suffering. The pattern of breathing will shift and change. You may notice irregular breaths with periods of no breathing. These pauses may last for longer periods of time. Breathing may become heavy and deeper or very shallow and quick. Silent, gasping movements of the mouth without taking in any air may happen in the last minutes of life. Often the last breaths are deep and sighing.

What You Can Do

If noisy breathing is upsetting to you or other family members, you can:

• Elevate the head of the bed
• Turn the person from side to side
• Avoid suctioning, which has little effect and will often cause more congestion
• Using a soft damp cloth wrapped around your finger, gently wipe the mouth of any secretions that accumulate
• Talk to your Arbor Hospice care team. There are medications available to help dry up some of the secretions and decrease the noise.