title: The sound of death rattle I: are relatives distressed by hearing this sound?
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Bee L Wee Sir Michael Sobell House, Oxford Radcliffe Hospitals NHS Trust and University of Oxford, Oxford. bee.wee@hmc.ox.ac.uk
authors.forename: Bee L
authors.initials: BL
authors.lastname: Wee
authors.forename: P G
authors.initials: PG
authors.lastname: Coleman
authors.forename: R
authors.initials: R
authors.lastname: Hillier
authors.forename: S H
authors.initials: SH
authors.lastname: Holgate
mesh_terms: D001293:Attitude to Death; D001601:Bereavement; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D012135:Respiratory Sounds; D013315:Stress, Psychological / Q000209:etiology*; D019452:Terminally Ill / Q000523:psychology*