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


CONCLUSIONS
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.
Wee
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B
Sir Michael Sobell House, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK. bee.wee@hmc.ox.ac.uk
Coleman
Pg
P
Hillier
R
R
Holgate
St
S
D001291:Attitude of Health Personnel; D001293:Attitude to Death; D005260:Female; D017144:Focus Groups; D017051:Hospice Care; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000523:psychology*; D012135:Respiratory Sounds; D013315:Stress, Psychological / Q000209:etiology; D013727:Terminal Care / Q000523:psychology*; D019452:Terminally Ill; D014838:Volunteers / Q000523:psychology*