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What Is a Death Rattle?

A death rattle may occur when a patient is near death and experiencing trouble breathing.
One technique used to manage a death rattle is to reduce the amount of fluids a patient is given.
If a person is near death, he or she may not be able to cough or swallow like a healthy person.
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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 14 July 2014
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A death rattle is a physiological phenomenon which occurs in someone who is near death. The death rattle often plays a role in fiction, with Victorian authors in particular being especially fond of describing this phenomenon in lurid detail. When a patient develops a death rattle, it usually means that he or she is within 24 hours of dying. However, certain medical conditions can cause similar symptoms, making proper diagnosis critical to ensure that there is not another underlying cause.

When the death rattle develops, a patient's breathing starts to sound gurgly, as though the patient is gargling, and the noise can resemble that of a rattling or fluttering. The condition is caused by the accumulation of saliva and mucus in the throat, through which air will be forced as the patient breathes. Although death rattle does not necessarily indicate that the patient is in discomfort, it can be disconcerting for the patient's family and loved ones.

The death rattle is caused because the patient's coughing and swallowing reflexes are impaired or absent. Normally, people swallow on a regular basis to drain oral secretions from their throats, and they can also cough to expel mucus. In someone who is dying, this may not be possible, and as a result, these fluids build up.

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In end of life care, several techniques can be used to manage death rattle. The patient may be given fewer fluids to reduce secretions, and drugs can also be used for the same purpose. Topical applications of atropine to the throat, for example, will reduce the amount of mucus secreted. Suctioning can also be used to remove the accumulated fluid from the throat.

Other signs that a patient is in the end stages of death can include severely labored breathing, with or without a death rattle, along with jaw movements which correspond to each breath. Caregivers use these symptoms to identify a patient in the phase known as “active dying” so that they can provide specialized care and alert family members to the fact that death is imminent.

When a death rattle develops, it indicates that the patient should be provided primarily with supportive care, rather than medical measures which are designed to stave off death. Pain management medications may be used if the patient is experiencing a painful medical condition, and psychological comfort in the form of religious officiants, gentle touch from loved ones, soft music, and other means may also be provided.

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anon926033
Post 77

My lovely girlfriend was in hospital after an awful near drowning incident. I went to visit her like I did everyday she was there. Once though, while she was sleeping, she started to breathe shallowly and this horrible gurgling sound came from her throat. Then foam, saliva and mucus started coming out of her mouth. I quickly, whilst crying hysterically, buzzed for help. The doctors quickly came and performed CPR, defibrillator and all. They wouldn't let me in the room and I was just hysterical, so upset that I vomited. Luckily they were able to revive her and she survived.

anon357452
Post 76

I wrote post no. 58 about a year and a half ago. My memory is that I was up about another hour, then tried to get some sleep around midnight. I wanted to be awake at the time he passed, but there was no way of knowing how long that might be. I tried to sleep, was exhausted, but the rattle was keeping me up. (Pretty disconcerting.)

I put on some headphones with something to drown out the sound, and quickly went to sleep. I suddenly woke up about two hours later (for no apparent reason). After removing my headphones, I could tell his breathing had gotten a little more rapid and shallow. I checked his hands and feet, for color changes. No change.

While I was standing beside him, he took a last few breaths and passed quietly. I am profoundly grateful that I was awakened. I don’t suppose that in the grand scheme of things God cared whether I was standing there; I don’t think dad cared at that point, but it mattered to me.

I did want to comment on post no. 69. Seriously, to suggest that those who have a quiet, peaceful passing must be saved, and those who have a more painful passing are going to hell is just not right.

I suspect that if we compared beliefs, there is more we agree on that what we don’t, but that theory is just incorrect. I’m pretty confident Jesus was quite uncomfortable in his final hours (being nailed to a cross and all), and in fact, cried out in his agony that he felt forsaken by his father. There is no indication that he passed with a peaceful smile on his face. This is no indication of his righteousness, or the eternal status of his soul.

I do not believe that the circumstance of our births, our lives, or our passing is necessarily fair recompense for something we did or didn’t do in life. I do believe that all will be set right, and everyone will get what they deserve after this life. I would argue that the Bible backs me on this.

To suggest that those who suffer more at their passing do so because of their failure to follow God’s laws is judgmental, wrongheaded, and an insult to good people everywhere. As a fellow Christian, I am offended you would suggest to those who are trying to cope with what in many cases is a difficult ending to a life well lived, that what they are seeing is only the beginning of eternal suffering.

I am sorry for your loss, and hope that the consideration of your post was impaired by your grief, and had you taken time to think it through, you might have been more charitable.

I am profoundly grateful that my dad’s passing was relatively easy, and my heart aches for those of you who have to endure a more difficult transition. I pray for peace and comfort for you all.

anon350327
Post 75

After caring for my precious father for 8 1/2 months and believing I was ready, and that his time had come and thought so many times before his death was happening, only to be caught off guard and him go quite unexpectedly. It's been nearly two months and I cannot wrap my head around what I witnessed.

He was 86 years old and diagnosed with stage 2 lung cancer, on top of COPD which he had for 45 years but it was managed. He chose no treatment. He was tired. After many ups and downs in April, he seemed to improve a bit and was getting stronger. I thought to myself, well, the doctors might be wrong. He turned 87 in May and there were a couple of bad episodes between then and August, and it was obvious he was declining, but I could never have imagined how quickly. He was not needing oxygen very often. His vitals were good and although he was slow, he could walk.

About the first of August, he went to sit in a chair at the table and yelled like he hurt his back. He dealt with that pain for a few days until I could no longer manage him at home. I called our hospice nurses and asked if we could put him in inpatient until his back got better. It only hurt when he moved – that was the strange thing. I just could no longer assist in getting him to the bathroom to the table, etc. As they wheeled him out of his house, I promised him as soon as his back healed he would be right back home. This was just a week later.

I stayed with him most the time the next day and he had a pretty good day. He was getting out of bed and sitting in a chair. We talked a lot and he watched TV, but when it was bedtime, I needed help getting him to bed. But he was fine -- even showered. I gave him a hug and left at about 11 p.m. The next morning I arrived at about 8:30 and dad had changed. There were fans on him and he was barely alert. It was then I was told my father was definitely dying and to call the family. I was shocked and in such disbelief.

He was in and out of consciousness most the day. But when he was alert, he perked up even giving his great-grandkids a high five. As the night progressed, he took out his hearing aid. I never imagined that was the last time I would speak to him.

Earlier, he had coughed up a little blood, which is the first time he had ever done that. At about 11:30 p.m., he began the death rattles which were so horrifying to me. They gave him meds to help with it, but it didn't help for long. He began coughing up blood to the point of it going across the room, but he never realized he was doing it. The whole night was like that: towels and towels of clean up work.

I walked out to go check on my daughter in the waiting room, only to overhear the hospice nurses talking that they had never seen anything like this, that the amount of blood was unbelievable. My heart broke. I wasn't wrong. He was dying a normal death. He became restless because the medicines were not working and there was just lots of blood.

At about 6 a.m., he made another strange sound he opened his eyes for just a second. There was one last blow of blood, he began taking his final breaths and at 6:17 a.m. he took his last breath. I am traumatized by this and no one gets it.

I promised him he was going home on top of it all. I could not have handled this at home I would never been able to get through without the help of hospice, but I am still in shock he gone. And they way he died tortures my soul. I know he believed in God. He was baptized at 86 years old. I heard his prayers, but why the horrible death?

anon348181
Post 74

I watched my Grandmother die a week ago. She was 95 and had a second stoke a couple of months earlier. She was bedridden, and being fed and washed, but still had all her marbles and put a brave face on things.

One morning, she vomited brown fluid and then could no longer eat or drink. I was told a person can go three days without fluids. She lasted nine days. What a fighter.

The death rattle started about 5 p.m., and over the next few hours she went through periods of calm and then more agitated times. Her fingers turned black and her breathing was incredibly fast for 10 minutes, then calmed down. In her last moments, she struggled for breath, her eyes glazed over and then horrible brown gunge poured out of her mouth. I am so glad I was there to offer what comfort I could. But what I experienced has had a profound effect.

Why is there no support for this? The rest of the family say she passed quickly and peacefully at 6:30 a.m. They weren't there for the last ten hours. So sorry to all of you who are coping with your experiences.

anon348121
Post 73

I was with my uncle upon his passing. The death rattle haunts me, but not as much as what seemed to be him gasping for breath. I had not educated myself any further than the book hospice gave us. I'm a little relived to read what the above nurse wrote on the term of fish out of water.

We didn't give morphine as my uncle had no pain. No meds were given, but the death rattle still occurred. What bothers me the most is he was awake and unresponsive but had reached for my mother's hand as I was holding the other. What gives me comfort is the peace in his house that was there days before and is still there now after his passing. He was saved and had accepted Jesus into his heart and I believe that is what comforts me the most.

You are never prepared for that moment. It changes you. Although I heard and saw what I thought was discomforting for him, perhaps it was more discomforting for me at the time, as he did not scream or even whimper.

With death occurs regret comes for the living. I think about that day and wonder if he was in pain or scared, and could I have done anything. The ultimate answer is no. I did all I could by being there, praying and just letting him know he was loved.

anon346260
Post 72

My mom was a stroke victim. She suffered the stroke in the pons area of her brain, which led to extreme difficulty with word retrieval. She had difficulty with communication (this was progressive as she was able to communicate much better the first couple of years) among other things. She suffered with her loss of independence over a period of four years.

During the last days of her life, she stopped eating and drinking as others have described, but the day before she died her fever spiked to almost 106 degrees. She was shaking uncontrollably (I was not there but it sounded like convulsions to me), and she began to have difficulty with breathing.

They got her fever down fairly quickly, but after that she managed to say that she could not see. She was administered morphine every hour during the last 24 hours to help calm her. She would have periods of calm, but then would jerk awake with her arms out and she would scream the most terrifying scream. At this point, she was given morphine every 15 minutes. I finally arrived and witnessed this happening.

I held mom and told her I loved her and that it was okay to pass. I tried to comfort her as best I could. Then, she was given another morphine injection and she never woke again. She had death rattles and her breathing was labored for another few hours moving from her stomach to her chest, then she passed peacefully. I am truly struggling with the screaming that occurred as she would jerk awake. I want more than anything to understand what was happening during this dying process.

anon343269
Post 70

My husband of 22 years died a week ago. He was at home and had the aid of hospice. He suffered a double coma a year and a half before with the death rattle and so much pain he not only couldn't be repositioned, but I couldn't even touch his hand. I did CPR in ICU back then and saved him.

This time, he had overwhelming infection after infection and I called in hospice. This time the secretions were foaming. Last time, they were so thick that the suction would clog. I phoned the hospice nurse and told her he was rattling, then that stopped and foaming was coming from his nose and mouth. I couldn't roll him myself so I cleared his mouth and nose, sat him up, told him I loved him and thanked him for the woman he helped me become. I read a poem, lay beside him and fell asleep.

The nurse knocked at 10 minutes after 12, I woke and saw he was gone. I feel this passing was painless and he waited until I went to sleep, and so did he. He was in hospital after hospital for over two years and wanted to be in the home he built.

I still was shocked because he had been doing so well up till a few hours before his passing. I just want to hear his voice again. Even after all the trauma, he always pulled through, and I thought we'd have more than three days at home together.

anon342467
Post 69

My dad died after having the death rattle the last three days of his life. Certainly, no one explained anything to me or the family. He had been in a nursing home but to sum it up, the death rattle is horrifying to hear. I could barely stand to be in the same room.

Being a born-again Christian, or in other words, baptized in the name of Jesus Christ and having received the gift of the Holy Ghost (God's Spirit) living in me just as it states in the Bible, I was able to pray for him for the Lord to just take him on. It was certainly an experience I never want to relive again in my lifetime.

I have read a lot of the posts here and don't see anyone who talked about life death where you go from here, except some said their loved ones would be better off after they die because they would then be at peace as they would be in heaven! I know when someone has died, the first thing you hear is the person is at peace now there in heaven and they're not suffering anymore.

Read in the Bible where it explains in Acts 2:38 and 40 and John 3:5 where the Lord Jesus tells us all what we have to do in order to get there, and it's the same for every one of us! There is no other way.

I pray by placing this in here it will touch someone to go and get prepared for when your day comes, because you don't just die an go to heaven. The Bible speaks of a heaven and a hell and not everyone goes to heaven unless they followed the instructions given in the Bible.

I truly believe when you're saved you go peacefully when you die. I watched both my parents die and my dad fell out of the church and my mother did everything the Bible speaks of and stayed in the church until the end of her life and she died peacefully. You can tell the difference even after death as they lie there in their sleep. I've seen those who were saved look so peaceful and those unsaved look as if they seen a ghost! Believe me, you don't just die and automatically go to heaven.

May your loved one die peacefully saved! Amen. I truly believe after reading these posts you can know where that person went as the Lord lets us know when we're saved. We don't have to wonder.

anon339450
Post 68

My grandma died two weeks ago and nothing could prepare me for the last few hours of her life. My daughter and I showed up to her room to hear a sound I will never forget. No medical professional explained to me what was happening and I was horrified by what appeared to be my grandma struggling to breath as she gurgled and moaned. I have never felt so helpless. What I saw and heard that day will forever be with me. I am grateful that I was there with her at the end so that she didn't die alone but I will never forget her last few hours.

May God and Jesus Christ give all of you peace as you deal with these memories because I share your sorrow.

I love you grandma, and may you experience God's love and peace forever.

anon333077
Post 67

My grandfather is 95 and for 12 hours he has been sleeping with heavy breathing with his mouth open. We cannot wake him up and he has no response. He only responds to light or a moving hand near his eyes. Is this the death rattle that you talking about?

anon332568
Post 66

Hospice was not at all helpful. Each person who visited cared, but two visits a week at 20 minutes each time with a continually changing staff was not helpful or even hopeful. My wonderful quiet, sensitive, shy father with a wonderful sense of humor, suffered greatly as he died. I alone was with him touching and soothing him as best I could. It has been a year and I am still broken inside that a good person who "never took the smile from anyone's face" was not helped to die with dignity by Hospice, as his doctor promised me.

anon331316
Post 65

I sadly watched my lovely gran die last week, and I truly believe she died a horrible death; the rattling sound will haunt me forever. We weren't told to expect this and had no support whatsoever. I feel she was in pain till the very last breath. Sleep tight nain. I love you always.

sensible99
Post 64

I am so glad I have come across this post. To know others have been through similar experiences, brings me comfort. My almost 90 year old Mother who I greatly loved and adored and was my best friend, died last month in a nursing home where I was with her every single day all day for the past 475 days. She had congestive heart failure and Alzheimers and by the last thirty days of her life had generally stopped eating meals and lost a massive amount of weight. A tube was ruled out by a medical directive by Mom herself, and other family, so I was powerless to do anything but watch as the end approached, like some massive storm waiting to happen.

It became apparent toward the end that Mom could no longer swallow food even if she had wanted to, or even take a spoonful of water without choking. She was in such a weakened state that the nurses, including hospice, advised our family of the dangers of aspiration.

Once there was no intake of fluids or any nourishment, I braced myself for I knew we were facing death head on, and just waited and waited out the days and hours. Mom slept and slept and was given morphine, but nothing else, even though hospice had promised us additional meds. During the last four days I watched the horror of the death scene unfold and then the terrible death rattle came on the fourth day along with the laboured breathing. The hardest part for me was watching Mom turn into a cadaver, and that she would awaken for short periods at a time as my sister would wipe tears falling from her eyes. She was not able to speak but she could follow us with her eyes, so whether she was suffering, hungry or thirsty or not, God only knows.

Before she drew her last breath I believe Mom knew that all of her family was with her during her last days and hours, and she knew how much her family loved her. Tomorrow is my Mother's 90th birthday and even though she will not be here on Earth with us, I am glad she is in a much better place. My life however, will never be the same, as I still cannot imagine life without her.

anon309096
Post 63

I've just left the hospital where my dad is very ill but now the death rattle has started. I wish God would take him. He's been through so much.

anon288214
Post 62

My mother died two weeks ago. I have enough experience in emergency care and have this to say about what we “want” to hear versus facts: My mother died the most horrible death this way. I call it the morphine drip chamber. The comfort care means “comfort” for the family and was not for her by any means.

When I walked into the room, she was surrounded by my grown children, and my father, who tricked her into this against her will. The death rattle and anything that seems uncomfortable --it is. If people would stop trying to “fluff” the family, maybe others like me will be determined to change this process. It is inhumane.

I found my mother lying down flat (first time ever has she ever been positioned this way). She was gasping to breathe, yet nobody in my family thought this was an issue because they were prepared as if this were something normal and expected. It is not. They stretch the time out (it is legal euthanasia) to let the “family” have time with their suffering loved one.

If we are to do this, then be certain that, no matter how much your loved one has suffered, that they and they alone make this decision as my mom would rather have suffered a little longer than leave her loved ones. She also did this her own way in her sleep, where she wanted to die, at home and not being surrounded by her loved ones because that was too painful for her.

As her heart rated dropped down to the 90s,70s 60s and 50s, her grandchildren said, “I love you gramma.” It went down to the 40s and 30s and I said, “I love you, Ma,” and she lifted her jaw as always to reply back, but there were no other jaw movements, a tear came from her right eye and she flatlined. This was the most cruel thing of all her 15 years of suffering mostly from depression from losing the use of one leg by surviving aortic rupture during repair.

My point? Don’t lie or fluff people; it is just too much crap. To the kind nurse who has helped many people die in comfort, gently turning their head and placing them on their side, God bless you. My mom’s nurse just stared at me when I insisted she raise my mother’s head, turn on the o2 and pass me a mask or cannula to help ease the compensation from her organs shutting down.

Do any of you think this is hard for the family? Use common sense and just think how hard it is for the dying. The truth will bring about change and better ways. As much as I was against doing this to my mom, she was at the point of no return when I was allowed in, so I just asked them to bring on the meds -- as much allowed by law -- to end this crap, since I didn’t give a hoot for any of our family. It was her death, and I wanted her comfortable. That’s all that matters. Knowing they are OK will bring immediate comfort to the family. It is a shame to allow this slow, dragged-out death rattle or whatever anyone wants to call it, and to justify it. This was emotional and physical torture for her.

anon287696
Post 61

Continuing post 60. Whether intentional or not, the drug (dilaudid) that my loved one repeatedly asked not to be given was most likely the cause. It was forced on her several days earlier and she had a short episode of the rattle then. When we found out it had been given, we then again asked for morphine only.

The day of her death, the doctor convinced me that she needed to change her to the dilaudid because she was needing pain meds more often, which was not true. It appears she was medically murdered because death was not coming to her soon enough for those who were suppose to give her care.

anon285998
Post 60

Answer to if they are in distress or aware during the death rattle, sometimes. My loved one was. She had the rattle for about four or more hours and it was audible, although her breathing pattern had changed hours earlier.

In last minutes she sat up several times, and spoke through the rattle which was loud wheezing times 10. She screamed loud many times, "please help me, help me," and called my name. It was not just reflex, and she struggled to clear the mucus. It was drugs that caused her death, not cancer -- slowly paralyzing all of her body's systems. They increased sleep, suppressed her appetite and digestive system, reflexes and respiratory function.

anon282637
Post 59

I am a hospice RN and have been for many years. The 'death rattle' is the sound that sometimes presents during the actively dying state. The muscles in the throat that control swallowing grow weaker as we approach death and swallowing becomes more difficult and during actively dying, stops. The saliva that we produce (and which slows way down at end of life) tends to settle in the back of the throat and forms a thin film of saliva over the airway. The rattle is heard more on expiration as air bubbles through the saliva. We usually use atropine drops to help dry up secretions, but I find that gently positioning the patient on their side with the head of the bed elevated usually works well to displace the saliva off of the airway.

Some folks on this site posted questions about whether medication causes the death rattle and in my experience, it does not. And please remember, if your family member had pain before they became non-responsive (as they approach death) they will still have pain during the dying process even though they may not be able to demonstrate it (show you). Therefore, it is essential to continue pain medications when they are actively dying (and this is why hospice uses medications that are administered under the tongue as dying patients can't swallow but it gets absorbed well via this route).

The most significant clinical sign to tell you that your loved one is actively dying (within minutes to an hour or so) is when they move their mouths with each breath in what has been termed "fish out of water" breathing (though I hate this term as it implies respiratory distress and this is *not* respiratory distress. It is the last neurological push from your brain as brain functions cease).

I've been with hundreds of people as they died and I am blessed by the experience of being with them and their families during one of the most intimate times of a person's life. It is sacred and I am grateful beyond words to know and work with those facing life-limiting illnesses.

anon282366
Post 58

As I am reading this page, I am listening to my dad's death rattle. I keep getting up every few minutes to check for color changes in his legs and feet. Nothing yet.

I am feeling okay. Hospice has done a nice job of prepping me for this time. It certainly isn't pleasant to experience, but I guess it's time. Some posts complain or question whether the pain medications exacerbate the problem. There is a part of me that doesn't care. It is bringing relief from pain. In fact, if it does speed his passing, I'll be glad. This is no longer a life for him. He has lived well, and there are others waiting for him. I'll miss him terribly. I am guessing that the next few hours will be a lot harder on me than him. But I'm glad he'll be at rest soon.

anon282083
Post 57

My precious mother passed away just a few days ago after battling ovarian cancer for two and a half years. I thought I was prepared for her death since I had read about the death experience, after promising her that I would be with her until the end and I would care for her at home. I called Hospice about three days before she died. They didn’t think she would make it through the night, but she did.

She continued to be a semi-comatose state for the next two days. Early on the second day, she even asked me to clean her up from head to toe. Shortly after, she released a lot of foul-smelling, rootbeer-colored urine. She looked so sad as I cleaned her up again and changed her sheets. I put a new pajama top on her and her favorite hand-embroidered pillowcases on in hopes to cheer her up. Her last moments of clarity were late on that second day.

She started moaning upon exhalation a few hours later. It was horrible! I continued morphine and Lorazepam according to instructions, but the moaning continued. Hospice came at 11 p.m. and increased the morphine. They said the moaning was exhaustive moaning, not pain. I do so hope they were right.

The death rattle started about 2 a.m. the next day. I was prepared and explained it to my sisters and brother. About 8 a.m., my two young adult nieces came to be with her, since she had raised them.

Dark foam started bubbling in my mother’s mouth. I cleared it away with a mouth swab. I called Hospice shortly thereafter. As I was describing the dark fluid to the nurse, my mother’s eyes flew open and she had convulsions with teeth clacking. Then, horrible dark brown fluid poured out of her mouth and she started gurgling. I told Hospice to send a nurse because my mother was dying.

I turned my mother on her side and volumes of fluid came out of her. She had another convulsion with teeth clacking before her pulse stopped. We were so heartbroken that she passed so violently.

I quickly asked if we could get mom cleaned up so we would have a better memory of her before she left her house. We cleansed her, lotioned her, powdered her from head to toe, brushed her teeth, dressed her in lovely pajamas, put my sister’s afghan on her and made a bouquet from flowers given her by one of the nieces. We removed every sign of illness that we could from her room.

We waited for Hospice for an hour. I called again and was told that they had failed to relay the information that my mother was dying. The nurse officially declared her death at 9:40 a.m.

My mom looked lovely as other family members came to say good-bye but I struggle to put her death scene out of my mind. My heart hurts for my nieces. I still can’t find much information about what happened. Her sister-in-law is a Hospice nurse. She said my mother’s advanced cancer caused bleeding in her organs that was expelled at death.

If anyone else with a similar experience has more information for me, please post.

anon280652
Post 55

My brother (66 years old) is in the final stages. It is just to horrible to stay with him and listen to him gurgle, and seeing horrible mucus being wiped away from his mouth.

He got married a month ago to his partner of 20 years. She is with him all the time. He has had an inoperative tumor between his bladder and bowel since November 2011. He has suffered for so long. I'm waiting for the phone call today to say he is at peace. He has said several times he just wants to die now.

Why can he not just have the extra bit of morphine to send him on the way? Such sad stories here.

anon280439
Post 54

About this post: I suffer deeply over remembering my precious mother going through the death rattle. She had told me as a girl that when her aunt died at home during the Great Depression, that she (my Mom) never forgot hearing the death rattle in her aunt when she was dying.

So, when this was happening to my mother, dying who was from severe, painful breast cancer, I did not know if the Dilaudid we asked the doctors to give her for pain was causing the death rattle (by suppressing her cough or her being able to awaken to cough), or if the death rattle would have happened anyway, and the Dilaudid was keeping her from coughing or, if the Dilaudid made her "drowning" from lung fluids (death rattle) made her terror and pain much less. She did try to cough up the secretions (I asked her to do this as I thought I was helping her), but she was too weak.

Was this weakness from the narcotic (Dilaudid), or from imminent death? I feel as though I let her drown, her worst fear always, even though I also was told by doctors that "patients are not bothered by the gurgling sounds, only family." That is not true. I watched my mother's face contort in terror when she became more alert at times, and could not cough. Did I drown her by just trying to keep her from being in pain with doctors giving Dilaudid? I am not sure. And, I do not believe the doctors as they say little except for me to go on with life. No kidding!

But, I hear the comment above: "Even though the medical staff kept telling me she was not in any pain, how do I know she wasn't? Has anyone ever come back to say oh, don't worry -- even though I was shocking to death for two days, I was fine!" Amen! No one who has died has yet to weigh in on this, and until someone can, I feel sick at heart and like I let my poor mother drown by doctors giving her pain medicines!

anon279892
Post 53

My mom died in July 2012. She was diagnosed with stage 4 lung cancer in February. Her tumor was shrinking and she was doing better. The day before she died we went over to her oncologist to get the day after shot. She took them some peanut butter pinwheels and chewie charlies that she made. She even walked through wal-mart after we left. She refused to ride in a wheelchair she said that if she could walk she would just push the cart. We came home and she seemed fine. She was happy and said how much she enjoyed our day together.

I talked to her that night and she was tired, but she was O.K. The next morning, dad called me telling me that she was dying. I was hysterical, but I drove as fast as I could to the house. He was doing CPR and then I did CPR also. It didn't do any good. Dad said she got up and wanted some coffee. She sat on the couch and he brought it to her. The next thing he knew she made this horrible sound and she slumped over. Mom didn't have the rattling sound on the day before when I saw her. She was breathing good.

I do think that mama knew she was going to be leaving us. She had made several comments and things that I just didn't catch. She told me on Monday that everybody dies and when my number is up I will go. I thought it was a future thing, not now. She waited until our day out to be finished with this life on earth.

I am having such a hard time. My mom was everything to me. She was my best friend and my mother. We talked several times a day and we went everywhere together. I just needed some more time. I am glad that she didn't suffer. She wouldn't have wanted that at all. Just wish I would have known.

anon279045
Post 52

My mother died of cancer, and 35 hours before her death, saliva started to accumulate in her throat and I used a syringe to pull that out. Then the next day we took her to the hospital. About three o'clock in the morning, the death rattle started and about 5:45 p.m., she took her last breath.

I did not drop even a single tear for about three hours after her death as the loss was far from what I thought. May God bless your mother. I love you, mama.

anon278985
Post 51

My mother died five months ago in a fatal car accident that left my father on life support for the next 11 days before spending his final seven days in hospice.

For 18 days we endured being with him and his mostly lifeless body. We talked to him, we laughed around him, we played music, we did everything we could to make sure he somehow knew we were there with him and that it was OK for him to pass on to be with my mother (whom we had yet to even mourn). But all that love and sharing that we filled the room with for the first two weeks came to an abrupt halt when the death rattle started on day 15.

As others have said, watching and hearing that for three days is just etched into my mind. The sight, the smell, the thought of what was happening, after everything else that had happened -- we just knew it was close to being over. While we try to celebrate their lives, I'm left with the vision of my father's final days and the deterioration we watched quickly take place. I don't wish that on anybody, but it certainly helps to know others have experienced the same thing.

anon276164
Post 49

My dad died at home last week. The district nurses nurses were supposed to be on hand to support us but they weren't. My dad had the death rattle for three days. I didn't know what it was at the time, and not one medical person who visited during this time told us what it was called. They just said it is normal and more worrying for you than the patient.

Thick, green, smelly fluid kept running out of his mouth and we didn't know what to do. His final few hours were peaceful and this is what I will remember.

anon270270
Post 48

My mom is in the end stage of COPD and very close to death. Tonight for the first time I heard that death rattle. I am the health care proxy so I asked for more frequent doses of morphine and when she became comfortable again I came home. I can't bear to watch her die.

All the information I have gotten online has helped me to know that her death is very near. As much as I have the urge to go back, I can't watch her take her last breath. Mom, I love you.

anon265767
Post 47

My father passed away three months ago with Lung cancer. He had the death rattle, only I did not know it was that until reading these articles. He was in a nursing home and the staff there told us his chest was congested so we did not think anything.

Funny thing though, when I walked into his room that morning, I knew in my heart that it was the day he was going to die. He had the look of death on his face and it was heartbreaking. He was given something to dry up the congestion in his chest, along with a lot of morphine (which I believe eventually killed him). He was in a deep sleep and his chest was heaving up and down with that terrible sound.

I had heard that the fingernails start to turn blue when the time is near, so when that started to happen, we all knew his time was near. Most of the family was with him and we kept talking to him and telling him it was okay for him to go since he suffered enough.

About three hours later (just as I stepped out of the room for five minutes), he passed away peacefully. I regret leaving the room but was assured that it was quick and peaceful. He just stopped breathing.

We stayed with him for the next four hours and watched the changes in his body occur. I held his hand as the blood drained and my sister and sister washed his body and prepared him to be taken away. We were all so glad to be with him to the end.

It was my first experience with death. I have to admit, I am now no longer afraid to die after witnessing this. They do go to a better place.

anon258351
Post 44

I lost my mom to cancer 5 years ago. I was absolutely horrified at the death rattle during my mom's journey! I was so uneducated about the process and was terribly shocked! I was so afraid to sleep after because I had horrific nightmares and daydreams of the sights, sounds and smells.

There was nowhere to escape what I saw, heard, and smelled and it took over my mind. I wanted to remove myself so far from it (wish I wasn't there).

After about six months of tormenting myself, I decided to turn a negative into a positive. I now find solace in the fact that I was there for her during her journey. I wouldn't trade one second of time spent with her! And would do it all again!

She was a lovely lady and the best mom a girl could have and I feel lucky and honored to have held her hand as she completed her journey! I wish this forum had been up during that time. It would have helped me greatly!

anon256921
Post 43

I am 25 now but when my grandfather died I was 13 and 1/2 almost 14, but he had been sick for a while. He had beat prostate cancer and had very bad diabetes, to where he had to give himself insulin shots in the stomach.

But the night he died I will never forget. I was in the living room watching tv, he came by and patted me on the head, used the bathroom, then ate an orange.

About an hour or two later, I heard this terrible, crazy noise. It was an awful rattle I had never heard before, so I peeked through his curtains that covered his bedroom and he looked fine; he was just lying there looking like he was sleeping, but making this terrible noise. I still regret it till this day and it weighs on me, but I did not do anything.

I watched for a few minutes and thought he would be fine, but around 5:30 I jumped up from a dead sleep (which I have never done before) and just sat straight up. I did the same thing about five minutes later. Now that I know about the death rattle I probably could have saved him, or at least woke my grandma up so he could go to the hospital. I still don't know why I didn't do anything but he just looked peaceful, like he was sleeping, which he was.

I still feel so much guilt. He might have lived a longer life if it weren't for me being so stupid, but all of your stories helped. God bless you all and thank you. --Courtney

anon255708
Post 42

I'd like to reassure people that it's possible to have the death rattle but die a peaceful death. My father had this rattling sound for several hours before his death, but he seemed completely unaware of it. A nurse gave him an injection to dry up some of the fluid. The sound was still there but reduced in volume.

My dad's breathing got slower and slower until eventually it just stopped. It was all very peaceful and natural, with absolutely no sign of pain or struggle or distress. When I mentioned this to the nurse, she said that's the way it usually is, that the patient just goes into a deep sleep. The death rattle may or may not happen, but the breathing slows down and in the end it just stops.

I'm really sorry to read here how many people were unprepared for the death rattle or who saw their loved ones struggle; that must be very traumatic. But many people pass over very peacefully and this can have an equally strong effect on those who watched their passing. After seeing my dad's death I completely lost my long-held fear of the dying process.

I should maybe add that both my grandmothers passed in non-traumatic ways, both dying in their sleep at home with no sign of any distress having taken place (they both passed away during the night in normal sleep). So please don't think all deaths must be distressing in the way they actually happen, because I can assure you it isn't so.

amypollick
Post 41

@anon254902: The girl was probably uncomfortable discussing it because she was so inexperienced and had no idea what to say to you, or how much to say, and may not have understood it herself. My guess is she wasn't even with your mom when she passed. They probably heard the monitors beep and she was gone by the time they got into the room. Otherwise, she would have known exactly what happened.

I lost my dad in 1995. He was only 61. I don't think he suffered, but if he did, I don't want to know. He is at peace now, and that's what's important to me.

Try not to dwell on whether your mom was awake or asleep, or whatever. It's counterproductive and guaranteed to drive you nuts wondering, because you'll never know with absolute certainty. Your mom is at peace and not hurting with cancer pain anymore. That's what you need to hold on to.

anon254902
Post 40

I never knew what my mother went through when she died in 2006, because she died in the middle of the night in the hospital, and I'd gone home for sleep. When the hospital called to report her death, it was a very inexperienced young girl who called and said she was there (when she died) when I asked. She didn't know what to say for the most part. She said Mom was awake when it happened, which I thought was strange due to heavy dose of something so she wouldn't suffer with the n cancer pain.

I got the idea she suffered since the girl was so uncomfortable discussing it. Mom was on a dnr in the hospital. Is there any medically trained person who can shed light on if she suffered, or is it hard to know?

anon247135
Post 39

My 91-year-old mother-in law died in our home and she had that "death rattle" in the final hours but I do not think that she was struggling in any conscious way. It was loud and upsetting to us but I think it is the natural process of dying and has been since the beginning of time.

Death is hard, but there is peace at the end and I could feel it as she took her last breath. We did not create the world and the life in it, so we cannot control the dying process which is as "natural" to man as the pangs of giving birth. Neither process is usually easy. Do not be overcome with sorrow - the best is yet to be!

anon245799
Post 38

My father passed away in August 2010. I pulled him out of the pull and began CPR and he regained his color and got a pulse but he wasn't breathing, and about a minute later I heard a "snoring noise." He was rushed to the ER via ambulance and was pronounced dead within that hour, after several procedures.

Every day of my life since he has passed that "noise" has haunted me, but reading this made it clear to me to exactly what that noise was. It still breaks my heart. I miss him so much. The doctors said he didn't suffer, and I am just hoping that that is true. I hope he did not suffer. He was a good man and is missed deeply by everyone. Now I am going to school for Registered Nursing.

anon242897
Post 37

My mom died almost a year ago from colon cancer. It was six weeks after she was diagnosed. She developed the death rattle 3 1/2 days before she died. It truly is the hardest thing to have to hear. It makes you feel like you are smothering as well.

They suctioned her often, but shifting of the body from one side to the other we were told later, only hastens the dying process. So the death rattle, even though it signifies death is soon, there is no real, certain time frame. Yes, it is the hardest thing to watch a loved one go through. No, you will never forget that sound and how it made you feel. God bless you all who have to endure it.

anon242596
Post 36

My dad died of cancer. The death rattle was awful to hear. I was not told this was a common act near death. I am a nurse but a pediatric nurse and never saw a child die. I wonder if they to have this awful sign. I so wanted to suction him. They had no suction on the wall in the hospice so I assumed it wasn't done.

I am ashamed to say I didn't want to show my ignorance. I did mouth care. I wish I had heard and known more about this as I put water on the sponges, believing I could remove the mucus better from his mouth. I may have made it worse as now I understand most of the secretions can be deeper in the lungs and continuously creating more I would expect while they are alive.So he would need less fluids.

Only deep suctioning might have helped lessen the sound but it probably would have meant doing it a lot of it and I know that suctioning deeply hurts and is uncomfortable so now I accept this death rattle, two years late in hearing. RIP dad.

anon241385
Post 35

The circulatory system starts shutting down from feet up, ending at the obvious heart, not head. Look at a circulatory system pic and see how it flows.

As for the death rattle, I'm a nurse and have heard several death rattles and several people die without them. Several experience pain, and some do not experience any. It all depends on underlying issues and the diagnosis, if any.

There's no need for anyone on here to be nasty to one another. This is meant for sharing experiences, right?

anon241085
Post 34

I'm glad to have read this. Right now, the palliative nurses are administering drugs to my father, at home. I suspect he only has about six hours or so left. Who knows? But, at least, I will be able to reassure my mother, as she watches her husband of 50 years die in her arms.

anon213922
Post 32

My wife died in the hospital, last August, after 23 months of stage IV diagnosed lung adenocarcinoma.

The end was sudden, from the moment where she communicated to me that she was abulic in about 4 hours. She was still recovering from palliative radiotherapy to the main tumor that was 6cm wide.

Death rattle occurred in the last hour, breathing once in each 30 seconds more or less. Her eyes were closed. She was given morphine. Last thing she asked me was the time. 7:10 pm. Before she called me to wake up (I was by her side, she didn't recognized that). She died half-hour later.

anon208061
Post 31

My precious mother died in April of ovarian cancer 13 days after she was told it was not the flu.

I had never heard of the death rattle. She had it for 48 hours. The sounds are etched into my brain. As long as I live, I will never forget her horrible death. I would have traded places with her in a flash. People around me who have not had this experience have no idea why I am haunted by her horrible death. I never left her side even though I wanted to disappear while she was experiencing this. Words do not exist to describe how terrible this rattle is.

Even though the medical staff kept telling me she was not in any pain, how do I know she wasn't? Has anyone ever come back to say oh, don't worry -- even though I was shocking to death for two days, I was fine!

MrsTerry
Post 30

Well, it looks like I have joined the elite club of those who have watched a loved one die horribly. My father paid my way into this club. He had to fight long and hard to get out of this world, and he did it with dignity and humor. His passing was horrific, only overshadowed by the pain he endured for the year prior.

I was lucky enough to be able to be with him every night of his last three weeks - either in the hospital or in hospice. I cherish each and every minute of those nights.

anon190602
Post 28

you should all ignore post 3. my heart goes out to you all.

anon181283
Post 27

I wish I had known about a "death rattle". None of the jerk nurses or anyone else informed us in palliative care about what would take place. I was so flipped out because this was such a sudden thing (blood clot in an artery near the stomach that couldn't be operated on) that I never researched anything. I was too focused on her.

When I heard her start breathing like this, I thought, "Oh what the hell is that?"

York Hospital in York Pa is supposed to be in the top 100 hospitals in the United States. Maybe for care but they don't tell people jack! I have to leave now, going to go cremate my mother and then maybe check myself into their third floor. Maybe the psychiatric unit is a little better, but then do I really care?

anon180974
Post 26

In the summer of 1998 my mother died of cancer. We only knew she had the disease for two months.

I spent as much time at her bedside as I could but I'm ashamed that I spent most of that time drunk.

The day she died, I was drunk and passed out on a pull-out beside her hospital bed. In the very early morning a nurse came in and woke me up. All she said was "I think it's time." I panicked. I pulled my chair close, grabbed her hand and started talking my mother into dying.

I told her that the 'beach' she's been wanting to go to was waiting for her. I told her to let life go. I heard the death rattle and I felt her squeeze my hand.

I was there when her breath stopped but I kept talking. I hoped she'd hear me and find some comfort in my voice/words.

At 7:38AM it was over. I ran outside. I lit a smoke. I stared at the pavement of the Hotel Dieu's emergency ramp and bawled my eyes out.

anon178126
Post 25

My Mom passed away from cancer in July 2007 at the Jo'burg Gen. We were called in at 4.15 a.m. and when I walked in there, my mom's eyes had bulged out and her mouth was open and she was moaning and trying to release her hands that they had tied so damn tight to the bed rails. I never got an explanation from the sisters or the doctor on duty as to why she was making those terrible noises and why her eyes were bulging without even blinking.

All sister could say to me was to pull myself together as my mother could hear that I was crying. I will never forget those last few hours of her life and hate myself for not having the money to have been able to let her die in a private hospital with dignified staff.

anon165991
Post 24

It's been 10 years since we lost my mother to cancer. Still to this day i can never forget the whole process that she went through. I thank god every day for every moment that we had with her, even though it was the most painful experience i have ever been through. The death rattle is the most horrible sound to hear but it gives the family and loved ones a heads up that the end is so very near.

anon154369
Post 23

I lost my mother exactly one year ago to colon cancer. Even though she was in stage four and she lived for two years since her diagnose, the process of her death is still as shocking and remember-able as it was one year ago. Once in her coma, which I made she it was drugged induced, her breathing first sounded like she was snoring then it went on to this railing noise which continued till her death. Not even the sounds of the equipment seem to help this horrific noise.

I recall being awakened out of my sleep only to find that this noise just kept getting worse. There was a point where I just wanted her to die already. Overall, my mother's death sounded painful, but I know she wasn't in pain and now she is in a better place.

anon151568
Post 22

My mom died this past Saturday in the nursing home. I was at her side. it was the most horrific thing I've ever witnessed. She basically drowned. The death rattle started about 3 p.m. and she took her last breath at 9:14 p.m.

Although she was 92, she was of sound mind and relatively good health; she just couldn't recover from a surgery she had three weeks ago for a perforated colon. Also we were told they had found a large mass; so yes she did have cancer.

I just don't understand. Once the death rattle begins why they didn't put her into a coma? she was suffering horribly! I cannot sleep thinking about what I witnessed and her horror! I love you Mom and I'm so sorry you had to go through this painful death to get to Heaven.

anon137882
Post 21

My mother found out in October she had cancer and already was in stage 4 colon cancer and they gave her three to six months. But she only lasted a few weeks. The last 36 hours with her will stay in my mind and dreams forever. The death rattle came within six hours of her passing. It got so loud it will remain a deafening sound in my ears forever.

Watching the foam bubble and settle in her throat haunts me during the day and wakes me at night. I wish I had been more prepared as I will never be beside someone at their last moments.

I was not told ahead of time and only knew by what I read on the internet. It was even more of a nightmare when she sat straight up one minute before she passed and looked around the room at everyone at her bedside. I do find peace that she did not suffer the long months we thought she would suffer with. And that I was there to make sure she knew I love her. I will miss you mama and love you forever!

anon134558
Post 20

my grandma passed in hospice last week and the nurses were very aggressive to prevent the death rattle. It is possible! She had drops every four hours and when her breathing worsened they quickly advanced to injections to "get ahead" of the rattle. They said if you can't get ahead of it, you can't make it go away.

She received injections every 20 min when it first really was starting and than they monitored her every few hours as needed. We were successful!

It is possible to prevent if you have good care. Best.

anon134503
Post 19

My dad died from cancer and he had death rattle which started around 24 hours before his passing. My dad was a strong man and yes you do die from the feet up! The docs told us that it was the diabetes that was causing his ankles to swell and within days he had lost nearly all has weight from his legs. within a further two to three months, his arms and head and chest. cancer is a horrific way to die and my heart goes out to all affected.

anon133957
Post 18

My sister died at 37 of cancer and the death rattle was the most heart wrenching as to me it sounded like she was crying when trying to gasp for air. I didn't know whether it was the morphine that paralysed her and couldn't swallow or from her dying from her hideous cancer. She was so strong and just kept fighting.

anon128350
Post 17

My grandma passed away in May. And at the time i was 18 and never suffered a loved one dying. So when i heard the "death rattle" about three days before she died, it really shook me up and i thought she was going right there. I knew she wasn't in pain as she was having morphine and the stuff to stop the sick feeling injected in her every 10mins so that reassured me she was just sleeping and not in pain.

anon126433
Post 16

My mum died of cancer this week and I was with her until the end. I found the death rattle very disturbing and still question whether I will ever find peace with her passing due to the distress I felt in hearing that.

anon123402
Post 15

My dad died the last of October. The rattle that we experienced bothered me tremendously at first because I was afraid he was suffering.

But as his breathing changed and after we called the hospice nurse to come and check on him, I felt better. After she left he was gone within the hour. His death was very peaceful with no gasp or choking at the end, which was my biggest fear.

My sister and I kept the morphine and atrovent going to help him.

Near the end his lungs and heart slowly shut down. He never got "cold" to the touch when alive. It is a memory that will stay with me forever but I was so glad that my sister and I were there with him, in his own home. He was aware we were there for many hours before even though he couldn't communicate. We spent quality time with him afterward as well. I will always be thankful to have been with him as he passed on. I hope someone will do the same for me.

anon113983
Post 14

They don't suffocate in saliva when they are dying! I recently lost my Mom from cancer and unfortunately hospice dropped the ball and had nothing to give her and showed up two hours after we called. During that time we heard the death rattle in my Mom, and ironically so did she.

When hospice got there they said she was dying but were shocked that she spoke clearly and asked if that rattle was pneumonia. It didn't hurt her at all, the only pain was from the cancer of which she had to suffer because they brought no drugs to give her. She died at 3:00, four hours after the death rattle started.

I thank God our whole family was there when she was able to talk and we all told her how much we loved her and she told us the same. The dying from the feet to the head is bull. When a person is dying they are dying as a whole person. My advice is just be there because it makes the transition for them easier and you will be so grateful that you were!

anon106239
Post 13

The humming is wrong the sound you hear is involuntary as the air passes through a throat increasingly congested with fluids the body cannot any longer remove by swallowing or coughing. This is more distressing for the relatives than the patient.

It is more or less correct we die from the feet up. As the circulatory system shuts down the extremities begin to die. This is often marked by a mottled blue colour to the feet which travels up the legs as death advances and the change of colour of the nail beds in feet and hands.

Medical staff routinely observe patients' feet as an indicator of imminent death. It is also probable that brain death marks the final moment and may occur a short time after the heart stops beating. However, it is unlikely at this point that the patient is at all aware. However deaths vary greatly and it is possible to be brain dead and all other body functions supported by machines. Perhaps 58962 should try reading too.

anon105733
Post 12

It has been five months since my mother's death and still this death rattle haunts me. just know that once it starts, the time for death is near. my mother couldn't speak just slight moans. when she would follow me with her eyes and when i looked at her, tears would roll down.

she knew what was going on and there was not a thing i could do to stop it. i think the foam coming out of her mouth and nose really left an impression i wish i could forget. i hope you all find comfort in this terrible time.-oyamhj

anon99780
Post 11

Unfortunately, I witnessed this last night with one of my patients. I am a nurse. It is excruciating to watch and see. You want to rescue and you can't. You want to prevent the family from having to go through this horrible time and you can't. The memory will be there always.

Pain management for my patient was difficult. Nothing seemed to take his pain away and he fought to get words out and you couldn't understand them always. I am all for chemically induced comas for the dying.

anon92910
Post 10

My mother just died today, and that was the most horrible death I have every seen. Her death rattle got louder. The death rattle is when your lungs fills up with fluids and it starts going throat and it comes out of the mouth if not suctioned. I witnessed this myself. There was no mottling in her body when she died. All people are different.

My mother fought for every breath she took and she also fought for her life also. Death rattle most of the time starts within 24 hours of death. Hospice was here with us and they helped us through this.

anon82858
Post 9

oyam - not sure how old you are (I'm only 24) but my mom recently died too, in her own bed, four days after my grandma - but hers was extremely horrible as well. when i think of the death rattle i think of how horribly she passed, and i feel this article doesn't represent the exact nature of the death rattle - the truth is not so pretty.

My mom only breathed like this for a few hours, her death was so quick, but that's the only "luck" we encountered as my poor mom suffered of cancer in life and a horrid death as well. the best way to educate yourself on the dying process is to read accounts of other people who lost loved ones.

oyamhj
Post 7

the death rattle is a horrid sound and as i searched frantically last night for some answer i felt the need to help someone like me. my mom died today. she had the death rattle for 24 hours.

her lungs filled up with fluid and she fought for every breath.it was the most horrible sound I've ever heard. if morphine is given by hospice just know there is nothing you can do to help them except let them know you are there for them and spend every second with them.

she died the most miserable death ever. it was heart wrenching. god bless and good luck

anon66643
Post 5

What a distressing answer for anyone about to lose a loved one and finding anon47218's answer. There are so very few facts in that paragraph, and if they truly believe that, I hope they come back to read the article above.

The poor kid's got to be horrified about death if he thinks that's how it always happens.

anon58962
Post 4

What an answer. Humming? Try to scream out? And the best yet, die from the feet up? The head is the last to die? Read some medical books, would you!

anon47218
Post 3

death rattle is when the voice box is no longer working and the ill person is saying his last good bye through humming. it's a sad fact and also the saliva can't be swallowed so it drips back into the lungs and can be distressing for the dying person and when it gets that bad they try to scream out and it's all because we die from the feet going up and the last to die is the head so if we are not unconscious by the time the respiratory system shuts down we are left suffocating in saliva and other body fluids. there i hope this answers your questions about the rattle.

taoni33
Post 2

What exactly are some physical signs of the body experiencing during the death stages? Are there any distinctive observations to look for that tell you the end is near?

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