The ‘Death Rattle’

Another phenomenon that often unsettles loved ones is the death rattle—a sound that occurs when saliva builds up in the mouth but is not swallowed due to the body’s shutting down process.

McFadden, who has spoken about this before, describes it as “the most normal thing” at the end of life, but acknowledges that “if you’re not used to hearing it, it can feel like the scariest thing you’ve ever heard.”

She explained, “People hear it, they don’t understand it, they automatically assume it’s coming from their lungs. That is not happening. It’s truly just a little bit of saliva.” The gurgling sound is simply saliva catching on the breath rather than a sign of distress.

Reassuring Families

McFadden emphasized that neither of these experiences—changes in breathing or the death rattle—cause suffering. “This is not making them feel that they are suffocating, and we know this because the body is showing that it is relaxed.”

She also pointed out that “the body is built to know how to die,” and in cases where patients do seem to struggle, medication can be given to help ease any discomfort.

Through her work, McFadden hopes to remove the fear surrounding death, helping families better understand and navigate the final moments of their loved ones’ lives.