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Tips for Careworkers:
Respiratory Secretions
What it is: When people have an infection of their airways or if they have difficulty swallowing then there can be a build-up of fluid in the respiratory tract. When they breathe and air passes through the fluid this can result in noisy breathing.
Why it matters: Noisy breathing is one of the most common terminal phase symptoms in people who are dying. Being unable to swallow or cough is common in people who are weak.
What I need to know: Noisy breathing due to respiratory secretions is often called ‘rattle’ or ‘death rattle’.
The noisy breathing does not usually worry the older person. However, the family and carers may be concerned.
Note
Noisy breathing due to respiratory secretions might be referred to as ‘death rattle’ or ‘rattling’.
Do
If the older person has noisy breathing, try repositioning them from side-to-side in a semi-upright position.
Do
If family or carers are distressed by the person’s noisy breathing let the nurse/supervisor know so that they can explain what is happening.
Do
If the older person is given medication for noisy breathing let nursing/supervisory staff know if you notice side effects including:
- delirium/agitation
- sedation (sleepiness)
- dry mouth
- urinary retention (not passing urine).
Do
Continue to provide mouth care often.
My reflections:
Does ‘death rattle’ worry the older person?
Does my organisation provide any material for family and friends to help them better understand what ‘death rattle’ is?
For references and the latest version of all the Tip Sheets visit
Practice Tip sheets for careworkers
CareSearch is funded by the Australian Government Department of Health, Disability and Ageing.
Updated July 2022
Page updated 21 July 2026
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