There are a few different ways that breathing changes during the dying process. This is usually a later sign and indicates changes in the body's ability to regulate its most basic functions. These changes usually happen after the person who is dying has become less responsive and aware of what is happening.
You may notice:
- Noisy or rattling breathing
- Shallow, irregular breathing with periods of no breathing for up to 30 seconds
- Panting type breaths
Sometimes the breathing may sound like rattling or gurgling. This should is caused by air moving through secretions in the upper airways. In the dying person, the reflex to "clear the throat" to move these secretions does not work. Although disturbing to hear, this sound does not mean that the person is suffocating or drowning. By the time that this change happens, the dying person is usually not fully conscious and does not seem to be aware of or distressed by this symptom.
The pattern of breathing will shift and change. You may notice irregular breaths with periods of no breathing. These pauses are called apnea and may last for longer periods of time. Breathing may become heavy and deeper or very shallow and quick. Silent, gasping movements of the mouth without taking in any air may happen in the last minutes of life. Often the last breaths are deep and sighing.
- Elevate the head of the bed.
- Turn the person from side to side.
- Avoid suctioning, which has little effect and will often cause more congestion and discomfort.
- Using a soft damp cloth wrapped around your finger, gently wipe the mouth of any secretions that accumulate.