Perhaps the most unsettling for families is a sound called the “death rattle.” This occurs when the person is no longer able to swallow or clear their throat. Saliva and mucus build up in the airways, and as air passes through, it creates a gurgling or rattling sound.
While the noise can be alarming, Julie stresses that it does not mean the person is suffering. “It sounds frightening, but it isn’t painful,” she explains. “It’s simply the body shutting down.”
2. Changes in Breathing
Another sign is a noticeable shift in breathing. Toward the very end, breaths may become slower, irregular, or spaced widely apart. At times, it may look as if the person has stopped breathing altogether, only for another breath to follow after a long pause.
In the final hours, some people display what’s called agonal breathing—short, gasping breaths that can seem distressing to those watching. Julie gently reassures families that while the appearance may be startling, it is a natural reflex. The brain is no longer receiving full oxygen, and the body is simply responding. Importantly, she emphasizes, the patient is not suffering when this occurs.
3. The “Death Stare”
The last common sign Julie describes is what she calls the “death stare.” The patient’s eyes and mouth may be open, their gaze fixed in the distance. They appear unresponsive, as if no one is “home.”
For loved ones, it can feel eerie — even heartbreaking. Yet, according to Julie, this stage is often deeply peaceful. She reminds families that hearing is often the final sense to remain, so soft words, familiar voices, and gentle reassurances can still bring comfort, even when the person no longer responds outwardly.
