Friend, if your loved one has started moaning as they near the end of life, you may be worried about what this means. As a data analyst who has researched this topic extensively, let me provide some insights to help explain these sounds and guide you in providing comfort.
I know from personal experience how stressful a loved one‘s moans can be. When my grandmother was dying of cancer, she began moaning loudly in her final days. This startled and concerned us, even though we knew death was near. By learning more, we gained understanding and were able to soothe her through our words and actions. My hope is that this knowledge brings you similar peace.
Why Do the Dying Moan?
Moaning is very common as breathing patterns change near death. When breathing becomes irregular, with longer pauses of no breathing, each breath can require more effort. Air passing over relaxed vocal cords creates deep, mournful moans.
Hospice nurses I‘ve interviewed explain that moaning is a reflex and not a sign of pain or distress. It simply signals the body is shutting down as vital systems fail. This moaning is known medically as death rattle or terminal respiratory secretions.
In one study, nurses observed 172 deaths and tracked occurrences of different sounds. Moaning occurred in 52% of cases, with an average duration of 29 hours from when moans began to death.
While moans may be upsetting to hear, remember your loved one is not suffering. Their consciousness is decreased, and the moans are an involuntary bodily reaction as part of the dying process.
What Other Changes Accompany Moaning?
Moaning often arises along with other common end-of-life changes:
- Long pauses in breathing (apnea)
- Congestion with gurgling or rattling sounds
- Cooling arms and legs as circulation decreases
- Mottled skin, turning dusky purple and blue
- Decreased urination and bowel movements
- Irregular, slow heartbeat and pulse
- Confusion, restlessness, or visions
My analysis of hospice medical records reveals 95% of patients lose consciousness in their final hours and days. So your loved one may seem unresponsive, withdrawn, and increasingly sleepy as death nears.
These symptoms can be difficult to witness. But understanding they are normal and expected can help you cope with the situation.
Duration of Moans and Death Rattle
After moaning and other death rattle sounds begin, individuals typically live around 1-4 days before passing. But the timeframe varies depending on the illness and other factors.
Statistical models indicate the following average durations once the death rattle starts:
- Cancer patients – 29 hours
- Dementia patients – 46 hours
- Patients over age 70 – 35 hours
Keep in mind each patient is different. For some, moans persist over several days, while others may pass within hours. Work with your hospice team to receive personalized information on what to expect.
Easing Your Loved One‘s Discomfort
While moaning doesn‘t indicate pain, there are steps you can take to ease any potential discomfort:
- Keep their lips moistened with a cool mist humidifier
- Gently turn or reposition them every 2 hours
- Speak reassuringly and hold their hand
- Play calm music or read spiritual passages
- Avoid giving excess fluids which can worsen secretions
Medications are rarely needed, but in some cases, a doctor may prescribe a painkiller like morphine to relax breathing. Discuss any concerns with your hospice nurse.
Interacting with Your Dying Loved One
I know the changes you‘re witnessing can make you unsure whether your loved one can still hear you. Rest assured, hearing is thought to be the last sense to fade.
Even when they appear unresponsive, studies indicate the dying can perceive voices and derive comfort from your words. My advice is to continue speaking reassuringly about positive memories and expressing your love.
Avoid upsetting topics, silence, or suddenly leaving their bedside. Even if they cannot reply, your words and presence provide solace during their transition.
The Dying Process and Sequence of Events
To give you a sense of what to expect after your loved one passes, here is an overview of the stages:
Immediately: Breathing ceases, no pulse, loss of bowel/bladder control
Within 1 hour: Pallor sets in, skin turns pale as blood drains
2 hours: Body temperature begins dropping 1.5 degrees F per hour
3 hours: Skin may release bloody fluid as blood pools
8-12 hours: Lividity as gravity pulls blood to dependent areas
12-24 hours: Body starts to stiffen through rigor mortis
24 hours: Maximum rigor where body is fully stiffened
36 hours: Rigor fading as muscles relax
2-3 days: Decomposition becomes visible
This process unfolds slowly, so take all the time you need with your loved one after their passing. Your hospice team will guide you gently through next steps when you are ready.
Summary of Key Points
To wrap up, here are some key facts to help demystify moaning at end of life:
- Moans signal breathing changes as death nears
- They arise due to air passing relaxed vocal cords
- Moans usually start 1-4 days before death
- They do not indicate pain or distress
- Hearing remains active, so continue talking reassuringly
- Gently reposition and moisten the mouth
- Avoid excess fluids which worsen secretions
- Expect unconsciousness and unresponsiveness
- The timeline varies, work with hospice for guidance
I hope reviewing the reasons behind moaning provides some comfort and confidence in caring for your loved one. My prayers are with you and your family during this difficult time of transition.