The sound of death rattle I: are relatives distressed by hearing this sound?

BACKGROUND: Death rattle is the noisy, rattling breathing that occurs in many dying patients. Health professionals intervene because the sound is said to distress attendant relatives. We found no formal study to confirm or refute relatives' distress, so we decided to ask the relatives. METHOD: Face-to-face semi-structured interviews with 27 bereaved relatives to investigate their experience of terminal care and what their response had been to the sound of death rattle if this had occurred. Interview transcripts were subjected to thematic content analysis. RESULTS: We found that almost half of the 12 relatives who had heard the sound of death rattle had been distressed by it. The others were either neutral about the sound or found it a helpful signal of impending death. CONCLUSION: We confirmed that some relatives do find it distressing to hear the sound of death rattle. However, our expectation that relatives are universally disturbed by this sound was unfounded. There is no justification for a 'blanket' approach to therapeutic intervention when death rattle occurs. A better understanding is required of how relatives make sense of the sound of death rattle.

The sound of death rattle II: how do relatives interpret the sound?

BACKGROUND: In an earlier study, we found that some bereaved relatives (five out of 12 interviewed) found it distressing to hear the sound of death rattle, but the remainder did not. In this paper, we report a second study in which we explored how a different group of relatives interpreted the sound of death rattle when they heard it. METHOD: We conducted face-to-face semi-structured interviews with 25 bereaved relatives using the principles of grounded theory. RESULTS: Seventeen of the 25 bereaved relatives interviewed had heard the sound of death rattle. Ten relatives were distressed by the sound, but seven were not. Some relatives regarded the sound of death rattle as a useful warning sign that death was imminent. Their interpretation of the sound was influenced by the patient's appearance, being less concerned if the patient was not obviously disturbed. Relatives were distressed when they thought that the sound of death rattle indicated that the patient might be drowning or choking. These concerns were reinforced by seeing fluid dribble from the dying patient's mouth. CONCLUSION: This study confirms the previous finding that not all relatives are distressed by the sound of death rattle. It also demonstrates that relatives interpret the sound in a variety of ways, some matter of fact and some distressing. We suggest that effective communication is helpful in uncovering relatives' interpretation of death rattle and dispelling unwarranted fears.

Risk taking as motivation for volunteering for a hazardous experiment.

Army male enlisted personnel were tested in two experiments to assess the psychological correlates of volunteering for a hazardous combat simulation, (Experiment 1) and a riskless, psychological experiment (Experiment 2). Subjects were given a biographical and personal habit questionnaire, the IPAT Anxiety Scale, Rotter's Locus of Control Scale, and Torrance and Ziller's life experience inventory. Results from Experiment 1 indicated that volunteers were significantly less anxious, and more willing to take risks than were nonvolunteers. Noncommissioned officers, smokers, laterborn children, and children of lower socioeconomic class parents were significantly overrepresented among the volunteers for this hazardous experiment. In Experiment 2, which solicited volunteers for a routine, nonhazardous experiment, the only variable to discriminate the volunteers from the nonvolunteers was mothers' education level. Results are in agreement with findings, using college students, that volunteer samples differ significantly from nonvolunteer samples, and that the characteristics that discriminate these two groups vary as a function of situational factors.