• Bl Wee, Pg Coleman, R Hillier, and St Holgate.
• Sir Michael Sobell House, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK. bee.wee@hmc.ox.ac.uk
• Palliat Med. 2008 Mar 1;22(2):173-6.

BackgroundHospice staff and volunteers frequently hear the sound of death rattle and offer explanations and reassurance to relatives and other patients. This paper describes our study into the impact of hearing the sound of death rattle on hospice staff and volunteers, part of our wider investigation into death rattle.MethodsSeven focus group meetings were held, involving a total of 41 participants from medical, nursing, chaplaincy, housekeeping and volunteer backgrounds. Meetings were audio-taped and the transcripts analysed using thematic analysis.ResultsMost participants expressed negative feelings about hearing the sound of death rattle and felt that relatives were also distressed by it. Medical and nursing participants reported diverse views on why they intervene. Some acknowledged the influence of their own emotional response to the sound. Others felt that intervention was part of their professional role or that the existence of a therapeutic option made it necessary to intervene.ConclusionDeath rattle has a negative impact on staff and volunteers who work with dying patients. This effect may influence their decision to intervene when death rattle occurs. Doctors and nurses need to consider why, when and how they intervene and the consequences of that intervention.

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