A hospice nurse with years of experience caring for people at the end of life has shared some of the most unsettling behaviors she has witnessed as patients approach death. These changes can be shocking for families who are unprepared, often causing fear or distress simply because they are unfamiliar with the body’s natural shutdown process.
One of the most noticeable changes involves breathing patterns. As the body weakens, breathing may become irregular, with long pauses followed by rapid breaths. While this can appear alarming, it is a normal physiological response and usually does not indicate pain or suffering.
Another commonly misunderstood sign is the “death rattle,” a gurgling sound caused by saliva collecting in the throat when the body no longer swallows reflexively. Though unsettling to hear, patients are typically unconscious and not aware of the sound.
The nurse emphasizes that these behaviors are part of the natural dying process, not signs of distress. Understanding what happens near the end of life can help families feel less afraid, reduce panic, and allow loved ones to focus on comfort, presence, and saying goodbye with peace rather than fear.

