The journey towards the end of life can be a challenging and emotional time, both for the individual facing the end of their life and for their caregivers and family members. One aspect of this journey that may be unfamiliar to many is the presence of self-soothing sounds made by the patient during the transition and actively dying phase. These sounds can be puzzling and sometimes unsettling for caregivers and family members who have never witnessed them. This article will explore self-soothing sounds, why they occur, and how caregivers and family members can distinguish between self-soothing sounds and signs of discomfort.

What Are Self-Soothing Sounds?

When someone you love is sick, and near the end of their life, you may notice that they make sounds different from their usual voice. These sounds may include humming, moaning, sighing, or even singing. These are called self-soothing sounds, a way for the person to feel better and more peaceful during this hard time.

Self-soothing sounds are not a sign that the person is hurting or unhappy. They are a sign that the person is coping well and accepting the changes in their body. Sometimes, the person may not even be aware that they are making these sounds because they are in a deep state of relaxation or meditation. Other times, the person may try to communicate something to you, such as their love, gratitude, or farewell.

You do not need to worry or feel sad when you hear these sounds. They are a natural and normal part of the dying process, showing that the person is finding comfort and peace in their way. You can support them by being present, listening, and responding gently. You can also join them in making self-soothing sounds if you feel comfortable and if they seem to welcome it. This can create a bond of love and harmony between you and the person and help them feel less alone.

Self-soothing sounds are a gift that the person gives to themselves and you. They are a way of expressing their feelings, faith, and readiness to let go. They say, “I am okay, and you will be okay too.”

Why Do Self-Soothing Sounds Occur?

Biological Process: As the person gets closer to the end of their life, their body undergoes changes that make it harder for them to talk like they used to. For example, their breathing may become slower or irregular, their mouth may become dry, or their muscles may weaken. These changes can affect how they make sounds with their voice. Sometimes, they may be unable to form words or say things that don’t make sense to you. This does not mean they are confused or unhappy; it just means their body is ready to say goodbye.

Comfort and Relaxation: When the person makes self-soothing sounds, they are not trying to tell you something or ask for something. They are simply trying to feel better and more peaceful. Making these sounds can help them relax their body and mind and cope with any emotions or thoughts that they may have. It can also help them connect with their inner self, spirituality, or higher power. These sounds are a way of expressing their feelings, their faith, and their readiness to let go.

Distinguishing Self-Soothing Sounds from Discomfort

Sometimes, it can be hard to tell if the person is making self-soothing sounds or if they are feeling uncomfortable. You may wonder if you should do something to help them or just let them be. Here are some ways to tell the difference between self-soothing sounds and signs of discomfort:

Self-Soothing Sounds

• Regular Rhythm: Self-soothing sounds often have a steady and smooth pattern, like a song or a chant. They may sound like humming, moaning, sighing, or even singing. These sounds can help the person feel calm and relaxed.
• No Signs of Distress: People usually look peaceful and happy while making these sounds. They may have a smile on their face or a serene expression. They may also close their eyes or gaze softly at something.
• Lack of Agitation: Patients making self-soothing sounds are not restless or fidgety. They do not move around a lot or try to get out of bed. They are comfortable and content with where they are.
• No Facial Grimacing: No sign of pain or discomfort on the person’s face. They do not scrunch their eyebrows, squeeze their eyes shut, or bite their lips. They do not look like they are hurting or suffering.

Signs of Discomfort

• Inconsistency: Discomfort-related sounds may be uneven and unpredictable. They may sound like groaning, grunting, gasping, or crying. These sounds can indicate that the person is feeling pain or distress.
• Visible Distress: Patients in pain or discomfort may show signs of distress, such as grimacing, clenching their fists, or appearing agitated. They may also sweat, shiver, or flush. They may look like they are scared or unhappy.
• Changes in Breathing: Discomfort can sometimes affect the person’s breathing pattern, such as making it faster or slower, deeper or shallower, or louder or quieter. They may also cough, wheeze, or snore. These changes can signal that the person is having trouble breathing or swallowing.
• Verbal Cues: Patients experiencing pain may use verbal cues or gestures to communicate discomfort. They may say things like “ouch,” “help,” or “stop.” They may also point to where it hurts or shake their heads. They may try to get your attention or ask for something.

Conclusion

When someone you love is very sick and near the end of their life, you may hear them make some sounds that are different from their usual voice. These sounds are called self-soothing sounds and are a way for the person to feel better and more peaceful during this hard time. They are not a sign that the person is hurting or unhappy. They are a sign that the person is coping well and accepting the changes in their body.

Sometimes, it can be hard to tell if the person is making self-soothing sounds or if they are feeling uncomfortable. You may wonder if you should do something to help them or just let them be. You can tell the difference by looking at some clues, such as how the person looks, how they breathe, and what they say. If the person looks peaceful, breathes smoothly, and says nothing or something nice, they probably make self-soothing sounds. If the person looks in pain, breathes hard, and says something that shows they are hurting, they probably feel uncomfortable.

Understanding self-soothing sounds can help you care for the person and make them feel loved. You can support them by being there, listening, and talking softly. You can also make self-soothing sounds with them if you want to and if they like it. This can make you and the person feel closer and less alone.

Self-soothing sounds are a gift that people give to themselves and others. They say, “I am okay, and you will be okay, too.”

Resources

Tip for Hospice Nurses: self-soothing vocalizations

Providing Comfort During the Last Days of Life with Barbara Karnes RN (YouTube Video)

Preparing the patient, family, and caregivers for a “Good Death.”

Velocity of Changes in Condition as an Indicator of Approaching Death (often helpful to answer how soon? or when?)

The Dying Process and the End of Life

The Last Hours of Life

Gone from My Sight: The Dying Experience

The Eleventh Hour: A Caring Guideline for the Hours to Minutes Before Death

By Your Side, A Guide for Caring for the Dying at Home

On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss

Finding Meaning: The Sixth Stage of Grief

It’s OK That You’re Not OK: Meeting Grief and Loss in a Culture That Doesn’t Understand

Need Help Dealing with Grief? GriefShare Grief & Loss Support Groups Are Here for You

Children’s Grief Resources

For Ages 4-6

• The Goodbye Book by Todd Parr – Perfect for very young children experiencing loss for the first time.
• The Dead Bird by Margaret Wise Brown – A simple story about finding and burying a bird.
• I Miss You: A First Look at Death by Pat Thomas – Helps younger children understand death and grief.

For Ages 6-8

• When Dinosaurs Die: A Guide to Understanding Death by Laurie Krasny Brown – Explains death concepts clearly for this age group.
• Badger’s Parting Gifts by Susan Varley – Shows how memories can comfort us after someone dies.
• Charlotte’s Web by E.B. White – A classic that explores friendship, death, and acceptance.

For Ages 8-10

• Bridge to Terabithia by Katherine Paterson – Deals with unexpected death and processing grief.
• Lifetimes: The Beautiful Way to Explain Death to Children by Bryan Mellonie – Explains the life cycle in nature and humans.
• A Taste of Blackberries by Doris Smith – About guilt and grief after a friend’s death.

For Ages 11-13

• All the Blues in the Sky by Renée Watson – About a 13-year-old whose best friend dies on her birthday, exploring grief through counseling group experiences.
• The Truth as Told by Mason Buttle by Leslie Connor – Chronicles a boy dealing with a friend’s death, learning disability, and community judgment.
• The Year of the Rat by Clare Furniss – A 15-year-old coping with her mother’s death during childbirth and caring for the baby sister.
• What On Earth Do You Do When Someone Dies? by Trevor Romain – Accessible for ages 8 to young teens, addressing common questions about death.

For Ages 13-18

• RIP Corey: My Friend Died and It Sucks! by Chris Buchanan – A graphic novel designed for teens of all reading abilities to process grief.
• The Astonishing Color of After – A Time Magazine selection exploring grief, family history, and healing through art.
• The Boy in the Black Suit by Jason Reynolds – A 17-year-old learning to cope with terrible news and finding support.
• Crying in H Mart: A Memoir by Michelle Zauner – A powerful memoir about losing her mother and Korean American identity.

Specialized Grief Resources

• Fire in My Heart, Ice in My Veins by Enid Samuel Traisman – An interactive journal for teens to work through the grieving process.
• Grief: Insights and Tips for Teenagers by Joe Jansen – Features words from other young adults who’ve experienced loss.
• Grief Recovery for Teens by Coral Popowitz – Body-based practices for managing grief’s physical effects.

Young Adult Literature Exploring Grief:

• Clap When You Land by Elizabeth Acevedo – Two sisters united by their father’s death and his double life.
• The Grief Keeper by Alexandra Villasante – Speculative fiction addressing grief, trauma, and immigration.
• Long Way Down by Jason Reynolds – A teen coping with his brother’s shooting death.
• King and the Dragonflies by Kacen Callender – National Book Award winner about family grief.

Helpful Online Resources

• The Dougy Center offers extensive free resources, including activity sheets, tip sheets, and guidance for children and families. They provide age-appropriate materials and have partnered with Sesame Street on grief resources.
• Winston’s Wish provides comprehensive bereavement support for children up to age 25, including online chat, phone support, and downloadable resources. It also offers specialized guidance for different types of loss.
• Sesame Street Communities: Helping Kids Grieve features interactive videos with Elmo and other characters, activities for expressing feelings, and guidance for families. All resources are free and available in multiple languages.
• National Alliance for Children’s Grief (NACG) provides educational toolkits, connects families to local support services, and offers professional development for those working with grieving children.
• GriefShare helps locate local grief support groups for families and provides daily email encouragement for those processing loss.

Enhanced Online Resources for Teens

Specialized Teen Platforms

• Talk Grief—Winston’s Wish operates this dedicated online space for teenagers and young adults aged 13-25. It features peer stories and professional support.
• Teenage Grief Sucks – A teen-run website opening conversations about grief where teens can read candid stories and share their own experiences.
• Actively Moving Forward – A national network specifically created for grieving young adults, addressing the unique challenges of this age group.
• The Dinner Party – Young adults in nearly 100 cities worldwide meet for dinner, creating community for emerging adults who’ve experienced loss.

Comprehensive Teen Support Centers

• The Dougy Center Teen Resources provide age-specific materials including tip sheets that acknowledge “grief usually does what it wants” and doesn’t follow rules or schedules. They emphasize that there’s no right or wrong way to grieve.
• Hospice of the Valley Teen Resources offers specialized materials addressing how teens grieve differently than adults, sudden versus expected death, and losing siblings or friends.
• Children’s Room Teen Program provides peer support groups and activities specifically for teens to connect around shared interests while processing grief.

Interactive Support Options

• Winston’s Wish offers immediate support through live chat, helpline, and text services – no waiting lists required. They also provide one-to-one sessions with bereavement specialists for teens 13 and older.
• HEART Play for Young Adults connects late high school and college-aged individuals, providing space to discuss challenges of graduation, leaving home after loss, and meeting new people.

Educational Resources for Teens and Families

• The JED Foundation provides mental health resources showing teens how they can support one another and overcome challenges during the transition to adulthood.
• Eluna Network offers grief resources organized by specific age ranges, including detailed developmental information and support strategies for both middle school and high school students.
• National Alliance for Children’s Grief provides educational toolkits and connects families to local services, with materials specifically designed for adolescent grief.