The "death smell"

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Hello,

I've been chatting with a couple of nurses about the nature of the "death smell". This was prompted by a recent story you may have seen about a nursing home cat who cuddled up to people who were going to die soon.

I hear that an ability to smell impending death is possible, and some nurses are aware of this smell. I've only been able to speak with a small number of nurses to date, and have had some trouble characterising the nature of the odour. I'm hoping that some of you kind people can offer your insights into this ability. My motivation is pure curiosity, with the hope of gaining knowledge.

What is the nature of the smell? If you had to compare it to something else what would it be?

Do you most often notice this smell in the aged at the onset of a "natural" death or those with a particular type of systemic problem (e.g. renal failure)?

If you have this ability do you think that it is an actual odour, or perhaps is it a more synaesthesic effect, where a "feeling" (precognition) is active as well?

Does anyone know of any research that has been done in this area? I've been looking through medical journals but haven't been able to find any.

Thanks for your time reading this post, hope you can help me.

Cheers,

Flobbadob

Specializes in Utilization Management.

It's hard to describe but I've smelled it many times (years ago, hospitals were not climate-controlled), and it is a very distinctive odor. I always thought it was coming from the skin somehow. Maybe it has to do with an organ failure thing?

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Specializes in Cardiology, Oncology, Medsurge.

I absolutely dislike having to have to take the "death tinged" musty dusty smell home with me and tearing off the carcass tinged scrubbies, "Peeyu." Worse yet, remnants of smell that stays with you in your nose, typically noticed on your day off when you couldn't be bothered.

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Specializes in Community Health, Med-Surg, Home Health.
We also had a cat in the nursing home who would go and curl up with failing residents.She never curled up with healthy ones! My cat will not sit on my knee when I come home if there has been a death in the Home,Spooky! As for the death smell well once you have smelled it you will always recognise it but never quite be able to describe it.

I have experienced that smell, and I agree with you...it cannot be articulately described.

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Specializes in Community Health, Med-Surg, Home Health.
I absolutely dislike having to have to take the "death tinged" musty dusty smell home with me and tearing off the carcass tinged scrubbies, "Peeyu." Worse yet, remnants of smell that stays with you in your nose, typically noticed on your day off when you couldn't be bothered.

Yeah, when I was an aide about 22 years ago, a patient died right in front of me. If I had to use a word to describe how it smelled, it reminded me of raw seafood (weird, I know). I remember being hungry later on and went to a deli to order my favorite crab salad, but when he prepared it, it reminded me so much of the smell from that patient that I was unable to eat it again for at least 10 years. And, yes, I remember the smell being on my clothes and feeling that enough showers could not remove that stench from me.

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Specializes in PICU, surgical post-op.

Can't describe the smell, but can definitely smell it just thinking about it.

I actually smelled it at work the other day on my patient, and was so concerned I mentioned it to the resident next time he was in the room. Kiddo ended up going on dopa and has been titrating up towards heaven ever since. Freaky ... first time I've smelled it that the kid hasn't passed away that day.

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To me it is a sweet yet sour smell. I havn't noticed it being stronger in patients with renal failure, but I have noticed it being stronger and beginning much sooner in patients with hepatic failure. Much like how an alcoholic retains a certain smell. I have a patient who is actively dying right now, but who has been doing so for over a week. We called the family in from many states away a week ago. They were planning on coming in last friday, but we called them on wednesday saying we didn't know if she would make it that long. One of them had to get leave from the military even, so we weren't just jumping the gun. We all really thought she was going. One of the main indicators was that death smell. Not to mention BP60/40, Spo277%on 3L. This patient has renal and hepatic failure. Quit dialysis last week, but I don't think it's the kidneys that are the problem. The ascites was horrendous prior to that. Anyway, just one opinion.

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Did they ever test the cat to make sure that it wasn't the reason those patients died?

I hope you're joking.:uhoh21:

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Specializes in ub-Acute/LTC, Home Health, L&D, Peds.
Can't describe the smell, but can definitely smell it just thinking about it.

I actually smelled it at work the other day on my patient, and was so concerned I mentioned it to the resident next time he was in the room. Kiddo ended up going on dopa and has been titrating up towards heaven ever since. Freaky ... first time I've smelled it that the kid hasn't passed away that day.

Funny I was just thinking the same thing, now I can smell that smell just thinking about it. Yes very fruity/musty smelling.

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Thanks for all of your great responses! Very interesting.

@sonicnurse2b: I think we're read some similar articles regarding the decomposition process after life functions have ceased. I suspect that these processes are related, but as far as I'm aware gut bacteria are producing much of this smell, and I'm not sure if it can account for the smell we seem to be seeing before death. It might well be a component, though, as the bodily systems that suppress uncontrolled bacterial growth slow down.

There have been a range of description of the smell, and quite a few are pointing at a hepatic link. The acidosis, acetone, fruity smells would tend to indicate an acetone smell on the breath. I think the acetone smell is related to a switch in bodily metabolism from glucose to fat, where excess acetone is produced via fat conversion and spills over into the blood stream....where it is then vented via the respiratory tract. Interesting given that glucose is produced in the liver.

It would seem from various comments that acetone might well be a component of the smell, but perhaps not the entire story. Various people have described the sweet/fruity component along with some other component, variously described as "sour", "awful smelling".

I've realised I've been making an assumption - namely that the smell is very faint. I've been assuming that because reputedly you need a keen sense of smell to detect it, and not all people can smell it. Is this actually the case, or is it more of a foreign smell that, once recognised, isn't very faint?

Its quite interesting that its possible to evoke this particular smell via a memory - that would tend to imply that its quite distinct from, for example, just an acetone (nail polish remover) smell.

Thanks very much again for the replies so far! Great food for thought. Actually on that note...a fair few responses have described the smell as coming from the breath, some from the skin - is it possible that both are involved? Perhaps the acetone smell coming from the breath (and providing the main component of the smell) and some other fainter odour coming from the skin? If a component were coming from the skin I would imagine that a patient's bedding would carry that component quite strongly.

Cheers,

F

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