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Palliative care - shortness of breath

Dyspnea - end-of-life

What it is

When you feel like you are not getting enough air or you're having trouble breathing, it is called shortness of breath. The medical term for this is dyspnea. Shortness of breath may just be a problem when walking up stairs. Or it may be so severe that you have trouble talking or eating.

Shortness of breath has many possible causes, including:

  • Anxiety and fear
  • Panic attacks
  • Lung infections, like pneumonia or bronchitis
  • Lung illness, like emphysema
  • Problems with the heart, kidneys, or liver
  • Anemia
  • Constipation

At the end of life, it is common to feel short of breath. You may or may not experience it. Talk to your nurse or doctor so you are prepared.

What you might feel

With shortness of breath you might feel:

  • Uncomfortable
  • Like you are not getting enough air
  • Trouble breathing
  • Tired
  • Like you are breathing faster
  • Fear, anxiety, anger, sadness, helplessness

You might notice your skin has a bluish tinge on your fingers, toes, nose, ears, or face.

What you can do

If you feel shortness of breath, even if it is mild, tell someone on your hospice care team. Finding the cause will help the team decide the treatment. The nurse may check how much oxygen is in your blood by connecting your fingertip to a machine called a pulse oximeter. A chest x-ray or an ECG (electrocardiogram) my help your hospice care team locate a possible heart or lung problem.

To help with shortness of breath, try:

  • Sitting up
  • Sitting or sleeping in a reclining chair
  • Raising the head of the bed or using pillows to sit up
  • Leaning forward

Find ways to relax.

  • Listen to calming music.
  • Get a massage.
  • Put a cool cloth on your neck or head.
  • Take slow breaths in through your nose and out through your mouth. It may help to pucker your lips like you were going to whistle. This is called pursed lip breathing.
  • Get reassurance from a calm friend, family member, or hospice team member.
  • Get a breeze from an open window or a fan.

To breathe easier, understand how to use:

  • Oxygen
  • Medicines to help with breathing

When to call the doctor

Any time you are unable to control shortness of breath:

  • Call your doctor, palliative care team, or hospice nurse for advice
  • Call 911 to get emergency help

Schedule a visit with your health care provider to discuss whether you would like to go to the hospital when shortness of breath becomes severe. Learn more about:

References

Bicanovsky L. Comfort care: symptom control in the dying. In: Walsh D, Caraceni AT, Fainsinger R, et al., eds. Palliative Medicine. 1st ed. Philadelphia, PA: Elsevier Saunders; 2008:chap 181.

Update Date: 5/7/2014

Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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