Hospice: Understanding and Caring for Dyspnea

Dyspnea (also called shortness of breath) is common in persons with serious or advanced illness. It makes breathing difficult and uncomfortable and can cause much suffering. Families may be affected as well as they watch their loved one struggle to breathe. Because dyspnea can be distressing for both patients and families, it is important to understand the scope of this symptom and the ways it can be treated.

What Are Common Causes of Dyspnea?

There are many causes of dyspnea. It can occur due to lung problems, such as chronic obstructive pulmonary disease (COPD). It can be a symptom of other health problems, such as heart disease or cancer. And it may develop as any terminal illness progresses. Dyspnea often causes anxiety, which in turn makes breathing problems worse.

How Is Dyspnea Treated?

The main goal of treatment is to help the person breathe more comfortably. To do this, medications and other therapies are often used.

• Medications can include:

  • Oxygen therapy. This treatment helps improve breathing. It may be prescribed if tests show low oxygen in the blood. It may also be prescribed if it adds to the person’s comfort.

  • Opioids. These medications are most often used to relieve pain, but they can also help ease shortness of breath.

  • Other medications. These can include medications to relieve specific problems that can occur with dyspnea, such as anxiety.

• Other therapies can include:

  • Breathing exercises. Patients are often taught pursed-lip breathing and diaphragmatic breathing to help them breathe better. These techniques can also help relieve dyspnea and anxiety.

  • Techniques to conserve energy. Patients are taught the best ways to move and use their bodies. This helps them conserve strength and makes breathing easier when doing normal tasks.

  • Body positioning. For some patients, sitting upright may increase comfort and improve breathing. It may also help to raise the head of the bed when resting.

  • Relaxation. This can help reduce stress and anxiety, which can make dyspnea worse. Some common methods include meditation and visualization. Simple activities, such as reading a book, watching a movie, or listening to music can also help patients relax and be distracted from shortness of breath.

How Can Loved Ones Help?

A patient’s loved ones often aren’t sure what to do to help relieve breathing problems. Begin by asking the doctor for advice on how to help the patient. These tips may help as well:

• Keep your loved one comfortable and safe.

  • Maintain a cool temperature in the patient’s room. Lower the thermostat or place a fan where it can blow gently on the patient’s cheek. Keep a window open to let in fresh air, if weather permits.

  • Help the patient conserve energy. Put items such as medications and walking aids within reach.

  • If the patient uses oxygen, keep sources of flame away from where the oxygen unit is stored. Check that the oxygen unit is turned off when it is not in use. And be sure to keep a fire extinguisher in the house.

• Don’t let breathing trouble isolate your loved one. Spend time with the patient doing normal activities. Eat meals, watch movies, and go outdoors with your loved one.

• Provide calm support. Try to stay calm and relaxed around the patient. Patients can often sense when family members and caregivers are worried about them. This can add to their anxiety, and make their dyspnea worse.