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    Palliative care - shortness of breath

    Dyspnea - end-of-life

    When a person feels like he or she is not getting enough air or has trouble breathing, it is called shortness of breath. Shortness of breath is a feeling the patient tells you about, like pain. This may just be a problem when walking up stairs, or it may be so severe the person has trouble talking or eating.

    Shortness of breath has many possible causes. These include:

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

    Feeling short of breath is a common symptom at the end of life. Talk with your doctors and nurses so you are prepared if it occurs.

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

    What You Might Feel

    With shortness of breath you might feel:

    • Uncomfortable
    • Like you're not getting enough air
    • Trouble breathing
    • Tired
    • Like you're breathing faster
    • Fear, anxiousness, anger, sadness, helplessness

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

    What You Dan Do

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

    Try moving or changing positions to help with shortness of breath:

    • 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.

    Understand how to use these treatments to breathe easier:

    • Oxygen
    • Breathing medicines
    • Morphine

    When to Call the Doctor

    Any time you are unable to control shortness of breath, you may:

    • 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:

    • Advanced care directives
    • Health care agents

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              Tests for Palliative care - shortness of breath

                Review Date: 4/7/2012

                Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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