Palliative care - shortness of breath
Dyspnea - end-of-life; Hospice care - shortness of breath
Palliative Care
Palliative care is a holistic approach to care that focuses on treating pain and symptoms and improving quality of life in people with serious illnesses.
When You Have Shortness of Breath
Someone who is very ill may have trouble breathing or feel as if they are not getting enough air. This condition 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 the person has trouble talking or eating.
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
Shortness of breath has many possible causes, including:
- Anxiety and fear
-
Panic attacks
Panic attacks
Panic disorder is a type of anxiety disorder in which you have repeated attacks of intense fear that something bad will happen.
- Lung infections, like pneumonia or bronchitis
-
Lung illness, like
COPD
COPD
Chronic obstructive pulmonary disease (COPD) is a common lung disease. Having COPD makes it hard to breathe. There are two main forms of COPD:Chroni...
- Problems with the heart, kidneys, or liver
-
Anemia
Anemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
- Constipation
With serious illnesses or at the end of life, it is common to feel short of breath. You may or may not experience it. Talk to your health care team so you know what to expect.
What You Might Feel When You are Short of Breath
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.
How to Help Yourself
If you feel shortness of breath, even if it is mild, tell someone on your 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) may help your care team find 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
.
Pursed lip breathing
Pursed lip breathing; COPD - pursed lip breathing; Emphysema - pursed lip breathing; Chronic bronchitis - pursed lip breathing; Pulmonary fibrosis - ...
- 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, nurse, or another member of your health care team for advice.
- Call 911 to get emergency help.
Discuss with your health care provider whether you need to go to the hospital when shortness of breath becomes severe.
Learn more about:
-
Advance care directives
Advance care directives
Living will; Power of attorney; DNR - advance directive; Do not resuscitate - advance directive; Do-not-resuscitate - advance directive; Durable powe...
- Health care agents
References
Leigh AE, Tucker RO. What can be done for patients with crisis dyspnea? In: Goldstein NE, Morrison RS, eds. Evidence-Based Practice of Palliative Medicine . Philadelphia, PA: Elsevier Saunders; 2013:chap 69.
Rakel RE, Trinh TH. Care of the dying patient. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine . 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 5.
-
Heart failure
(In-Depth)
-
Chronic obstructive pulmonary disease
(Alt. Medicine)
-
Non-small cell lung cancer
(In-Depth)
-
Ovarian cancer
(In-Depth)
-
Melanoma and other skin cancers
(In-Depth)
Review Date: 2/6/2016
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.