When terminally ill patients reach the end of their lives, it’s common for them to experience difficulties breathing, a condition known as dyspnea.
Dyspnea can occur due to an underlying condition (like cancer, heart failure, or chronic obstructive pulmonary disease) or it may be caused by a secondary issue, like pneumonia or organ failure.
While it’s normal for dying patients to experience dyspnea, it can be frightening for these patients and their families. Here’s what you need to know about dyspnea and how it impacts patients receiving end-of-life care.
What are the Signs of Dyspnea?
Dyspnea occurs when a patient experiences shortness of breath or labored breathing. This may occur suddenly or be a reoccurring issue as part of terminal illness. Patients may experience a tight feeling in their chest or simply feel like they can’t properly fill their lungs with air.
Their respiration rate will increase as they try to get more air when breathing. If the dyspnea impacts the patient’s oxygen levels, they may exhibit discoloration of their lips and nail beds.
Patients experiencing dyspnea may feel anxious and agitated due to their inability to comfortably breathe. This can make it even more difficult for them to breathe, making it essential for us to manage their condition so they feel more comfortable.
Many patients experience some level of dyspnea before receiving hospice care.
To manage dyspnea, is important for the patient to be comfortable and at ease by using the following treatments:
- Administering oxygen
- Adjusting doses for prescription medications
- Administering morphine that dilates the blood vessels and makes it easier for the patient to breathe
- Utilizing anti-anxiety medications
Depending on the severity of the dyspnea and the patient’s condition, medications may be used to keep them unconscious.
There are also environmental changes that may be made to their room, such as adjusting the humidity level, running a fan, or opening a window to increase the airflow in the room. If the patient is able to, they will be encouraged to use relaxation techniques, such as massage, imagery, or meditation.
Note that our focus isn’t necessarily on treating the underlying cause of the patient’s dyspnea; this usually isn’t possible once a patient is receiving end-of-life care. Instead, we direct our efforts to ensure that the patient is as comfortable and relaxed as possible.