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Palliative care - shortness of breath

Alternative Names

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 has many possible causes, including:

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

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.


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.
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