Managing breathlessness in palliative care

Palliative Care, an educational series from HammondCare

The approach to end of life, for whatever reason, can be a daunting time for everyone involved. However, many people - patients, their carers and family alike - are often surprised about the valuable and positive role that palliative care can play in improving quality of life and making this time more manageable.

Palliative care assists to improve people’s quality of life during the course of a progressive life-limiting illness. This care isn’t just about pain relief medicine. It is more holistic. It also addresses the psychological and spiritual aspects of care, providing support to help patients live as actively as possible.

Being well informed about palliative care can make this journey more manageable and help reduce the associated fears and concerns. That is why HammondCare is launching a series of articles to guide people on how palliative care can improve the quality of life for patients, their carers, and families.

A new topic will be posted each month and we hope you find them useful in your own journey.

Managing Breathlessness in Palliative Care

managing breathlessness in palliative care banner

Breathlessness

Breathlessness is the feeling of being out of breath. It is a common symptom in patients who have life-limiting illnesses. There are many different causes of breathlessness including cancer of the lung, anaemia, or illnesses such as chronic obstructive pulmonary disease.

You might find yourself out of breath doing activities you used to find easy. If you notice that you are feeling out of breath or your breathing feels difficult after light exercise, you need to inform your nurse or doctor. They can assess what might be causing your breathlessness and ensure that you receive the correct treatment. This sometimes includes introducing medications to help reduce the sensation of breathlessness. Or if the cause of your breathlessness is reversible, you may need treatment such as antibiotics.

Living with breathlessness can be incredibly frightening and a huge physical challenge. In the same way as you may need to modify your activities when living with fatigue and other symptoms, learning to make changes to your lifestyle may help you to cope with breathlessness.

If the cause of your breathlessness is irreversible, you may be referred to a physiotherapist or occupational therapist as they can sometimes offer specialised help. There are different ways to manage breathlessness and this may change as your illness changes and if your symptoms change. It is important that you always talk to your nurse or doctor if your symptoms are worsening so they can reassess your situation and adjust your medication or treatment if necessary.

Breathing control

One of the methods that may be used to cope with breathlessness involves a technique that helps you to control your breathing. The aim of this is to reduce the effort of breathing and to help you to obtain a sense of control over your breathing. It can also improve the efficiency of all respiratory muscles.

In order to practise, find somewhere quiet where you will not be interrupted and make sure you are comfortable. Before you start, sigh through your mouth to relax your shoulders and neck muscles. Then follow the steps below:

  1. Place one hand on your chest and the other on your abdomen
  2. Take a normal breath through your nose and feel the hand on your abdomen rise up and out
  3. Now breathe out through your mouth and feel the hand on your abdomen sink down and in; the hand on your upper chest should hardly move
  4. Breathe at a rate that is comfortable for you
  5. Try to make the breath out twice as long as the breath in (count slowly as you breathe)

Practising this technique may help you when you are having breathing difficulties. The more you practise, the easier it will be to control your breathing when you feel out of breath.

Other tips

Oxygen: it is often assumed that oxygen should be used to treat all breathless patients. You may find oxygen helpful, but there is evidence to suggest that it often does not relieve the symptom of breathlessness.

A fan: research has proved that the use of a fan is often more effective than the use of oxygen in relieving the symptom of breathlessness. If you are feeling short of breath, try using a fan to gently blow on your face and see if this helps.

Coping strategies: planning ahead is important. Sort out your priorities and set yourself realistic, achievable goals. Spread your activities over a period of time, rather than trying to do everything at once. You can also do things that will help you to conserve energy and reduce the physical exertion that might worsen your breathlessness:

  • Place chairs around the house, so you can sit and rest when you need to
  • Do household tasks sitting down – for example, preparing food
  • Have a shower when you feel able and on days when your breathlessness is troublesome, have a wash sitting down at the bathroom sink – this often requires less energy

Breathlessness can be frightening and difficult to cope with. However, there are many ways to help manage it. Make sure you ask for help when you need to, and contact your nurse or doctor if you are struggling.

If you have benefited from this information and would like to share it with others, then please do – we want more people to feel comfortable facing the issue of palliative care.

For further information on HammondCare’s Palliative Care services, please contact us on 1800 826 166.