Managing Shortness of Breath in Hospice Care: Non-Pharmacological Methods for Comfort

Published on February 23, 2024

Updated on February 28, 2024

, or dyspnea, is a common symptom that affects many patients in . It can make breathing difficult and uncomfortable, and cause and distress. As a , I know how hard it can be to see your loved one's struggle with breathlessness. That's why I want to share with you some methods that can help ease their breathing and improve their comfort.

methods are techniques that do not involve taking any medicine. They are safe, easy, and effective ways to manage . They can also help patients feel more relaxed and calmer and improve their quality of life. In this article, I will explain five non-pharmacological methods that have worked well for many hospice patients.

Pursed Lip Breathing

is a simple technique that can help patients breathe better. It involves breathing in through the nose and breathing out through the mouth, with the lips slightly closed. This way, the air can move out of the lungs more easily, and the airways can stay open longer. can also help patients control their breathing rate and rhythm.

To do pursed lip breathing, follow these steps:

  • Relax your neck and shoulders. You can sit or lie down in a comfortable position.
  • Breathe in slowly through your nose. Try to fill your lungs with air, but do not force it.
  • Purse your lips as if you were going to whistle or blow out a candle.
  • Breathe out slowly through your pursed lips. Count to 3 as you exhale. Do not blow too hard or too fast.
  • Repeat this cycle for as long as you need.

Pursed lip breathing can help patients breathe more easily and reduce the feeling of breathlessness. It can also lower their heart rate and blood pressure, and make them feel more relaxed. Pursed lip breathing can be done anytime, anywhere, and as often as needed.

Fan for Airflow

Another technique that can help patients with shortness of breath is using a fan for airflow. A fan is a device that creates a gentle breeze by spinning blades. A fan can be placed near the patient's face and pointed towards their cheeks. The fan should be on a low setting, and not too close to the patient's nose or mouth.

The fan for airflow can create a cooling and soothing sensation on the patient's skin. It can also increase the airflow around the patient's face and reduce the feeling of suffocation. The fan for airflow can help patients breathe more easily and provide a sense of relief.

The fan for airflow can be used whenever the patient feels breathless, or when the room is too hot or stuffy. The fan should be clean and dust-free, and the patient should be able to turn it on and off as they wish.

Upright Positioning

The way the patient sits or lies down can also affect their breathing. Upright positioning is a technique that involves sitting or lying in a way that allows the lungs to expand more fully and the diaphragm to move more freely. The diaphragm is a muscle that helps the lungs breathe.

To achieve upright positioning, the patient can:

  • Sit up straight in a bed or a chair, with their back supported by pillows or cushions.
  • Lean forward slightly, resting their elbows on a table or their knees.
  • Keep their feet flat on the floor or on a footstool.
  • Use a neck pillow or a rolled towel to support their head and neck.

Upright positioning can help patients breathe more comfortably and efficiently. It can also reduce the pressure on their chest and abdomen, and improve their blood circulation. Upright positioning can be done whenever the patient feels breathless, or when they are eating, drinking, or talking.

Activity Pacing and Rest

Some activities can make the patient feel more breathless, such as walking, climbing stairs, or dressing. Activity pacing and rest are techniques that can help the patient avoid overexertion and conserve energy. Activity pacing means doing activities at a slower and steadier pace, and taking breaks as needed. Rest means taking time to relax and recover between activities.

To practice activity pacing and rest, the patient can:

  • Plan and prioritize their activities for the day and choose the ones that are most important or enjoyable.
  • Break down their activities into smaller and easier steps and do them one at a time.
  • Use a walker, a wheelchair, or other assistive devices to make their activities easier and safer.
  • Rest before, during, and after their activities, and use pursed lip breathing or fan for airflow to ease their breathing.
  • Listen to their body and stop their activities if they feel too tired or breathless.

Activity pacing and rest can help the patient reduce the effort required for breathing and prevent breathlessness from getting worse. They can also help the patient maintain their independence and dignity and enjoy their activities more.

Cool and Comfortable Environment

The temperature and quality of the air in the patient's room can also affect their breathing. A cool and comfortable environment is one that is not too hot, cold, humid, dry, smoky, or dusty. A cool and comfortable environment can enhance the patient's comfort and reduce their feeling of breathlessness.

To create a cool and comfortable environment, the patient can:

  • Adjust the thermostat or use a fan, an air conditioner, or a heater to keep the room at a comfortable temperature.
  • Avoid smoking or being around smoke and keep the room well-ventilated.
  • Use an air purifier, a humidifier, or a dehumidifier to improve the air quality and moisture level in the room.
  • Keep the room clean and free of dust, mold, pollen, or other allergens that may irritate the lungs.
  • Use aromatherapy, music, or other soothing stimuli to create a relaxing atmosphere.

A cool and comfortable environment can contribute to a sense of relaxation and ease for the patient. It can also help the patient sleep better and feel more refreshed.

Conclusion

Shortness of breath is a challenging symptom that can affect the patient's physical and emotional well-being. As a , I care deeply about the patient's comfort and quality of life. That's why I use non-pharmacological methods to help them manage their breathlessness and feel more at ease.

Non-pharmacological methods are techniques that do not involve taking any medicine. They are safe, easy, and effective ways to manage shortness of breath. They include pursed lip breathing, fan for airflow, upright positioning, activity pacing and rest, and cool and comfortable environment. These methods can help patients breathe more easily and reduce their and distress. They can also help patients feel more relaxed and calm and improve their quality of life.

Remember, every patient is unique, and the effectiveness of these methods may vary. As hospice professionals, we are here to support patients and their primary caregivers, offering a flexible approach to symptom management that addresses individual needs and preferences.

Resources

How to Use Pursed Lip Breathing to Manage Shortness of Breath

Palliative Massage for Shortness of Breath

Non‐pharmacological interventions for breathlessness in advanced stages of malignant and non‐malignant diseases

Managing breathlessness in palliative care

Palliative Care and the Management of Dyspnea

Managing Shortness of Breath Near the End of Life

Eldercare Locator: a nationwide service that connects older Americans and their caregivers with trustworthy local support resources

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