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Palliative care - shortness of breath

Dyspnea - end-of-life; Hospice care - 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.

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 and a limited life span.

When You Have Shortness of Breath

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 chronic obstructive pulmonary disease (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, or 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 or the local emergency number to get 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

Braithwaite SA, Wessel AL. Dyspnea. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 21.

Johnson MJ, Eva GE, Booth S. Palliative medicine and symptom control. In: Kumar P, Clark M, eds. Kumar and Clarke's Clinical Medicine. 9th ed. Philadelphia, PA: Elsevier; 2017:chap 3.

Kviatkovsky MJ, Ketterer BN, Goodlin SJ. Palliative care in the cardiac intensive care unit. In: Brown DL, ed. Cardiac Intensive Care. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 52.

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Review Date: 1/18/2022

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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