​Dyspnea

Shortness of breath, also called dyspnea, occurs when the body cannot get enough oxygen. Either the lungs cannot take in enough air, or they cannot deliver enough oxygen to the blood stream. Shortness of breath has many causes, including illness, anxiety or pollution (including tobacco smoke).

What you need to know

Severe shortness of breath can be frightening for both the person experiencing it and anyone watching. Knowing what to expect may make it less disturbing.

• The skin around the mouth and nail beds may become blue-tinged.
• There may be large amounts of thick mucus that the person can or cannot cough up.
• Respirations may sound moist and gurgling.
• Breathing may be difficult when moving, talking, or even resting.
• Depending on the cause of the shortness of breath and the stage of the progressive illness, some treatment may be considered. Medication and other interventions may also be offered.

How you can offer comfort and care

• Your loved one may have less trouble breathing if the surroundings are calm and you follow certain guidelines.
• Encourage the quiet presence of a calm supportive family member or friend to help ease the anxiety.
• Plan frequent rest periods between activities if the shortness of breath is worse with movement, washing, dressing or talking.
• Ask visitors just to sit quietly and calmly so there is no need to talk.
• Be sure medication and other interventions prescribed for shortness of breath is taken as directed.
• Use a humidifier may help loosen mucus, making it easier for the person coughing.
• Avoid standing over or too close to the person. Open a window or use a fan to help give a sense of more surrounding air.
• Remove tight or constricted clothing. Use a lightweight blanket as bedding.
• Remember to remain calm in the person’s presence. Your distress can make your loved one more anxious, increasing the breathlessness.
• Help the person to a position that makes breathing easier. Lying flat often makes shortness of breath worse. Usually a high sitting position is best. Put several pillows or a special seat support pillow at the back. Another helpful position involves leaning on a bed table or high table with the head resting on crossed arms.
• Try a recliner chair for sleep as it keeps the body in a semi-upright position.
• Do whatever you can to help the person remain relaxed, as tense muscles add to breathlessness.
• Medications such as opioids may be prescribed to relieve shortness of breath.

Oxygen Therapy

What you need to know

Sometimes the doctor will recommend oxygen therapy to help ease shortness of breath.

Oxygen can be given in two ways:

• through a nose cannula – a short, plastic, disposable tubing that enters the person’s nostrils. (See Figure 27.)
• or using a disposable plastic face mask. It fits over the nose and mouth firmly and is attached to the oxygen supply.

How you can offer comfort and care

A mask or cannula needs attention to be as comfortable as possible.

• Remove and clean the mask as needed.
• Place something soft such as small cotton pads or moleskin between the tubing and the skin to lessen irritation.
• Tighten the elastic on a mask so that it fits snugly on the person’s face.
• The prongs of the nasal cannula must be in the person’s nose.
• Oxygen can dry the inside of the nose. A water-based, non-prescription preparation, such as Secaris^™, can help.