What it is: Dyspnoea is breathing difficulties or the sensation of breathlessness or shortness of breath.
Why it matters: Breathing difficulties are a common and distressing symptom in many advanced life-limiting diseases, and can cause significant disability, anxiety, and social isolation. Assessment and management planning by nurses is essential.
What I need to know: Effective assessment and management of dyspnoea is seen as an important quality measure in palliative care.
Dyspnoea is a subjective experience and may or may not relate to oxygen saturation levels. The use of oxygen will depend on the person’s acceptance and comfort. People with dyspnoea tire quickly and people who are easily fatigued often complain of dyspnoea.
Dyspnoea may be associated with heart failure, lung disease or cancer. It can also occur when there is no apparent diagnosis of cardiac or respiratory illness.
Dyspnoea reduces quality of life and it affects emotional, spiritual and physical wellbeing. Dyspnoea is made worse by fear and panic.
Shortness of breath is a complex symptom. Its treatment often requires a combination of general measures, non-pharmacological measures, and drugs. Opioids may help but people need to be monitored for any adverse effects.
Recommendations for managing dyspnoea at the end of life include:
- care based on a comprehensive assessment of the person and symptom distress
- discussion with person, family and health care team to agree goals of care
- manage related issues such as: fatigue, depression, anxiety, emotional issues
- physiotherapists can show the person, carers, health care staff, and the family useful exercises, positions and breathing control techniques
- opioids
- non-pharmacological approaches.