Dyspnoea
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Dyspnoea

Dyspnoea, or breathlessness, is when a person feels short of breath or struggles to breathe. It is common in people with serious illnesses like lung disease, heart failure, or cancer. Breathlessness can be very distressing and can be made worse by fear and anxiety. By providing calm and caring support, nurses and careworkers can help older people with breathlessness feel as comfortable as possible.

What I can do

You can’t always tell if someone is short of breath from looking at them and breathlessness affects each person differently. If you notice someone is breathing rapidly or appears anxious:

  • Ask them if they are short of breath and listen carefully to their response for signs of distress
  • Use simple tools like the Visual Analogue Scale or Modified Borg Scale to help the person rate their breathlessness from 1 to 10 and monitor changes across time
  • Document what they tell you to help the next person looking after them understand the situation.

To help someone breathe more easily, try:

  • Sitting the person upright or help them lean forward on a pillow or table
  • Encouraging airflow around the person using a handheld fan or open window
  • Teaching breathing control techniques, such as pursed-lip breathing, to help ease breathlessness.

The GP or palliative care specialist may need to assess and prescribe treatment. This could include:

  • Low dose morphine to relieve the sensation of breathlessness
  • Benzodiazepines for associated anxiety but not as a direct treatment for dyspnoea
  • Oxygen therapy if the person has low oxygen levels. It is not needed for everyone.
Tips for Careworkers: Dyspnoea
 
Tips for Nurses: Dyspnoea

What I can learn

The palliAGED Practice Tips give helpful guidance on supporting older people with breathlessness. There is a version for nurses as well as one for careworkers.

Watch the video Non-pharmacological and pharmacological interventions for breathlessness in the palliAGED Education on the Run Series for aged care nurses.

Non-pharmacological and pharmacological interventions for breathlessness

 

Explore the current research evidence on this topic by reading the CareSearch Dyspnoea Clinical Evidence Summary.

Prescribers can find advice on managing breathlessness with medications in the CareSearchgp and palliMEDs apps.

CareSearchgp app

What I can give

If an older person, their family or carer is struggling with breathlessness, these resources may help:

What I can suggest

Provide regular education sessions on assessing and managing breathlessness, focusing on both pharmacological and non-pharmacological strategies.

Promote interdisciplinary collaboration for holistic dyspnoea management. For example, physiotherapists and occupational therapists can:

  • Advise on activities that trigger breathlessness
  • Provide equipment which can help ease breathlessness, like walking aids
  • Teach controlled breathing exercises to help people feel more in control of their breathing.

Consider introducing activities that might help reduce the fear and distress associated with breathlessness such as:

  • Relaxation techniques
  • Complementary therapies, such as acupuncture
  • Cognitive behavioural therapy.

Foster a palliative care-informed culture by:

  • Providing access to palliative care teams for complex cases
  • Implementing guidelines for opioid and oxygen use in breathlessness to standardise care
  • Developing care protocols to support families and carers managing dyspnoea at home.


Page created 08 January 2025